Singapore needs more teams to vaccinate those homebound; existing medical teams stepping up

The daily workload has doubled in recent weeks for the dozen other home vaccination teams conducting at-home jabs.
The daily workload has doubled in recent weeks for the dozen other home vaccination teams conducting at-home jabs.PHOTOS: EDGEDALE MEDICAL CLINIC

SINGAPORE - Lugging a cooler chest containing Covid-19 vaccines and a 15kg suitcase filled with medical equipment, resuscitation tools and an oxygen canister, Dr Nathaniel Ng and a nurse headed to a Housing Board flat in Hougang to vaccinate a senior citizen.

After thoroughly checking that the woman was eligible for vaccination, and recording her vitals, the nurse administered the injection.

They then observed the bedbound senior for 30 minutes.

After confirming that she had no allergic or anaphylactic reactions, and therefore no need for their standby resuscitation equipment or medicines, they bid farewell and moved to the next location.

They had at least 10 more homes to visit.

The daily workload has doubled in recent weeks for Dr Ng and the dozen other home vaccination teams conducting at-home jabs.

The scheme caters to immobile seniors who are not able to make their own way to vaccination centres.

When it started in June, each home vaccination team visited six to eight households a day.

Since a month ago, they have had to inoculate up to 14 seniors a day, working shifts that last between 10 and 12 hours, said Dr Ng, who is medical director of home care service Jaga-Me.

Last Friday (Aug 6), Health Minister Ong Ye Kung revealed that the waiting time for a senior applying to be vaccinated at home is now eight weeks.

He called for healthcare workers outside the public sector to step forward to help. The Health Ministry (MOH) said 1,200 homebound seniors have been vaccinated under the initiative as at Aug 4.

Jaga-Me is one of three medical providers appointed by MOH to spearhead home vaccinations. It runs three teams, while two other firms, Speedoc and Edgedale Medical Clinic, run five teams each.

Speedoc's chief executive Dr Shravan Verma said demand for the service is extremely high, as more family members push for their elderly loved ones to be vaccinated. From Tuesday (Aug 10), differentiated measures will apply to vaccinated and unvaccinated individuals here.

"There has also been a whole-of-nation, whole-of-government effort in encouraging more people to get vaccinated (and) we have indeed been receiving longer lists," he said.

Currently, the teams innoculate seniors on weekdays, and use the weekends to study seniors' health records and to draw up the coming week's schedule.

At times, some of the homebound teams have also assisted mobile vaccination teams deployed to heartland locations near where many seniors stay.


Besides senior citizens, those who have been vaccinated at home included patients with dementia, stroke, and lung conditions. PHOTO: AIC

Teams under Jaga-Me have shortened their lunch breaks from an hour to 30 minutes and are even eating on the move so that more seniors can get their jabs, said Dr Ng.

They have also optimised their travel routes as much as possible to avoid delays on the road.

Despite this, some bottlenecks are more difficult to optimise away. For one, each team is constrained by the six-hour lifespan of the diluted Pfizer-BioNTech/Comirnaty vials.

"The vaccines can only last six hours after leaving the vaccination centre and the team needs to observe each patient for at least half an hour after administering.

"This means the number each team can vaccinate per day will hit a limit. Traffic may be bad at times also," said Dr Ng. "The workaround is to deploy more teams."

Besides senior citizens, those who have been vaccinated at home included patients with dementia, stroke, and lung conditions.

Younger people who are unable to leave their homes - including those with spinal muscular atrophy and autism - have also been vaccinated this way, added Dr Ng.

The initiative has helped push up vaccine coverage for those above 70 years old. At a press conference last Friday, Mr Ong said the vaccination rate for this age group is now 82 per cent, compared to 74 per cent a month ago.

The minister noted that the large majority of those still not vaccinated fall under two groups. The first are those who had earlier been advised not to take the jabs due to illnesses or allergies.

Singapore's expert committee has said that most of them can now be vaccinated, given data collected from millions of jabs given globally.

The other group are those who are immobile and confined to their homes.

While most people rested over the long National Day weekend, healthcare workers here ensured that the national vaccination drive remained in full swing.

Trucks armed with loudspeakers to spread the vaccination message in heartlands began plying the roads last Friday.

Mobile vaccination teams continued to be sent to various locations such as void decks, while vaccination centres at community clubs offered shots until the evening of National Day.

Stepping up to meet demand

All three firms which are currently providing home vaccinations told The Straits Times they are assembling more teams in order to meet the demand.

Speedoc said it will be forming three more teams.

"We have put out call-outs (for doctors and nurses), and are tapping all our professional connections to make it work," said Dr Verma.

At the same time, Jaga-Me is planning to form two more teams and have started to advertise for healthcare workers through job portals and social media, said Mr Julian Koo, the home care provider's chief executive.

Speedoc's and Jaga-Me's current teams are staffed by full-time and locum, or stand-in, healthcare workers.

Edgedale Medical Clinic has two more teams being formed in the next two weeks, said its director, Dr Yan Shi Yuan.

Some doctors and nurses have also signed up under the SG Healthcare Corps in response to Mr Ong's social media call.

One of them is Dr Desmond Wai from the Liver and Gastrointestinal Diseases Centre at Mt Elizabeth Novena Specialist Centre.


Edgedale Medical Clinic has two more teams being formed in the next two weeks. PHOTO: AIC

Dr Wai said he emailed the SG Healthcare Corps on Saturday and received an automatic reply saying that there has been overwhelming positive response to the Corps.

A follow-up email he received came with a form which asked for applicants' availability, such as weekdays or weekends, and when they can start work.

The form, seen by ST, stated that details of shortlisted applicants will be sent to the private medical service providers running the home vaccination teams, and that the providers will contact the applicants for an interview.

Dr Wai said he is happy to help with the home vaccinations, and that he is open to rescheduling his own patients' appointments as long as he has enough lead time.

"Most of my patients are very nice. If they know I'm helping with this (home vaccinations), they will be understanding," said Dr Wai.

"Weekends would eat into my family time, but if I were to spend one weekend for this 'national service' for the nation, I think my family won't mind."

Dr Wai, who shared Mr Ong's Facebook post on his own page, said he knows of a few more doctors who have signed up.

Dr Lee Joon Loong, medical director of Paddington Medical, called and e-mailed MOH when his wife alerted him to Mr Ong's Instagram post.

He wants to help with the home vaccination efforts on Tuesdays or Thursdays as he has stopped scheduling clinic appointments and elective surgeries on both days.

"I always have a passion for helping the elderly. If I'm needed as a geriatric-trained primary care doctor to help convince and vaccinate seniors, I'd gladly do so," he said.