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news VO L . 5 2 N O . 6 | J U N E 2 0 2 0 | M C I ( P ) 0 6 6 / 1 2 / 2 0 1 9
news
CON T E N T S
Vol. 52 No. 6 2020
EDITORIAL
BOARD
Editorial
04 The Editors' Musings 20 COVID-19 in Singapore
Editor Dr Tina Tan and Dr Jipson Quah Dr Kenneth Lyen
Dr Tina Tan
Deputy Editor 24 COVID-19 Pandemic:
Dr Chie Zhi Ying
A Life-Changing Experience
Editorial Advisors Dr Cheryl Chang, Dr Lucas Lim,
A/Prof Daniel Fung Dr Eugene Fidelis Soh and Anonymous
A/Prof Cuthbert Teo
Dr Toh Han Chong
Members Reflections
Dr Ganesh Kudva
Dr Lim Ing Haan
27 Love in the Time of Corona(virus)
Dr Jipson Quah Dr Ada Ngo
Dr Tan Tze Lee
Dr Jimmy Teo 28 Caring for COVID-19 Heroes (Part 1)
Dr Alex Wong
EX-OFFICIOS
Dr Tan Yia Swam Feature
Dr Ng Chew Lip
06 Apollo’s Arrows and Sun Tzu’s
EDITORIAL Stratagem
OFFICE Dr Gan Wee Hoe
Senior Manager
Sarah Lim
Assistant Manager President's Forum
Sylvia Thay 10 Adjustments and Adaptability
Editorial Executive Dr Tan Yia Swam
Daryl Lai
ADVERTISING AND Council News
PARTNERSHIP 12 Highlights from the
Li Li Loy
Tel: (65) 6540 9174 Honorary Secretary
Allan Kuek Dr Ng Chew Lip
Tel: (65) 6540 9175
Email: adv@sma.org.sg
13 Timeline of Events
PUBLISHER
Singapore Medical Association
2985 Jalan Bukit Merah AIC Says
#02-2C, SMF Building Opinion 34 Launch of AIC eServices for
Singapore 159457 14 Preparing for COVID-19 Pandemic:
Tel: (65) 6223 1264
Financing Schemes (eFASS)
Perspectives and Lessons Learnt Agency for Integrated Care
Fax: (65) 6252 9693
Email: news@sma.org.sg from the Surgical Department
URL: https://www.sma.org.sg Dr Chew Min Hoe
UEN No.: S61SS0168E
18 Keeping the Mobile Phone Charged
DESIGN AGENCY
Oxygen Studio Designs Pte Ltd During a Blackout
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PRINTER
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Cover photos:
Changi General Hospital
Opinions expressed in SMA News reflect the
Tan Tock Seng Hospital
views of the individual authors, and do not National University Health System
necessarily represent those of the editorial
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Association (SMA), unless this is clearly
specified. SMA does not, and cannot, accept
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editorial
Dr Tina Tan Dr Jipson Quah
Editor Guest Editor
COVID-19 Avengers Assemble!
Dr Tan is a consultant at the Institute Dr Quah is a GP and pathology clinical
The COVID-19 pandemic has officer in private practice. He enjoys
of Mental Health and has a special struck the world with unprecedented
interest in geriatic psychiatry. She is music-making, fitness activities and
force and is a deadly challenge like
also an alumnus of Duke-NUS Medical editorial work in his spare time.
no other in our generation. At this
School. Between work and family moment, there have been over
life, she squeezes time out for her six million cases and over 360,000 and Logistics Division (S.H.I.E.L.D) and
favourite pastimes – reading a good deaths. In comparison, during the our MOH/Public Health leadership is
(fiction) book and writing. 2003 SARS outbreak from November Nick Fury. Our surgeons, especially
2002 to August 2003, there were a the orthopods, are characterised by
total of 8,422 cases and 916 deaths. the mighty Thor (powerful lightning
COVID-19 continues to dominate our As a result, governments have been and mythical weapons) and Hulk
lives with its widespread impact. As scrambling to control the outbreak (smash!). Our infectious diseases
such, I hope readers understand and treat the ill. Different countries specialists and physicians are Vision
SMA News’ emphasis on related have adopted a variety of approaches. and Hawkeye, due to their incredible
articles, from the clinically practical Some of these measures include clinical acumen and ability to provide
to the very personal. It is my desire widespread lockdowns, closure of life-saving care. Spiderman represents
to give a voice to as many doctors as businesses, deploying and training our eager young colleagues (house
possible, to hear their perspectives medical personnel, and building officers and junior residents). Doctors
and to share lessons learned. temporary medical facilities. For from the pathology and laboratory
This month, we take stock and the medical fraternity, this means departments are like Doctor Strange!
