100 days on: the primary care response to COVID-19 in Singapore

Liow, Yiyang; Loh, Victor Weng Keong; Young, Doris

doi:10.11622/smedj.2020162

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…These 20 public primary care clinics located islandwide account for 21% of all primary care outpatient visits in the country [15]. Primary care providers were involved in setup and operations of community isolation facilities, public health preparedness clinics (testing, management and surveillance for COVID-19 cases) and act as sites for COVID-19 vaccination [16]. Singapore first started HCW vaccination against COVID-19 with the Pfizer-BioNTech/Comirnaty vaccine in end December 2020.…”

Section: Open Accessmentioning

confidence: 99%

COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore

et al. 2022

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Background Factors affecting COVID-19 vaccine acceptance and hesitancy among primary healthcare workers (HCW) remain poorly understood. This study aims to identify factors associated with vaccine acceptance and hesitancy among HCW. Methods A multi-centre online cross-sectional survey was performed across 6 primary care clinics from May to June 2021, after completion of staff vaccination exercise. Demographics, profession, years working in healthcare, residential status, presence of chronic medical conditions, self-perceived risk of acquiring COVID-19 and previous influenza vaccination were collected. HCW who accepted vaccine were then asked to rank their top 5 reasons for vaccine acceptance; HCW who were vaccine hesitant had to complete the 15-item 5C scale on psychological antecedents of vaccination. Results Five hundred fifty seven out of 1182 eligible HCW responded (47.1%). Twenty nine were excluded due to contraindications. Among 528 respondents, vaccine acceptance rate was 94.9% (n = 501). There were no statistically significant differences in COVID-19 vaccine acceptance between sex, age, ethnicity, profession, number of years in healthcare, living alone, presence of chronic diseases, self-perceived risk or previous influenza vaccination. The top 3 reasons for COVID-19 vaccine acceptance ranked by 501 HCW were to protect their family and friends, protect themselves from COVID-19 and due to high risk of acquiring COVID-19 because of their jobs. HCW with suspected or confirmed COVID-19 exposure were 3.4 times more likely to rank ‘high risk at work’ as one of the top reasons for vaccine acceptance (χ2 = 41.9, p < 0.001, OR = 3.38, 95%C.I. 2.32–4.93). High mean scores of ‘Calculation’ (5.79) and low scores for ‘Constraint’ (2.85) for 5C components among vaccine hesitant HCW (n = 27) highlighted that accessibility was not a concern; HCW took time to weigh vaccine benefits and consequences. Conclusion COVID-19 vaccine hesitancy is a minute issue among Singapore primary HCW, having achieved close to 95% acceptance rate. COVID-19 exposure risk influences vaccine acceptance; time is required for HCW to weigh benefits against the risks. Future studies can focus on settings with higher hesitancy rates, and acceptance of booster vaccinations with the emergence of delta and omicron variants.

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Section: Open Accessmentioning

confidence: 99%

COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore

et al. 2022

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“…The establishment of PHPCs was in line with ERMH's recommendations for governments to make advanced arrangements with private companies to ensure access to medical facilities during a health emergency [85]. As a result, acting as the first line of defense, PHPC-affiliated private actors have played an important role in reducing the burden on the operational capacities of public hospitals dealing with unconfirmed cases of COVID-19 [48].…”

Section: Harnessing Private Sector Capacity To Develop a Whole-of-soc...mentioning

confidence: 99%

Moving toward a common goal via cross-sector collaboration: lessons learned from SARS to COVID-19 in Singapore

