10 Facts About the COVID-19 Cluster in TTSH That Experts Say We Shouldn’t be Overly Worried About

The COVID-19 pandemic is a bit like taking a ride on a roller coaster without a seat belt.

There are ups and downs, you never feel safe, and you’re screaming most of the time.

On Monday, Tuesday, and Wednesday this week, a total of 5 COVID-19 cases were reported; one each on the first two days, and three on Wednesday.

Given how the pandemic has been in the last few months, residents expected infections to either go back down to one, or maybe rise a little to four or five.

But nope. The coronavirus just loves surprises

16 community cases were reported yesterday, of whom 8 were linked to a nurse at Tan Tock Seng Hospital (TTSH) who was confirmed as a COVID-19 case on Wednesday (28 Apr).

Since a cluster has formed in a hospital, residents are understandably worried.

If you’ve been too busy fighting with your partner at IKEA’s new outlet in JEM and you don’t know what the heck I’m talking about, here are 10 facts about the COVID-19 cluster in TTSH.

It Started With the Detection of Nurse’s Infection

On Wednesday, people noticed that residents all across the country started to sweat profusely for no reason at all.

This was the same day that the Ministry of Health (MOH) confirmed the infection of a nurse working at TTSH.

The 46-year-old Philippine national developed a cough, sore throat, and body aches on 27 Apr and sought medical treatment at the hospital.

Her result came back positive on the same day and she was warded at the National Centre for Infectious Diseases (NCID).

The nurse had already completed her vaccination regimen – she received the first dose on 26 Jan and the second on 18 Feb.

Unfortunately, it seems that her infection was detected a little too late.

2 Staff Members & 6 Patients Subsequently Tested Positive

Since then, two more staff members and 6 patients in the same ward as the nurse – Ward 9D – have tested positive for the coronavirus.

The two infected staff members are a 30-year-old doctor and an 18-year-old healthcare assistant trainee.

The doctor developed a fever on Tuesday (27 Apr) and had not gone to work since then. However, he had attended to patients in Ward 9D before his onset of symptoms.

He sought medical treatment at a clinic on Tuesday and underwent a COVID-19 test, which came back positive the next day.

He was then taken to the NCID.

Like the nurse, the doctor had been fully vaccinated at the time, having received his first dose on 18 Jan and the second on 8 Feb.

His serology test came back negative, meaning it’s a current infection.

The healthcare assistant was found to be carrying the virus after she was tested on Wednesday, along with other patients and staff members in Ward 9D.

This is Singapore’s First COVID-19 Hospital Cluster

We’ve had clusters at SAFRA, churches, and Mustafa Centre, but never at a hospital.  Indeed, this is Singapore’s first COVID-19 hospital cluster.

And with a total of 9 infections linked to the cluster, it’s also our largest active cluster.

Two Wards Have Been Locked Down

Every time Singaporeans see the words “lockdown” or “locked down”, they fall to the floor, curl into the fetal position, and hold their recently-purchased toilet paper close to their chest.

This lockdown, however, was confined to two wards in TTSH.

To contain a potential outbreak, Ward 9D, where all the confirmed COVID-19 cases were either working or admitted as a patient, has been locked down.

So too has Ward 7D, where one of the patients of Ward 9D was held before being transferred.

Five of the Patients are Aged Between 74 & 94

The patient who was transferred is a 57-year-old man who was initially warded in Ward 7D, before being transferred to Ward 9D.

He developed a fever on 16 Apr but did not seek medical treatment.

Two days later, when he also developed a runny nose and cough, the man went to TTSH’s emergency department.

There, he tested negative for COVID-19 and was placed in Ward 7D.

On 20 Apr, the man was transferred to Ward 9D. Since his fever persisted, he was reviewed by an infectious diseases physician and transferred to an isolation ward on 27 Apr.

He finally tested positive the next day and was transferred to NCID.

The other five patients are aged between 74 and 94. The 94-year-old woman’s serology test is positive, indicating past infection.

Only two were symptomatic, developing symptoms on 25 Apr and 28 Apr.

All Patients & Staff Members Will Be Tested

After the nurse’s infection was detected, TTSH tested all patients and staff members who had been in the same ward.

Now that the cluster has grown, the hospital has expanded testing to include all employees working in TTSH wards as a precautionary measure.

All close contacts of the cases, including patients, visitors, and staff who have been in the affected wards, will also be placed on quarantine.

Most Visitors to TTSH Have Been Barred From Entering the Hospital

When the first few infections in the cluster were detected, TTSH limited the number of visitors for a patient to two a day.

Then, just a day later, the hospital announced that it will be barring all visitors from entering its premises.

The only exception is for critically ill patients.

Elective Patients Will Be Deferred Except For Urgent Cases

Another precautionary measure taken by TTSH is to defer all elective patients – patients who ask to be admitted – except for urgent cases.

Accident and emergency cases that are not life-threatening will be redirected to other hospitals.

A Leak of Infections in a Hospital Was “Inevitable”

As Professor Dale Fisher, a senior infectious disease consultant at the National University Hospital (NUH), pointed out, a “special focus” has been placed on preventing an outbreak of COVID-19 in hospitals.

This is because they are full of vulnerable patients and healthcare workers who treat them.

Prof Fisher noted the strict measures taken by hospitals since the pandemic began, such as limiting the number of visitors and screening them for symptoms.

But even with all these safety measures in place, “breaches are somewhat inevitable” on occasion, he told ST.

“Any patient being admitted who could possibly have Covid is isolated until their swab result comes back. Our efforts so far have worked, but now it does look like a leak has occurred – which is in reality somewhat inevitable after so long.”

Experts Say There’s No Reason to be Paranoid

The experts say there’s no reason to be paranoid, however, and that we should avoid speculating about the source of the breach.

“Until the investigation is undertaken, it won’t be clear where the breach happened. But so far, all the rules have shown great outcomes and kept the hospitals transmission-free,” Prof Fisher said.

Moreover, the majority of hospital staff have already received both doses of the COVID-19 vaccine, which gives more than 90% of recipients protection against severe illness and death.

Though the risk of transmission should be lower in those vaccinated, people can still transmit the disease, which is why TTSH has implemented such strict safety measures.

The goal here is to contain infections, which the authorities have managed to do in the past with other clusters.

“Our strategy is to aggressively test and draw a wide ring around the cases, to try and prevent further spread,” MOH said.

“This additional testing will enable us to draw out any hidden links.”

Featured Image: Google Maps