Surveillance for COVID-19 in Cardiac Inpatients: Containing COVID-19 in a Specialized Cardiac Centre

Wee, Liang En; Wen, Rong; Sim, Xiang Ying Jean; Ng, Kym; Phoon, Poh Choo; Wong, Aaron; Chua, Terrance; Venkatachalam, Indumathi

doi:10.1016/j.cjca.2020.05.031

Cited by 3 publications

(7 citation statements)

References 4 publications

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“…Improved segregation for symptomatic inpatients was hence adopted campus-wide, for general medical and surgical patients in the acute tertiary hospital as well as inpatients of the various specialised centres on campus (cardiology, neurology, and oncology patients). The detailed implementation and specialty-specific protocols have been published elsewhere [ 11 , 16 , 17 , 18 , 19 ]. In brief, in these converted RSWs, infrastructural enhancements were implemented (half-height partitions between beds and reduced number of beds per cubicle), and HCWs used disposable gloves, gowns, eye protection, and N95 respirators until COVID-19 was excluded.…”

Section: Methodsmentioning

confidence: 99%

Containment of COVID-19 and reduction in healthcare-associated respiratory viral infections through a multi-tiered infection control strategy

Wee

Venkatachalam

Sim

et al. 2021

Infection, Disease & Health

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Background During the ongoing COVID-19 pandemic, healthcare-associated transmission of respiratory viral infections (RVI) is a concern. To reduce the impact of SARS-CoV-2 and other respiratory viruses on patients and healthcare workers (HCWs) we devised and evaluated a multi-tiered infection control strategy with the goal of preventing nosocomial transmission of SARS-CoV2 and other RVIs across a large healthcare campus. Methodology From January-June 2020, a multi-tiered infection control strategy was implemented across a healthcare campus in Singapore, comprising the largest acute tertiary hospital as well as four other subspecialty centres, with more than 10,000 HCWs. Drawing on our institution’s experience with an outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003, this strategy included improved patient segregation and distancing, and heightened infection prevention and control (IPC) measures including universal masking. All symptomatic patients were tested for COVID-19 and common RVIs. Results A total of 16,162 admissions campus-wide were screened; 7.% (1155/16162) tested positive for COVID-19. Less than 5% of COVID-19 cases (39/1155) were initially detected outside of isolation wards in multi-bedded cohorted wards. Improved distancing and enhanced IPC measures successfully mitigated onward spread even amongst COVID-19 cases detected outside of isolation. COVID-19 rates amongst HCWs were kept low (0.13%, 17/13066) and reflected community acquisition rather than nosocomial spread. Rates of healthcare-associated-RVI amongst inpatients fell to zero and this decrease was sustained even after the lifting of visitor restrictions. Conclusion This multi-tiered infection control strategies can be implemented at-scale to successfully mitigate healthcare-associated transmission of respiratory viral pathogens.

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Section: Methodsmentioning

confidence: 99%

Containment of COVID-19 and reduction in healthcare-associated respiratory viral infections through a multi-tiered infection control strategy

Wee

Venkatachalam

Sim

et al. 2021

Infection, Disease & Health

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“… 2 Early in the outbreak, comprehensive infection prevention measures were implemented at the National Heart Centre Singapore, the largest cardiac center in Singapore. 7 To date, no nosocomial transmission of COVID-19 has been reported at our centre, 8 and services were continued throughout. We evaluated trends in HF admissions with concomitant RVIs over an unbroken 10-month period during the pandemic, when public health measures were instituted to decrease SARS-CoV-2 transmission.…”

mentioning

confidence: 89%

“…During the pandemic, around one-fifth of admissions to our centre (22.0%, 1487/6758) were tested for SARS-CoV-2; only 0.34% (5/1487) tested positive for COVID-19, one of whom presented with decompensated HF. 7 A significant reduction in HF admissions with PCR-proven RVIs was observed at a large cardiac centre coinciding with the widespread adoption of public health measures during a pandemic. This reduction was sustained even after the reversal of community-wide lockdown measures; while non-HF admissions rebounded after lifting of lockdown, the reduction in HF admissions persisted.…”

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confidence: 99%

“…During the pandemic, all inpatients with upper respiratory tract infection symptoms were tested for SARS-CoV-2 as well as common RVIs. 7 , 8 The rates of HF admissions with PCR-proven RVI before and during the pandemic were compared using the incidence rate ratio method. A waiver of informed consent was obtained.…”

mentioning

confidence: 99%

“…During the pandemic, approximately one-fifth of admissions to our center (22.0%, 1487/6758) were tested for SARS-CoV-2; only 0.34% (5/1487) tested positive for COVID-19, one of whom presented with decompensated HF. 7

Fig. 1 Admissions for heart failure with concurrent respiratory viral infections, and trend of all-cause admissions at the National Heart Centre, Singapore (January 2018 to October 2020).…”

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confidence: 99%

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Reduction in heart failure admissions with concomitant respiratory viral infections during the novel coronavirus disease-2019 pandemic: Unintended consequence of public health measures in Singapore

Wee

Jinquan²,

Chan

et al. 2021

Journal of Cardiac Failure

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One Year on: An Overview of Singapore’s Response to COVID-19—What We Did, How We Fared, How We Can Move Forward

Anand

Shuy

Lee³

et al. 2021

IJERPH

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Background—One year has passed since the first COVID-19 case in Singapore. This scoping review commemorates Singaporean researchers that have expanded the knowledge on this novel virus. We aim to provide an overview of healthcare-related articles published in peer-reviewed journals, authored by the Singapore research community about COVID-19 during the first year of the pandemic. Methods—This was reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. It included healthcare-related articles about COVID-19 published between 23 January 2020 and 22 January 2021 with a Singapore-affiliated author. MEDLINE, Embase, Scopus, Web of Science, CINAHL, PsycINFO, Google Scholar, and local journals were searched. The articles were screened independently by two reviewers. Results—The review included 504 articles. Most of the articles narrated the changes to hospital practice (210), while articles on COVID-19 pathology (94) formed most of the non-narrative papers. Publications on public health (61) and the indirect impacts to clinical outcomes (45) were other major themes explored by the research community. The remaining articles detailed the psychological impact of the pandemic (35), adaptations of medical education (30), and narratives of events (14). Conclusion—Amidst a resurgence of community cases involving variant COVID-19 strains, the resources from the research community will provide valuable guidance to navigate these uncertain times.

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Surveillance for COVID-19 in Cardiac Inpatients: Containing COVID-19 in a Specialized Cardiac Centre

Cited by 3 publications

References 4 publications

Containment of COVID-19 and reduction in healthcare-associated respiratory viral infections through a multi-tiered infection control strategy

Containment of COVID-19 and reduction in healthcare-associated respiratory viral infections through a multi-tiered infection control strategy

Reduction in heart failure admissions with concomitant respiratory viral infections during the novel coronavirus disease-2019 pandemic: Unintended consequence of public health measures in Singapore

One Year on: An Overview of Singapore’s Response to COVID-19—What We Did, How We Fared, How We Can Move Forward

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