look back at how the pandemic has increased personal protective (They provide crucial diagnostic
unfolded in Singapore. Looking equipment measures, deployment in services which guide our diagnosis
forward, we anticipate much effect COVID-19 facilities and cancellation of and policies). Radiologists are
on the mental health of doctors, and clinics, operations, leave, conferences probably Black Panther (usually in
we are glad to have worked with the and fellowships. We also have to adapt dark rooms and very technologically
Singapore Psychiatric Association to quickly to government policies and advanced). Psychiatrists have got
highlight this issue for our readers. Ministry of Health (MOH) circulars. to be Scarlet Witch, with powers
In this issue of SMA News, we have of hypnosis and telekinesis. The
Last, but certainly not least, I am GPs and family physicians are the
invited colleagues to detail their
also delighted to welcome Dr Lim
unique experiences in fighting against Guardians of the Galaxy, running
Ing Haan to the Editorial Board. public health preparedness clinics
COVID-19. If I may borrow references
from the Marvel Universe, we (The and Swab And Send Home schemes.
Avengers) are battling COVID-19 I hope you have an enjoyable
(Thanos), a plague that threatens to read and would spend some time
wipe out swaths of the population and pondering about which Avenger
completely change the way we live. you might be as we continue the
Akin to The Avengers, we have the fight against COVID-19. As part of
courageous public sector (Captain a team, we all have different roles
America) and private sector (Iron Man) to play in order to complete the
doctor-heroes. MOH is the Strategic Infinity Gauntlet and eradicate
Homeland Intervention, Enforcement COVID-19 from the world.
04 JUN 2020 SMA News
Welcome
On Board
Dr Lim Ing Haan is an interventional cardiologist in Mount Elizabeth Hospital where
she shares a clinic with her twin – Dr Lim Ing Ruen, an otorhinolaryngologist.
After her return from Duke University in 2005, she coordinated the set-up of the
Primary Percutaneous Coronary Intervention Service in Tan Tock Seng Hospital in
2007, and remains on its Acute Myocardial Infarction Service till today.
She is committed to innovation and was the course director of a number of
regional courses in cardiology intervention. She often gets invited to lecture at
international meetings.
Dr Lim and her sister are the only set of twins to graduate from NUS School of Medicine (1995) and she was the only female
interventional cardiologist in Singapore for 17 years. Her favourite pastimes are jogging and travelling.
SMA News is looking for
writers to contribute!
If you have a burning desire about a certain topic,
or an intense passion for something you have to get
out, send your thoughts to news@sma.org.sg and
let them be seen by the world!
JUN 2020 SMA News 05
FEATURE
A & pollo’s
rrows
Sun Tzu’s
Stratagem
Text by Dr Gan Wee Hoe | Photos by SingHealth and SGH
The culprit causing COVID-19 has been This is an infection where the fallout Another epochal event was the 1918
described as a “very smart virus [that] will – in terms of mortality, socio-economic influenza pandemic. It started at the tail
find ways to remain in the human pop- consequences and the profound impact end of World War I (WWI), when the four
ulation”.1 An infected patient recounted on the way of living as we know it – is years of war prior had already resulted
how battling the disease was akin to of monumental proportions. By many in insufferable hardship and depletion
“running a marathon on the bed”.2 accounts, we may only be at the end of of resources.
These are just two of the many the beginning.
