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      Responding to the COVID-19 outbreak in Singapore: Staff Protection and Staff Temperature and Sickness Surveillance Systems

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          Abstract

          Background

          Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by 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 January 23,2020.

          Methods

          We conducted a cross-sectional study, from January 23,2020 to February 23,2020, among healthcare workers to evaluate the effectiveness of the staff protection and surveillance strategy in TTSH, a 1600-bed multidisciplinary acute-care hospital co-located with the 330-bed National Centre for Infectious Diseases (NCID). As of February 23,2020, TTSH/NCID has managed 76% of confirmed COVID-19 cases in Singapore. The hospital adopted a multi-pronged 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 hospital-wide fever and sickness surveillance, with 1,524 frontline staff working in COVID-19 areas under close surveillance. Among frontline staff, a median of eight staff illness episodes was seen per day, and 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.

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          Author and article information

          Journal
          Clin Infect Dis
          Clin. Infect. Dis
          cid
          Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
          Oxford University Press (US )
          1058-4838
          1537-6591
          21 April 2020
          21 April 2020
          Affiliations
          [1 ] Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital,  Singapore
          [2 ] Occupational Health Services, Tan Tock Seng Hospital,  Singapore
          [3 ] Department of Infectious Diseases, Tan Tock Seng Hospital,  Singapore
          Author notes
          Corresponding author. Angela Chow, Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng Singapore, 308433 Singapore. Tel: +65-63577477; Fax: +65-63577465; E-mail: angela_chow@ 123456ttsh.com.sg
          Article
          ciaa468
          10.1093/cid/ciaa468
          7188160
          32315026
          © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

          This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

          This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

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          Categories
          Major Article
          AcademicSubjects/MED00290
          Custom metadata
          PAP
          accepted-manuscript

          Infectious disease & Microbiology

          covid-19, novel coronavirus, surveillance, healthcare workers

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