Coronavirus: Hospitals expanding ICU capacity in anticipation of needs

Facilities sufficient now but Gan stresses need to preserve buffer by observing circuit breaker rules

Hospitals have started converting other wards into ICUs and negative pressure isolation wards over the last few weeks.
Hospitals have started converting other wards into ICUs and negative pressure isolation wards over the last few weeks.ST PHOTO: KUA CHEE SIONG

Hospitals are ramping up intensive care unit (ICU) capacity in line with the rising number of Covid-19 patients and the expected number who will need such facilities, Health Minister Gan Kim Yong said yesterday.

But the minister added that even though there is sufficient capacity at the moment, circuit breaker measures should be observed so that this buffer is preserved and the number of patients treated in the ICU is reduced as much as possible.

Mr Gan was responding to a question during a virtual press conference by the multi-ministry task force handling the virus outbreak, which he co-chairs.

A high of 32 Covid-19 patients in the ICU was recorded on April 10. The number has declined since then, with 21 in the ICU as of yesterday. A total of 14,951 Covid-19 cases have been confirmed in Singapore so far, including 528 cases yesterday.

Elaborating on the plans to expand ICU capacity, the Health Ministry's director of medical services Kenneth Mak said all hospitals have been asked to reduce non-urgent clinical work and to allow ICU beds to be reserved for those who truly need them, especially those with Covid-19.

Hospitals have also started converting other wards into ICUs and negative pressure isolation wards over the last few weeks.

"They have expanded their capacities already, at least twice now, and we continue to complete conversion works in the rest of the hospitals to increase our capacity," Associate Professor Mak said.

At the back end, additional equipment has also been procured, including ventilators and equipment used for monitoring patients. Additional procurement efforts continue, added Prof Mak.

In terms of manpower needed to support the expanded ICU facilities, the Health Ministry has asked hospitals which have ICU-trained staff deployed in other roles to consider deploying them back to clinical duties.

Those who have been trained in the past and are proficient in ICU care but are now engaged in other roles are also undergoing refresher training to make sure that they retain their competencies.

"We have invited those who have left nursing and gone into other careers to consider coming back into the nursing workforce and we will be providing additional training to make sure that they are ready to take on these added roles if we need to fill up these additional ICU beds," said Prof Mak.

 
 
 

Such work is in progress to ensure sufficient capacity in anticipation of any future demand, he added.

Mr Gan said: "I should add that I always want to take this oppor-tunity to remind ourselves that while we have sufficient capacity at the moment, I do want to preserve the buffer that we have. We must never take healthcare capacity for granted."

The minister said it was still important to observe the safe distancing and circuit breaker measures to reduce the numbers in the ICU as much as possible.

"And even the cases in the dormitories - we also have a plan to address these issues to make sure that we minimise the risk of complications from these patients and to also reduce the mortality.

"So, I think these are our key objectives from a medical point of view. So, while we have sufficient ICU capacity, we should never take it for granted and we should continue to ramp up as much as we can and to reduce complications as much as we can," added Mr Gan.

 
 

In an earlier briefing yesterday, Prof Mak said that setting up additional facilities to care for Covid-19 patients was not easy and that it required careful preparation.

Plans might be in place but activating them takes time. "So, many of these plans have to be activated and exercised in anticipation of the possibility that there may be more patients coming. We need to do that well ahead of time," he said.

"And that is the reason we are expanding both the facilities and capacity in our hospitals but also outside the hospitals in these community care and community recovery facilities."

 
A version of this article appeared in the print edition of The Straits Times on April 29, 2020, with the headline 'Hospitals expanding ICU capacity in anticipation of needs'. Subscribe