The H1N1 virus infected one-third
crippling accounts of COVID-19 that of the world’s population and was
have emerged since the tentacles of this Pandemics in human history associated with at least 50 million
pandemic first surfaced at the turn of The bubonic plague in the 14th century deaths. The epidemiological observation
the decade. wiped out almost a third of Europe’s of the high mortality in the 20- to
On 31 December 2019, the Wuhan population. Caused by Yersinia pestis 40-year-old age group (apart from the
Municipal Health Commission reported and spread by infected fleas carried by young and the elderly) was surprising
to the World Health Organization (WHO) rodents to humans, the disease was so to many. During WWI, the US had joined
China Country Office on a cluster of pneu- contagious that it has been described to aid the Allies’ eventual victory against
monia cases occurring in the capital city by the Italian poet Giovanni Boccaccio Germany. Of the US fatalities on the war
of Hubei province. Subsequent reports that “the mere touching of the clothes front, half were due to influenza and not
suggest that the first case could be traced appeared to itself to communicate the attributed to direct enemy action.6
back to as early as 17 November 2019.3 malady to the toucher”.4 Ironically, WWI also shaped the social
Much has been postulated, re- Ships were sailing into ports with attitudes among the citizenry in many
searched and written about COVID-19. crew either severely ill or dead. To countries, who were by then used to
At the time of writing, global case count stem the spread of infection, officials restrictions in their daily lives. This,
has crossed the five-million mark with kept sailors in isolation on their ships together with the advent of science
the infection claiming more than 331,000 for 30 days (trentino), which was later and technology propelled by the war,
lives. As countries gradually ease lock- lengthened to 40 days (quarantino).5 ensured equanimity and acceptance as
down restrictions, reports of second and This public health concept has proven its public health measures were applied on
third waves are already surfacing. effectiveness even up to the present day. a large scale.
06 JUN 2020 SMA News
Rain of Apollo’s arrows The Art of War by Sun Tzu is one of of large-scale swab and serological
the most well-known guides on military testing to ascertain their COVID-19
Even with humankind’s experience
warfare. A general from the 5th century BC, status, and the setting up of community
with past pandemics, it remains almost
Sun Tzu has been widely acknowledged as care and recovery facilities to allow the
unfathomable how a contagion such as
a master strategist. The Art of War is said to recuperation of those infected.
a virus, measured only in nanometres,
have shaped Mao Zedong’s thinking and One may question the political
has thrown the order of life of almost the Chinese communists’ actions against
everyone topsy-turvy. wisdom of the State taking the lead
the Japanese.9 at great cost, given that the majority
With COVID-19, WFH and HBL (which of migrant workers come under the
stands for work from home and home- The art of war is of vital importance
to the State. It is a matter of life and employment of private companies.
based learning, respectively) are now
instantly recognisable acronyms with death, a road either to safety or to ruin. The political will for Singapore to take
thematic associations with Singapore’s The contemporaneous application these extraordinary measures is because
circuit breaker measures. Global losses of Sun Tzu’s teaching on battle first and foremost, it is the right thing to
are estimated at up to USD 8.8 trillion7 preparation is to recognise that political do. Migrant workers have contributed to
(SGD 12.5 trillion) and economic considerations, policy decisions and our nation building and development.
ground actions are inextricably linked Until recently, they belonged to a
repercussions have become a leitmotif
and deterministic to success or failure. segment of the workforce in Singapore’s
of a COVID-19 Black Swan event.
society that was not often talked about.
In modern day Singapore and much Singapore has long relied on migrant
workers for infrastructure building and Our Government is also keenly
of the developed world, our usually very
other essential services. Today, we have aware of the policy consideration
low mortality rates from communicable
about 200,000 of them housed in 43 that without addressing the problem
diseases threw the hard truth of
purpose-built dormitories, 95,000 in 1,200 of infection in the migrant worker
COVID-19 deaths into sharp relief. The
factory-converted dormitories, 20,000 population, we cannot win the war
five countries with the highest number against COVID-19. Many of them work
of fatalities are all in North America and in construction temporary quarters and
85,000 in Housing and Development in the community and share the same
Europe, with the US leading the pack. It social and recreational spaces as fellow
is a surreal situation. Board flats and other private residential
premises across the country.10 Singaporeans. The position statement
Apollo, a god in the ancient Greek that Singapore has “a responsibility to
pantheon, shot arrows of plague at the While much has been debated on our migrant workers”12 dictated the
Greek army for nine continuous days whether we can afford to reduce our decisive actions that unfolded over the
because King Agamemnon captured dependence on migrant workers, last couple of months.
and refused to release the daughter of what is clear and present today is the
disproportionate impact of COVID-19 In many aspects, the “dormitory
Chryses, who was Apollo’s priest. operation” is not only a whole-of-
on this group of residents in Singapore.
