Go to the GP, polyclinic if Covid-19 symptoms are mild, stop hospital bed crunch

Public hospitals are urging individuals with mild to moderate symptoms of Covid-19 infection to visit a general practitioner (GP) clinic or polyclinic near their home.

These clinics will refer the patients to an emergency department (ED) or to a specialist for outpatient care, if it is needed.

The call came as Covid-19 infections and hospitalisation numbers increase, putting a strain on hospitals here.

A Straits Times reader in her late 70s, who does not want to be named, said she was discharged from the Singapore General Hospital (SGH) after being warded for three nights for lung infection. This took place during the last week of November, the week of the highest number of infections recorded in 2023 up to that point.

Sharing her experience, she said while the initial triage and tests at the ED at 9.30am on Nov 25, “was fast and efficient”, the wait for a bed in the ward was “painful”.

The retiree said she saw patients on trolley beds along the corridors outside the ED observation rooms as she was being wheeled to the holding area.

“I was told there were no beds available in the wards as they were fully occupied. I was then put in a huge unisex hall near the Outram Community Hospital. It felt like being in a grand central station (in New York City) with the constant traffic of patients being wheeled in from the emergency room and patients to their wards,” she said.

In the week ended Dec 2, 32,035 people were diagnosed with Covid-19 – the highest number of infections recorded up to that point in 2023.

The Ministry of Health (MOH), raised the alert on Dec 8, but it reassured people this number is not as high as during the pandemic; and that the circulating variants are not known to cause more severe illness.

MOH also said the average daily Covid-19 hospitalisations rose to 225 from 136 the week before. The average daily intensive care unit (ICU) cases rose to four cases from one case in the previous week.

The ministry said then that the rise “could be due to a number of factors, including waning population immunity and increased travel and community interactions during the year-end travel and festive season”.

With the bed crunch in hospitals being a reality again, patients are finding themselves in holding areas for longer periods.

“Although the doctors did make their rounds in the hall, I was not able to rest (while waiting for a bed in the ward). Men and women were put together in the same hall. The woman next to me was ranting loudly while another was groaning in pain. I managed to get a bed just after midnight,” the ST reader said.

In his reply to The Straits Times, acting chairman of the Division of Medicine at SGH Geoffrey Samuel said patients from the emergency department “may be housed in a transient ward at our linkway to Outram Community Hospital” while awaiting admission.

“We recognise that the physical environment may not be ideal but would like to assure that patients receive the same level of medical care as they would in a normal ward. Our colleagues also ensure that patients remain comfortable while waiting,” Dr Samuel said.

Dr Samuel added that patients who are in a less critical condition can receive appropriate care through alternative avenues, including Mobile Inpatient Care@Home (MIC@Home), where patients receive hospital-level care while at home.

“Suitable patients from the ED and inpatient wards are also transferred to the Outram Community Hospital or transitional care facilities for step-down care,” he said.

The hospital has also moved more elective inpatient surgery cases to day surgery.

“Some patients are cared for in a short stay ward where they are monitored for less than 24 hours after the (day) surgery. This initiative helps free up hospital beds for acute admission from the ED,” Dr Samuel said.

The daily Covid-19 hospitalisation and intensive care cases seen at the hospitals under the NUHS group and Tan Tock Seng Hospital remained stable, the respective spokesmen said.

The hospitals said they will continue to monitor the situation closely and patients requiring care will continue to be attended to.

A spokeswoman for NUHS said: “We continue to remain vigilant and maintain surge capacity in our inpatient facilities, including our intensive care and isolation facilities. We are doing our best to optimise resources and will adjust our response to meet changing needs accordingly.

“Where necessary, we will redeploy and increase manpower to better support high attendance at our EDs.”

She added that the NUHS triage process includes having a senior emergency physician review the cases for admission to hospital, to “avoid unnecessary admission”.

Like SGH, hospitals under the NUHS group are offering alternative arrangements such as the NUHS@Home recovery programme, teleconsultation, tele-rehabilitation, tele-monitoring, remote prescribing, and delivery of medication.