Structural Changes To Be Made To Address Long Waits At Hospitals & Crowded EDs
Last month, reports emerged that waiting times at some hospitals’ A&E departments had stretched up to 50 hours, sparking concerns among residents.
Up To 50 Hours Waiting Time For Beds At S’pore Hospitals, Emergency Departments See More Patients
Speaking in Parliament on Tuesday (8 Nov), Health Minister Ong Ye Kung outlined a series of factors that resulted in the prolonged wait for A&E beds.
These include the prevailing suite of eased Covid-19 measures, the diminishing protection that vaccines are giving to our population as a whole, and perhaps most unsurprising of all, the fact that the Covid-19 pandemic is still ongoing.
Mr Ong also said hospitals in Singapore would no longer be setting aside whole wards for Covid-19 patients, instead focusing on the severity of patients’ conditions.
Long waits at hospitals due in part to ‘limited’ effectiveness of SMMs & vaccinations
Responding to parliamentary questions on Tuesday (8 Nov), Mr Ong noted that Singapore hospitals, especially the emergency departments (EDs), have been very busy over the past year.
Even though life has returned to normal like the pre-Covid era, he stressed that the hospital’s current heavy workload is because the pandemic is not over.
It may feel like it is over for most of us, but it certainly is not over for our hospitals and healthcare workers. We are learning to live with the virus as an endemic disease.
Living with the virus means accepting that Covid-19 will be a permanent feature in our lives. To tackle this, Singapore has three main public health measures:
- Safe management measures (SMMs)
- Vaccination
- Healthcare system
Even though vaccination exercises are ongoing, Mr Ong said maintaining our immunity and resilience would not help achieve the “quantum improvement in resilience” observed at the start of the national vaccination programme.
Mismatch of demand & supply of hospital beds during an infection wave
As SMMs and vaccinations become more limited in effectiveness, he explained that the “burden of endemicity” now falls disproportionately on our healthcare system.
While the long waits at hospitals were only reported recently, Mr Ong said our healthcare institutions have been experiencing it for the entire year.
As such, he urged residents to bear the healthcare workers’ sacrifice in mind as they enjoy their “freedom”.
Mr Ong pointed out that the root of the bottleneck situation at hospitals was actually not the EDs. Instead, it was the mismatch of demand and supply of hospital beds during a Covid-19 wave.
Source: Singapore General Hospital on Facebook
For example, at the peak of this mid-year Omicron Wave and recent XBB wave, patients with Covid-19 added another 600 ED visits daily. “This is 30% more workload at the ED, which is very significant,” he said.
He also noted that the supply of hospital beds has several constraints, such as longer stays due to an ageing population, construction disruptions of new healthcare facilities, and supply constraints of beds.
‘Immunity debt’ among children causes high number of hospital visits
Mr Ong also brought up another problem at KK Women’s and Children’s Hospital, which has been seeing an increased number of daily visits. He said such levels were only experienced during Chinese New Year when most clinics are closed.
“This is a separate problem due to what we call an ‘immunity debt’ in children,” he said.
The safety measures, such as mask-wearing, have protected children from various forms of viral infection, not just Covid-19.
Now that life is back to normal, viral infections are making a strong comeback and demanding payback, with interest.
Singapore hospital no longer setting aside whole wards for Covid-19 patients
To effectively tackle the issue of crowded EDs, Mr Ong said hospitals would no longer be setting aside entire wards for Covid-19 patients.
In turn, this will help to free up beds that other patients can occupy.
Mr Ong said our high vaccination rates and immunity levels should allow hospitals to triage or assess their patients based on the severity of their conditions, as with all other patients.
This flexibility is important to our hospitals, to help them optimise the use of beds. In a crunch situation, just like an expressway with very high throughput, it makes all the difference.
However, he assured the public that hospitals would take the necessary precautions to prevent infectious diseases from spreading.
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Featured image adapted from Sengkang General Hospital.
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