Some scholars in Greek mythology Since the first cases were diagnosed in Government endeavour, but a whole-
have drawn a link between plagues migrant workers in early February 2020, of-society effort. Ultimately, Singapore
and leadership. King Agememnon’s dormitory residents now (as at 24 May is aware that we can overcome our
ill-considered decision resulted in 2020) account for 29,363 of 31,616 cases current public health crisis only if our
devastating losses in his army. It was of COVID-19 infections in Singapore.11 migrant workers, too, win the fight
said that “…he [King Agememnon] rages against COVID-19.
Close, communal living and the
with baneful mind, and knows not at all
pattern of life are probably significant If you know the enemy and know
to look both before and after…”. 8 The yourself, you need not fear the result
factors in disease propagation. There
ability to understand cause and effect of a hundred battles.
are countries facing the same issues
unpins the ability for effective prevention, which compartmentalise them away and
preparation and prosecution of an Shortly after their report of atypical
choose to do nothing, but Singapore is pneumonia cases to the WHO China
operation. This is manifestly projected in one of the few governments in the world
the management of a public health crisis. Country Office, Chinese scientists
which has arguably done the most to isolated and fully sequenced the virus in
contain COVID-19 in migrant workers. early January 2020. The gene sequencing
Sun Tzu’s stratagem
Additional housing arrangements data was submitted to Virological.org,
Most people will agree that handling were onboarded to de-densify living a forum for analysis and interpretation
a public health crisis is akin to waging quarters. Significant resources were of virus molecular evolution and
a war against an invisible enemy. deployed from the public and private epidemiology. This early access was
Strategies and tactics therefore need to healthcare sectors to ensure timely pivotal in allowing scientists around the
be employed, overlaid by political will access to healthcare for every migrant world to kickstart research in diagnostics
and underpinned by unity of the people. worker. These also include the conduct and therapeutics.
JUN 2020 SMA News 07
from COVID-19 can be
avoided if there were
timely access to intensive
care resources to support
those with severe disease
through their most critical
periods of illness.
Hospitals have
concurrently been ramping
2
1
up their intensive care
capacities. Refresher
training for healthcare
workers with previous experience in
WHO also activated its R&D scientists from the National University critical care has been conducted to
Blueprint soon after. The Blueprint of Singapore’s School of Public Health scale up more teams. Ventilators, other
improves coordination among has enabled us to better understand the life support equipment and medications
scientists, clinicians and public health transmission dynamics and apply the are stockpiled to enable hospitals to
professionals in research priorities right interventional strategies. go into surge capacity when infections
and the development of public health To leverage our strengths and exploit peak nationally.
response standards – absolutely vital as the enemy’s vulnerabilities is a time- To date, Singapore’s fatality rate
the world comes to grips with a highly tested stratagem that applies to both from COVID-19 stands at 0.1%, among
infectious novel pathogen. conventional warfare and the non- the lowest in the world. In comparison,
It is estimated that from January to conventional battleground, such as the countries such as the UK, Italy and
April, more than 23,000 scientific papers COVID-19 pandemic. Belgium have fatality rates in excess
on COVID-19 have been published of 13%.16
The good fighters of old first put
at a doubling time of 20 days!13 This
themselves beyond the possibility Even for our migrant worker
is an astounding pace that left many
of defeat, and then waited for an population, generally of the young-
“drowning in COVID-19 papers”.
opportunity of defeating the enemy. to-middle age groups and largely free
While Singapore may be a small nation, of serious chronic diseases, additional
Merely five months into the pandemic,
we punch above our weight and are an we are still a distance away from measures have been put in place
undisputed powerhouse for translational developing an effective cure or vaccine. to reduce morbidity and prevent
research in biomedical sciences. While the “enemy” is holding the mortality. They are equipped with
From the early days of the pandemic, higher ground, one should bid for time, health monitoring devices, such as
our hospitals and research agencies minimise unnecessary confrontations thermometers and pulse oximeters;
actively participated in multi-centre and losses, and await the right they also have round-the-clock access
clinical trials on different modalities of opportunity for a decisive strike. to medical care, including after-hours
COVID-19 treatment. We also made major telemedicine services.
