Over two-thirds of Covid ICU beds occupied; healthcare system prepares to step up more beds

MORE than two-thirds of Singapore's Covid-19 intensive care unit (ICU) beds are now occupied, as the coronavirus caseload weighs on the healthcare system.

"Our hospitals and healthcare workers continue to come under pressure," Health Minister Ong Ye Kung said at a virtual media interview on Wednesday (Oct 20).

Some 89 per cent of the healthcare system’s roughly 1,650 isolation beds are filled, as are 71 per cent of Covid-19 ICU beds. When non-Covid-19 patients are taken into account, overall ICU occupancy is about 67 per cent. (See Amendment note)

While he stressed that Singapore has the capacity to set aside more Covid-19 beds, he warned: "Electives (procedures) are starting to be postponed, and if we have to beef up ICU or isolation beds, I think there will be a greater reduction of normal medical care, non-Covid medical care."

His comments came as the Ministry of Health (MOH) said in a press release on Wednesday that it is "proactively working with the public, community and private hospitals to set aside more beds" for Covid-19.

Hospital clinical teams have been actively referring more stable patients to field hospital-like Covid-19 treatment facilities (CTFs); community isolation facilities; or home recovery, which the MOH said is to reduce the load on the system. The ministry is also working with community hospitals to operate more CTF-type beds for older Covid-19 patients with comorbidities.

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When asked by The Business Times about Singapore's plans for crisis standards of care - that is, guidelines on how healthcare should be rationed when medical services are overwhelmed - Ong instead pointed to ongoing triage across Home Recovery and various treatment facilities.

"But when it comes to ICU, hospitals will only admit those who really need that close observation and need that care by ICU-trained healthcare workers.

"So the ICU numbers, I don't think there is much scope to triage them away and we just have to give them all the appropriate medical care that they need."

Singapore now has roughly 4,200 Covid-19 beds available across hospitals and CTFs.

Of the 207 ICU beds set aside for Covid-19 cases, 71 are now occupied by intubated patients and another 75 by those who need close monitoring and treatment to prevent further deterioration, according to Ong in his remarks. No figure was given for the number of non-Covid-19 ICU beds available.

Meanwhile, another 100 ICU beds can be activated for Covid-19 cases, although Ong warned that such a move would be "at the expense of further degradation of normal service and normal medical care".

Ong noted that Singapore has tapped the private healthcare sector for vaccination operations, swabbing, and care facilities management.

"We have also reached out to them to also help take in some patients, Covid and non-Covid, so that we can share the burden as one healthcare ecosystem," he added.

Still, the minister spoke of working towards "a new equilibrium with the virus" as more vaccinated individuals get booster shots or are infected with only mild flu-like symptoms, raising the level of immunity in society over time.

“When that happens, we will see cases falling and we can open up social and economic activities without cases rising very rapidly,” he said. 

Singapore reported a record 3,994 new Covid-19 infections on Tuesday night, with 84 per cent of the population having received both doses of the vaccine.

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Amendment note: This article has been amended to reflect updated figures from the Ministry of Health on hospital bed occupancy.