Life In the Time of COVID-19

A display of commemorative items from TTSH-NCID’s COVID-19 journey in the TTSH Heritage Museum. Take a closer look online at these items that hold significance and were key in our fight against COVID-19 contributed by staff and departments.

High Flow Nasal Cannula Device

This device is used in High Flow Nasal Cannula Therapy as an alternative to respiratory support for COVID-19 patients who were critically ill. Used together with awake prone positioning, this was a game-changer for managment of COVID-19 pneumonia and was used in the NCID Intensive Care Unit, reducing the number of patients who required intubation and ventilator support.

Storage Box Transportation System for COVID-19 Swab Samples

Triple packaging for COVID-19 suspect samples is mandatory. Previously, each sample was transported in individual plastic bags, inside a transport container. Now, multiple samples are placed in a rack, in a small box within a transport container - saving time, effort and plastic.

Personal Protective Equipment (PPE)

A key infection control measure, PPE keeps healthcare workers safe as they go about delivering care to patients. It includes masks, gowns, gloves, as well as goggles or face shields that are used not only in outbreak areas, but also during higher-risk procedures such as intubation. Throughout the pandemic, every staff serving at the frontline had to don PPE for personal protection.

When supply chains were affected due to the global pandemic, the Hospital stayed ahead of the curve by adapting and improvising work flows. One example was the switch from using disposable visors masks to re-usable goggles for certain areas like the Screening Centre during the initial COVID-19 spike.

3D Printed Face Shields

Goggles and Face Shields are important components of the PPE. A team from the Centre for Healthcare Innovation Living Lab (CHILL), in consultation with Adjunct Assistant Professor Shawn Vasoo, Clinical Director, NCID and colleagues from the Department of Infection Control designed and produced two face shields that emphasised safety and comfort for the users. The CHILL design team first developed prototypes by using maker tools and 3D printing to fabricate the face shield components that were subsequently assembled together. In June 2020, Siemens and its partners came on board to help optimise the 3D printed face shields, adding enhanced durability and strength to create a viable product for the market.

Set of goggles

This set of goggles were part of Personal Protective Equipment used by Mr Christopher Soh, Deputy Director of Nursing, Emergency Department (ED). This includes two pairs from 2003 and 2009, worn during his fight against SARS and the H1N1 pandemic. The rest of the goggles were worn throughout the two years of the pandemic in the ED and Screening Centre. They played their small part in the initial rapid national surge response against the first covid wave in Singapore.

Coloured Duct Tapes used for staff identification

Coloured tape was used for easy identification of staff at the NCID Screening Centre, Intensive Care Unit and main COVID-19 wards when it was difficult to differentiate each other in the Personal Protective Equipment. These innovations were simple, but yet significant enough to improve work flows.

Translated Instructions for patients

When COVID-19 cases in the dormitories dominated in the second wave, the Screening Centre faced huge numbers of migrant workers waiting to be tested. To facilitate communication, the Speech Therapy Department together with colleagues from Nursing and Kaisen Office designed an advisory with simple instructions and visuals in Mandarin/Tamil/Bengali to inform patients what to expect and to take note of.

Respirator Fit Test Kit

Respirator fit-testing is a procedure that is done to ensure an N95 respirator is able to fit the wearer's face shape for a tight seal to ensure maximum protection. A respirator fit test kit is used to check face-to-mask seal. A bitter tasting solution is sprayed into the hood environment with the mask in place to ensure the fit is right. Over the past two years, a group of 15 dedicated trainers from the Department of Infection Control spent more than 800 hours fit-testing more than 10,000 staff for safety. This includes staff who require to be re-fitted.

Poly Mailer Bags for Medication Delivery

The poly mailer bag is used as a packaging for medications for delivery to patients' home. It marks the significance of TTSH's Medication Delivery Service during COVID-19, especially when the circuit breaker was in place and patients' medical appointments were postponed. There was a steep ramp-up in the Medication Delivery Service to bridge medication supply for patients, and ensured treatment continuity especially when patients could not visit the hospital. The white bag is used for general ambient medications, while the blue bag is used for cold-chain medications. Additional instructions printed on the back of the bag also play a part in ensuring medication safety.

4-hourly Report Chart of staff swab numbers

At the peak of the crisis, the team was working on rotating shifts 18hrs a day to support 4-hourly reporting. After the closure of the TTSH cluster, reporting was streamlined to 2 times a day. This chart shows the Rostered Routine Testing (RRT) swab numbers that was reported to senior management.

Self-administered Antigen Rapid Test (ART) kit

These self-test kits were distributed to all staff for twice-a-week rostered routine testing (RRT) after a step-down from Polymerase Chain Reaction (PCR) routine testing 19 weeks after the regular swab testing was put in place. The Singapore Government ceased RRT for all sectors from 29 March 2022.

Rostered Routine Testing (RRT) Kit for inpatients and Staff

In the early days, staff had to undergo regular Polymerase Chain Reaction (PCR) routine testing to identify early asymptomatic cases. TTSH was able to achieve about 99.5% PCR RRT swab rate for staff prior to the conversion to Antigen Rapid Test RRT. Registered Nurses also carried out PCR swab tests for patients in the wards. This was part of regular scheduled testing based on patient's risk stratification, to detect any COVID-19 infection early as protection for other patients in hospital and for staff.

Covid Vaccination syringe and vial

Vaccination was a vital step in our fight to control COVID-19. On 30 Dec 2020, Ms Sarah Lim, Senior Staff Nurse, National Centre for Infectious Diseases (NCID) was the first person in Singapore to receive a dose of the Pfizer-BioNTech vaccine. Subsequently, the TTSH Occupational Health Clinic carried out a hospital-wide COVID-19 Vaccination Exercise for TTSH and NCID staff. 74.9% of staff were vaccinated in 11 weeks. The covid vaccination syringe and vial also signifies NCID's continued research work on antibody and immune response to COVID-19 vaccination.

Visitor Stickers Chart

During the pandemic, all visitors had to complete Travel and Health Declaration and perform Safe Entry before they were allowed to enter hospital premises, as part of contact tracing efforts. TTSH's Visitor Experience Services made use of colored stickers for easy visitor identification. A different color was used for every day of the week. The different sticker shapes also represented different visitor criteria.

Hydrogen Peroxide

Hydrogen peroxide is used in Hydrogen Peroxide Vapour (HPV) decontamination processes to sterilise and disinfect surfaces contaminated with microorganisms. This process was commonly used within COVID-19 wards in TTSH and NCID during the pandemic.

Hydrogen Peroxide Vapour (HPV) Decontamination Report

This HPV report reflects the decontamination cycle for TTSH Ward 9D which underwent HPV decontamination upon the discovery of a COVID-19 cluster in TTSH.

Body bag with transparent window

Body bags were used for deceased patients with COVID-19. Each body bag measures approximately 218cm by 100cm. The double layered transparent window allows for the next-of-kin of the decease to see the patient's face as a final farewell for their loved ones, while keeping safe.