Primary prevention has been the
breakthroughs in developing the first- mainstay of public health strategy In the absence of effective
in-the-world rapid COVID-19 detection against COVID-19. Whether it is safe therapeutics or vaccines, COVID-19
system employing the surrogate virus distancing, the wearing of masks or remains a significant threat to public
neutralisation test,14 and using serological the practice of hand hygiene, these health. We need to buy time for scientists
testing to establish a link between two measures seek to minimise infections in to do their work. Before we reach there,
local COVID-19 clusters.15 the general populace, especially those the preventive strategy is the best we
from the vulnerable groups. have in our limited armamentarium.
In foreign worker accommodation,
the pattern of disease spread differs Flattening the curve is what we seek
depending on local ecological, to achieve epidemiologically, which will
Concluding thoughts
environmental and social factors translate into lower peaks of infected A Gallup poll of the most important
specific to each dormitory. Working cases that could otherwise overwhelm events in the 20th century featured,
with infectious disease modelling our healthcare system. Many fatalities among others, the World Wars and Neil
08 JUN 2020 SMA News
Armstrong’s 1969 historic landing on
the moon.17 Pandemics did not make Dr Gan is Head and Senior References
Consultant, Department of
it to the list. COVID-19 may just be the 1. Tan A. Covid-19 caused by a ‘smart virus’ that
Occupational and Environmental
historic event to tilt the equation. can find blind spots, crucial for system to be
Medicine at the Singapore General
flexible to overcome challenges: experts. Available
The auntie from the nasi padang Hospital. He was seconded to the at: https://bit.ly/3d161H3.
Ministry of Health (MOH) from April
store which I frequent predicted that 2. Lee LY. ‘Running a marathon on the bed’:
to June 2020 and served as the MOH
it would take “at least three years” for policy member in the interagency COVID-19 survivors describe their struggles with the
Singapore’s economy to turnaround to task force to manage and contain coronavirus. Available at: https://bit.ly/3d7IS5L.
the pre-COVID-19 state. A friend, who is the spread of COVID-19 in foreign 3. Ma J. Coronavirus: China’s first confirmed
a freelance sports coach, has not been worker dormitories. The opinions in COVID-19 case traced back to November 17.
working since the shutters came down this paper are those of the author’s Available at: https://bit.ly/2LZNTkO.
and do not reflect the positions or
on sports halls throughout the country. views of MOH or SingHealth. 4. Mark JJ. Boccaccio on the black death: Text and
commentary. Available at: https://bit.ly/2LXx9Lg.
Yet, there are positives out of this.
COVID-19 has accelerated revolutionary 5. History.com Editors. Black death. Available at:
https://bit.ly/2X2gf4l.
disruptive technology. My neighbour,
a lawyer, shared with me how he has 6. Billings M. The influenza pandemic of 1918.
Available at: https://stanford.io/2TEzfE8
adapted to working from home using
different platforms for teleconferences 7. Asian Development Bank. COVID-19 economic
impact could reach $8.8 trillion globally – new
and virtual meetings. Instead of meaning
ADB report. Available at: https://bit.ly/36ydmeJ.
to go speedily, “Zoom” has taken on a
whole new dimension. 8. Homer. The Iliad. Available at: https://bit.
ly/2M2nEKE.
We need to get ahead of the curve in Legend 9. Kuiper K. Sunzi: Chinese strategist. Available at:
order to secure order back to our lives. 1. Providing primary care medical services to https://bit.ly/2Xz3hu4.
Sure, there will be new norms to adapt migrant workers at their place of residence
10. Ng JS, Ong J. The Big Read: Solving Singapore’s
to. Old habits like queuing for bak kwa 2. SingHealth deployed medical and dental foreign workers problem requires serious soul
at People’s Park will have to change. teams to swab migrant workers in dormitories searching, from top to bottom. Available at:
to ascertain their COVID-19 status
Employment landscapes will evolve. https://bit.ly/2XsfsJ2.
However, what is immutable is the 3. Donning personal protective equipment
11. Ministry of Health, Singapore. 24 May 2020
(PPE) before commencing clinical duties
resilience of the human spirit and our daily report on COVID-19. Available at: https://bit.
