Valuable lessons from first brush with Covid-19 helps Lee Ah Mooi home deal with second incident

Lee Ah Mooi Old Age Home was the first nursing home to report a coronavirus cluster.
Lee Ah Mooi Old Age Home was the first nursing home to report a coronavirus cluster.PHOTO: LIANHE WANBAO

SINGAPORE - Lee Ah Mooi Old Age Home had a brush with Covid-19 twice this year, but the two incidents could not have been more different.

In March, it became the first nursing home to report a coronavirus case at its branch off Thomson Road. At its peak, there were 14 residents infected, of whom four later died.

The home's administrator, Mr Then Kim Yuan, who was working from home at the time, said that with all staff and residents quarantined, it was a difficult situation to manage.

Then in August, a former staff member of the home tested positive after returning home to the Philippines. Although that person was asymptomatic, 90 staff and residents at the home's Silat branch - where the person was from - were swabbed. Nobody tested positive.

This time, armed with the lessons learnt from March, the home's processes were smoother, said Mr Then.

When the first case was identified on March 31, he said business continuity plans were thrown out the window as all staff were under quarantine.

Said Mr Then: "It was a whole new experience for all of us at that point. Whatever workflow processes from our emergency preparedness exercises we had previously formulated with the Health Ministry (MOH) and Agency for Integrated Care (AIC) could not really work.

"I had to identify my priorities at that point - health and safety, service continuity and staying in touch with the residents' family members."

He fielded hundreds of phone calls from anxious family members, and worked round the clock to liaise with the authorities.

And after the resident tested positive, MOH and AIC representatives visited the home, and stayed until 4am. They were back again at 7am the next day.

It was an overwhelming period not just for the residents but also staff members, who felt physically and mentally drained.

Infected residents were warded at the Singapore General Hospital and National Centre for Infectious Diseases, and the home had to deal with calls from the two healthcare institutions for residents' medical records and other information.

In hindsight, Mr Then said shared electronic medical records would have helped, but the push towards digitalisation took a back seat after the healthcare sector faced several cyber attack incidents in recent years.

"I hope in the future we will go in that direction because having such records in times of a pandemic would be very useful," said Mr Then.

There were also other stress factors, such as some staff being evicted by their landlord.

Mr Then said he made sure he lent his support in whatever way possible as there were concerns that staff would be blamed for bringing the virus into the nursing home.

The nursing home's counsellors also reached out to staff and conducted self-care workshops. Support from the Government, such as a $500 allowance for workers who were transferred to designated accommodation or hotels, also helped, said Mr Then.

In August, when a former staff member tested positive, things were handled were differently, said Mr Then. For instance, within two hours of notifying the authorities, a conference call was set up and instructions were given out.

He said: "We can really see how far we've come - the procedures and protocols were so seamless. It was different from the March episode, when we had to find a way forward, try to fit the solutions and deal with things as they came along."

Mr Then said he found he could take a step back in August as his team was able to handle the incident, and put in motion their revised business continuity plan.

Beyond the pandemic, the home plans to explore more digital solutions, such as remote monitoring, which will be useful for residents with higher care needs.

It is also merging its vital signs monitoring system with its electronic medical records, which will improve efficiency.