Responding to the COVID-19 Outbreak in Singapore: Staff Protection and Staff Temperature and Sickness Surveillance Systems
Responding to the COVID-19 Outbreak in Singapore: Staff Protection and Staff Temperature and Sickness Surveillance Systems
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DOI：
10.1093/cid/ciaa468
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发表时间：
2020-10-15
影响因子：
11.8
通讯作者：
Chow, Angela
中科院分区：
文献类型：
--
作者：
Htun, Htet Lin;Lim, Dwee Wee;Chow, Angela
背景资料。2019年冠状病毒病(新冠肺炎)是由一种新型冠状病毒(SARS-CoV-2)引起的新兴传染病，于2019年12月在武汉首次报告，中国。自2003年严重急性呼吸系统综合症(SARS)爆发以来，新加坡陈德胜医院(TTSH)定期对员工进行高过滤N95呼吸器的适配测试，并建立基于网络的员工监控系统。针对新加坡于2020年1月23日出现的首例输入性新冠肺炎病例，加强了常规系统的管理。我们于2020年1月23日至2月23日在医护人员中进行了一项横断面研究，以评估TTSH的工作人员保护和监测策略的有效性。TTSH是一家拥有1600张床位的多学科急性护理医院，与拥有330张床位的国家传染病中心(NCID)共存。截至2020年2月23日，新加坡76%的新冠肺炎确诊病例已得到控制。医院采取多管齐下的方式对潜在新冠肺炎接触人员进行保护和监测：(1)基于风险的个人防护装备；(2)员工发热和疾病监测；(3)加强对身体不适的员工的医疗监测。共有10583名工作人员接受了全院范围的发烧和疾病监测，其中1524名工作在新冠肺炎地区的一线工作人员受到密切监测。在前线工作人员中，平均每天发生8次工作人员疾病发作；近10%(n=29)导致住院治疗。未发现工作人员感染COVID-19。一个健全的工作人员保护和健康监测系统在非暴发期间定期实施，并在新冠肺炎暴发期间得到加强，有效地保护前线工作人员免受感染。
Background. Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by a novel coronavirus (SARS-CoV-2) and first reported in Wuhan, China, in December 2019. Since the severe acute respiratory syndrome (SARS) outbreak in 2003, Tan Tock Seng Hospital (TTSH) in Singapore has routinely fit-tested staff for high-filtration N95 respirators and established Web-based staff surveillance systems. The routine systems were enhanced in response to Singapore's first imported COVID-19 case on 23 January 2020.Methods. We conducted a cross-sectional study from 23 January to 23 February 2020 among healthcare workers to evaluate the effectiveness of the staff protection and surveillance strategy in TTSH, a 1600-bed multidisciplinary acute-care hospital colocated with the 330-bed National Centre for Infectious Diseases (NCID). As of 23 February 2020, TTSH/NCID has managed 76% of confirmed COVID-19 cases in Singapore. The hospital adopted a multipronged approach to protect and monitor staff with potential COVID-19 exposures: (1) risk-based personal protective equipment, (2) staff fever and sickness surveillance, and (3) enhanced medical surveillance of unwell staff.Results. A total of 10 583 staff were placed on hospitalwide fever and sickness surveillance, with 1524 frontline staff working in COVID-19 areas under close surveillance. Among frontline staff, a median of 8 staff illness episodes was seen per day; almost 10% (n = 29) resulted in hospitalization. None of the staff was found to be infected with COVID-19.Conclusions. A robust staff protection and health surveillance system that is routinely implemented during non-outbreak periods and enhanced during the COVID-19 outbreak is effective in protecting frontline staff from the infection.