4. Extracorporeal membrane oxygenation ly/2ZDIAzB.
fortitude in the face of adversity. simulation training with full PPE
12. Ministry of Manpower. Ministerial statement
We will overcome.
by Mrs Josephine Teo, Minister for Manpower.
Available at: https://bit.ly/3c5Yzcq.
Information is accurate as at time of writing. 4 13. Brainard J. Scientists are drowning in COVID-19
papers. Can new tools keep them afloat? Available
at: https://bit.ly/36wbZgC.
14. Duke-NUS Medical School. Duke-NUS,
3 GenScript and A*STAR launch first-in-the-world
SARS-CoV-2 serology test to detect neutralising
antibodies without need of containment facility or
specimen. Available at: https://nus.edu/2LXFOx8.
15. Channel NewsAsia. Duke-NUS used COVID-19
antibody tests to establish link between church
clusters in a world-first. Available at: https://bit.
ly/3c7cbUC.
16. Rajendran S. Singapore’s COVID-19 death rate
low, but seniors vulnerable. Available at: https://
bit.ly/2ZEQoRL.
17. Newport F, Moore DW, Saad L. The most
important events of the century from the
viewpoint of the people. Available at: https://bit.
ly/36v0XbA.
JUN 2020 SMA News 09
PRESIDENT’S FORUM
Adjustments and
Adaptability Text by Dr Tan Yia Swam
First, I want to say a warm hello to of contacts? How is the rest of the world coronavirus-related articles free for all
our youngest colleagues – the newly doing? Are the new clusters of infections to access!
graduated doctors who are now in the in China and South Korea under control? Social updates: using the social
workforce. Some of you have reached One thing that I can now fully media of our choice, we can keep in
out to me personally in the past months appreciate is the fact that history touch with friends and families, and even
to share your hopes and dreams for the repeats itself. We can look back at past make new friends! Home bakers flourish
future, as well as your concerns during pandemics,1,2 and learn from them. and MasterChefs are born!
this COVID-19 pandemic. The clinical behaviour of the virus may Entertainment: Youtube, or TikTok for
I hope that you are settling into your be different, but the human reactions those who like to perform.
work. Housemanship isn’t easy at the best are predictably the same. Heck, even
of times. With COVID-19 hanging over our watching zombie and apocalypse Work: Zoom, Microsoft Teams and
heads, this poses an additional challenge. movies will give you pretty much the Cisco Webex – for meetings, presentations
Some of you would have received a same spectrum of reactions! and conferences. Home-based learning
forwarded message from one of the was the bane of many parents working
Perhaps COVID-19 is a wake-up call from home, but it did allow for the
doctors who was a houseman during for the whole world.3,4 Are humans
SARS. I hope that you derived some children to continue with lesson plans.
overpopulating the world? We need to
comfort and inspiration from seniors be better custodians of the earth. We Online shopping, food and grocery
who went through a similar challenge. need to respect animals, their living deliveries: there are so many new players
These are uncertain times for spaces and their boundaries. People in the market with better deals and better
everyone and it can be very stressful need to give each other space. We need services. Even hawkers are using social
having to face so many unknowns and to live in the present moment. I hope media to reach out to customers.
potential dangers. But I can assure you that everyone here has found some kind Contact tracing: apps and QR
that you are not alone. Together, we can of inner peace during the circuit breaker codes allow for more efficient, accurate
overcome this. – with introspection – and picked up contact tracing.
some form of mental resilience. We may
Telemedicine (TM) is something that
Uncertainties also have learnt how to make do, and to
has been talked about for a few years,
be thankful for what we have.