2022

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Background The spread of COVID-19 has taken a toll on many countries and its healthcare system over the last two years. Governments have sought to mitigate the repercussions of the pandemic by implementing aggressive top-down control measures and introducing immense fiscal spending. Singapore is no exception to this trend. Owing to a whole-of-society approach, Singapore is still being lauded globally for its relatively successful record at controlling both community and trans-border spread. One notable effort by the Singapore government has taken place through its cross-sectoral collaborative partnerships with the private stakeholders behind the success. Methods/results In an attempt to better explain Singapore’s robust yet strategic response to COVID-19, this study focuses on how the experience of the SARS outbreak has informed the government’s collaborative efforts with other stakeholders in society, beyond mere transnational cooperation. Taking a comparative case study approach in the specific context of Singapore, we perform a content analysis of related government documents, mainstream newspaper articles, and academic journal articles in an inductive manner. By closely comparing two global healthcare outbreaks, we note four differences in approach. First, during the COVID-19 pandemic, Singapore has focused on securing sufficient essential healthcare resources with contingency plans to strengthen preparedness. Second, the government has actively harnessed the capacity of private entities to promote the resilience of the healthcare system and the community. Third, Singapore’s management policies have been made not only in a top-down, centralized style during the initial response stage, but also with a greater proportion of bottom-up approaches, particularly as the pandemic trudges on. More interestingly, the multi-faceted repercussions of COVID-19 have gradually opened the door to a greater variety of collaborative partnerships in sectors beyond healthcare services. The participating stakeholders include, but are not limited to, local and international business actors, non-profit organizations, academia and other countries. Lastly, as the pandemic has continued, the Singapore government has managed outward to tap the expertise and knowledge of the private sector, in particular leveraging science and technology to improve control measures and putting supportive programs into practice. Conclusion The evidence from our focused analyses demonstrates that the nature and scale of the COVID-19 pandemic produced more collaborative partnerships between the public and private sectors in Singapore as compared with the SARS outbreak. What is more, our findings offer evidence that through adaptive learning from the prior global healthcare outbreak, plus some trial and error during the initial phase of the ongoing pandemic, public- and private-sector partners, both in and outside of the healthcare service sector, have tended to “act alike,” working together to achieve a common goal. Both have been socially responsible, providing public services to people in need to promote the rapid resilience of the community, and sharing the associated risks. Overall, this study has deep and wide implications for other governments and policy makers who are still struggling to maximize essential resources and minimize the negative impacts of the healthcare crisis.

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“…Primary care providers were involved in setup and operations of community isolation facilities, public health preparedness clinics (testing, management and surveillance for COVID-19 cases) and act as sites for COVID-19 vaccination. 11 Since December 2020, Singapore has offered HCW vaccination against COVID-19 with the P zer-BioNTech vaccine. It will be vital to study the perspective of primary care HCW who serve on the frontlines; thoughts and behaviours regarding the COVID-19 vaccine will de nitely in uence patient's vaccine decisions.…”

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confidence: 99%

COVID-19 Vaccine Acceptance and Hesitancy among Singaporean Primary Healthcare Workers

Koh

Liow

Loh

et al. 2021

Preprint

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BackgroundFactors affecting COVID-19 vaccine acceptance and hesitancy among primary healthcare workers (HCW) remain poorly understood. This study aims to identify factors associated with vaccine acceptance and hesitancy among HCW.MethodsA multi-centre online cross-sectional survey was performed across 6 primary care clinics from May to June 2021, after completion of vaccination exercise. Demographics, profession, years working in healthcare, residential status, presence of chronic medical conditions, self-perceived risk of acquiring COVID-19 and previous influenza vaccination were collected. HCW who accepted vaccine were then asked to rank their top 5 reasons for vaccine acceptance; HCW who were vaccine hesitant had to complete the 5C scale on psychological antecedents of vaccination.Results557 out of 1182 eligible HCW responded (47.1%). 29 were excluded due to existing contraindications. Among 557 respondents, vaccine acceptance rate was 94.9% (n=501) and 5.1% were hesitant (n=27). COVID-19 vaccine acceptance was not associated with sex, age, ethnicity, profession, number of years in healthcare, living status, presence of chronic diseases, self-perceived risk or previous influenza vaccination. The top 3 reasons for COVID-19 vaccine acceptance ranked by 501 HCW were to protect their family and friends, protect themselves from COVID-19 and due to high risk of acquiring COVID-19 because of their jobs. The 15-item questionnaire from the 5C psychological antecedents of vaccination was completed by 27 vaccine hesitant HCW. The mean scores for the components of the 5Cs were: ‘Confidence’ (3.96), ‘Complacency’ (3.23), ‘Constraint’ (2.85), ‘Calculation’ (5.79) and ‘Collective responsibility’ (4.12).ConclusionCOVID-19 vaccine hesitancy is a minute issue among Singapore primary HCW, having achieved close to 95% acceptance rate with 5% hesitancy rate. Future studies can focus on other settings with higher hesitancy rates, and acceptance of booster vaccinations with the emergence of the delta COVID-19 variant.Trial RegistrationThis study was approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB), Singapore on 26th April 2021 (Reg No. 2021/00213).

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100 days on: the primary care response to COVID-19 in Singapore

Cited by 8 publications

References 13 publications

COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore

COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore

Moving toward a common goal via cross-sector collaboration: lessons learned from SARS to COVID-19 in Singapore

COVID-19 Vaccine Acceptance and Hesitancy among Singaporean Primary Healthcare Workers

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