Ward 9D at Tan Tock Seng Hospital to reopen on Saturday with enhanced measures

[SINGAPORE] Tan Tock Seng Hospital (TTSH) is reopening Ward 9D, the epicentre of its Covid-19 outbreak, from Saturday (May 22), with a suite of enhanced measures to better protect its patients and staff.

Epidemiological investigations into the cause of transmission within the hospital are still being determined, the hospital said.

Singapore's director of medical services Kenneth Mak had said on Tuesday that the authorities are investigating the possibility of airborne transmission within the hospital, pointing to reports that suggest a stronger possibility of airborne transmission in certain settings, particularly closed environments with limited airflow and poor ventilation.

To allow for better ventilation and air purification, TTSH has installed exhaust fans and portable Hepa filters in Ward 9D, a C-class ward.

It will progressively implement this in all the hospitals wards as it gradually reopens them for admissions.

The hospital had halted admissions for two weeks amid a cluster which grew to 46 patients. It was linked to Ward 9D, where a nurse was on April 28 reported to have tested positive for Covid-19.

Two patients, both linked to the TTSH cluster, have died due to Covid-19 complications.

They are an 88-year-old Singaporean woman, who had a history of cancer, hypertension, congestive cardiac failure, stroke and hyperlipidaemia, and a 70-year-old man who had a history of lung cancer and artrial fibrillation.

The ward - which has a bed capacity of 40 - is segregated into cubicles, with an average of six beds per cubicle.

Speaking to the media at a visit to Ward 9D on Friday, Dr Hoi Shu Yin, who is chief nurse at Tan Tock Seng Hospital, said that each cubicle within the ward is equipped with exhaust fans to facilitate air change around six to 12 times per hour. This way, air in the cubicle is constantly replaced.

In addition, each cubicle has a portable Hepa filter, which helps to remove airborne particles such as dust, pollen, mold and bacteria.

Prior to re-opening each ward for hospital admissions, Dr Hoi said that the wards will undergo one round of deep cleaning, using ultraviolet and hydrogen peroxide vapour for high-touch areas.

TTSH on Tuesday had announced that it will be progressively resuming admissions, after conducting six rounds of testing for all inpatients, and two rounds for all 12,000 staff on campus. Their swab test results have consistently returned negative.

Three other wards - Ward 7D, 9C and 10B - will remain in locked down mode.

As part of added precautions, Associate Professor Bernard Thong, divisional chairman (medicine) at TTSH, said that rostered routine testing will be in place for all its staff - once every two weeks for those who have been vaccinated, and once a week for those who have not.

More than 80 per cent of the hospital's staff have been vaccinated so far, he added.

Since the emergence of the cluster, the hospital has also escalated its personal protection equipment (PPE) protocols. "In the inpatient setting, PPE includes the use of googles, N95 masks, as well as the gowns...on top of the usual hand hygiene measures and safety measures which have been enforced during this period of time," said Dr Thong.

He added that staff have been segregated into zones to avoid intermingling.

This proved "very challenging" over the past two to three weeks, Dr Thong said, as the teams were leaner since a significant number of staff had been placed on quarantine.

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