Having been in the Editorial Board for but I don’t think there is widespread use
more than a decade, and being the of it, as yet. Guidelines are in place and
SMA News Editor for five years, I have Positive aspects in 2020 many providers exist – yet some of us are
always felt that the challenge of SMA This is as good a time as any for a very hesitant. I see the pros and cons of it,
News is that we are not able to have real- pandemic; I don’t mean this frivolously. and while I see the great potential, I am
time updates. I am now penning this in The Internet has allowed the world to be wary of the pitfalls as well. The SMA TM
early May, for the June issue! Like many connected in a way never seen before. Workgroup hopes to bridge the gap, to
of you, I have so many questions about I grew up in the 90s, and I remember ensure that TM is utilised appropriately.
the future. I don’t have answers – but I what life was like before the Internet. I
have read many good articles by others choose to look at the positive aspects Leadership
that may help to shed some light. of technological advances in helping us
Leadership in healthcare, businesses
I’m postulating that, by the time you cope amid COVID-19.
and politics:5 Thanks to social media,
are reading this, Singapore should have Daily news updates: the challenge there is a lot more transparency and
lifted the circuit breaker on 1 June, and is knowing how to differentiate reliable accountability. Journalists and bloggers
perhaps we will be seeing the effects of sources from tabloids or fake news. critique leadership everywhere, and these
it. Have the numbers of new infections Gov.sg gives daily abbreviated updates, articles are made available to any reader.
gone up? Have we identified the sources while key medical journals have made Anyone can comment, and those of us
10 JUN 2020 SMA Newswho read such posts see the potential community – your family and your staff
References
toxic effects of “keyboard warriors” or look to you for guidance.
“trolls”. Free speech online may seem like 1. History.com Editors. Pandemics that changed
history. Available at: https://bit.ly/2WNb2x6.
a basic right, but the anonymity allows The future
for cowards and bullies – those who do 2. Centers for Disease Control and Prevention. Past
Finding meaning in the new world:7 pandemics. Available at: https://bit.ly/2zfcIGI.
not take any personal responsibility, and
Everyone would have suffered some
relish in the attention and resulting chaos 3. Cafaro P. A lesson from the COVID-19 pandemic
kind of loss. Those families who have on the perils of density. Available at: https://bit.
– to be at their worst.
lost a loved one to COVID-19 and its ly/2Zkkaex.
In SMA News, the Editorial Board takes complications. Patients who may be 4. Hamwey R. Environmental impacts of
great efforts to curate the articles written living with the sequelae of this illness. coronavirus crisis, challenges ahead. Available at:
to try and reflect accurately what is Healthcare workers who continue to face https://bit.ly/2AO1pG4.
happening on the ground. We are glad daily stress when looking after infected 5. D’Auria G, De Smet A. Leadership in a crisis:
that many doctors have been sharing patients. Business owners who are Responding to the coronavirus outbreak and
meaningful reflections on work, and trying to keep their businesses running. future challenges. Available at: https://mck.
personal anecdotes on how COVID-19 co/2zSgm9A.
Workers who have been retrenched.
has affected their practices and personal People who are struggling to make ends 6. Gates B. Responding to COVID-19 – a once-in-
lives. We stay true to our core mission – meet. The lost months – of work, income, a-century pandemic? Available at: https://bit.
to have an SMA for doctors, for patients. ly/3bRF9Yu.
time and relationships – we will never
get back. 7. Berinato S. That discomfort you’re feeling is grief.
Healthcare and technology:6 The Available at: https://bit.ly/36gES0a
advances are remarkable. Sequencing Experts have been sharing their
of the viral genome by various groups opinions about how long-lasting
is happening at a speed never before COVID-19 may be, and are urging world Dr Tan is a mother to three kids,
possible, and the free sharing of wife to a surgeon; a daughter and
leaders to rethink the way we run our
a daughter-in-law. She trained as
scientific knowledge has allowed daily lives. I hope for the best, but am a general surgeon, and entered
scientists and doctors to be even more prepared for the worst. How will this private practice a year ago, focusing
effective in understanding this illness. affect my practice and my patients? on breast surgery. She treasures
The unscientific mind would criticise this How do I look after my children and my her friends and wishes to have
as, “how come you all still don’t know more time for her diverse interests:
elderly parents and in-laws? How do I
anything”. The fact is, the explanation is cooking, eating, music, drawing,
keep in touch with friends? writing, photography and comedy.
just too complex to share in a few lines.
Doctors should keep up to date with In the coming months, each and every
the scientific literature and not just be one of us has to rethink and redefine our
reading popular news articles for their role in society, and find meaning in what
knowledge. Critical analysis and thinking we do.
remains our key weapon. Speculation “We are in the same storm, but not in
and extrapolations just confuse every- the same boat.” But together, we will ride
one. Every doctor is a leader in our out the storm.
Illustration: Dr Justinian Zaicouncil news
From the Honorary Secretary
Report by Dr Ng Chew Lip
Dr Ng is an ENT consultant in public service.
Government indemnity coverage for healthcare
After a day of doctoring and cajoling his workers deployed to WOG COVID-19 efforts
two princesses at home to finish their food,
his idea of relaxation is watching a Netflix SMA is glad that the Ministry of Health (MOH) has clarified,
serial with his lovely wife and occasionally via an advisory on 26 April 2020, to the extent not covered
throwing some paint on a canvas.
by any existing insurance, indemnity or compensation
schemes, the Government of the Republic of Singapore will
indemnify anything done or omitted to be done in good
faith and with reasonable care by all medical practitioners
and healthcare workers, in the discharge or purported
discharge of their functions and duties in relation to
Whole-of-Government (WOG) efforts to prevent and
reduce the spread of COVID-19. Members are reminded
that in any incident, you must notify both your indemnity
provider and MOH.
SMA Secretariat Office – operations from 19
June 2020 onwards SMA wrote to MOH to request a Point of Contact (POC)
from which doctors can obtain urgent advice and notify
Despite the reopening of more workplaces in Phase 2, details of incidents to. We have been informed that the first
the Multi-Ministry Taskforce has reiterated that safe POC should be the Healthcare Institution (eg, public sector
management measures and telecommuting must remain cluster) that deployed you. The Institution will assist in
the default for all businesses. The SMA Secretariat Office investigating and managing incidents, as well as informing
will thus remain closed until further notice. the Institution’s indemnity providers and MOH. We are
also advised that for any other queries, you may email
Nonetheless, the Secretariat will continue to provide the moh_qsm@moh.gov.sg.
more essential membership services, as it has been during
the circuit breaker.
For general enquiries, you can contact us at: https:// Childcare arrangements for healthcare workers
www.sma.org.sg/general/contactus.aspx. Members can
also call our main line at 6223 1264 or the staff’s direct line. Many doctors’ care arrangements for their children
were disrupted by schools/pre-schools closures and
Professional indemnity
the disallowing of children from being dropped off at
PS: 800 616 7055 (toll-free) / mps@sma.org.sg
M grandparents’ homes announced on 10 April 2020. SMA
Income MMI: 6223 1264 / sma@sma.org.sg formally wrote to the Multi-Ministry Taskforce on COVID-19
JLT Medefend Scheme: 6411 9002 / website: http://www. to express our concerns and propose arrangements for the
medefend.com.sg Taskforce’s consideration.
Membership matters SMA was heartened that the Taskforce subsequently
granted exemptions to parents who are essential service
E mail membership@sma.org.sg, or call the following workers or healthcare professionals to continue to tap on
numbers grandparents for childcare support on a daily basis. Cases
New sign ups, renewals and Medik Awas: 6540 9193 eligible for exemptions include:
Clinic assistant courses, update of personal information
and other general queries: 6540 9194 • Both parents are essential service workers and are
unable to work from home;
SMJ • One parent is a healthcare professional (eg, doctor,
Email smj@sma.org.sg nurse, allied health professional, support care staff ) and
is unable to work from home;
SMA News
• One parent is an essential service worker who is unable
Email news@sma.org.sg, or call 6540 9181 to work from home, and has a child/children below the
For the latest updates, please visit https://www.sma.org.sg. age of three.
12 JUN 2020 SMA NewsTimeline of Events
council news
Government releases in Singapore sma’s actions
February 2020
03 February
03 February • Published SMA e-News on COVID-19 (formerly 2019-nCoV)
• Ministerial statement on Whole-of-Government response
to 2019-nCoV 12 February
• Visitor Resource Pamphlet
07 February • Guides on using telemedicine during an outbreak
• DORSCON level raised to Orange
13 February
08 February • SMA initiated the #sgartforhcw to encourage our
• Advisory on large-scale events healthcare workers
13 February 21 February
• Support for healthcare workers whose leave and holiday • SMJ calls for COVID-19 papers with fast-track review
plans have been cancelled and publication to enable timely dissemination of
important information
March 2020
25 March
10 March
• Update on Whole-of-Government response to COVID-19
• SMA collated and shared resources for psychological support
by Mr Gan Kim Yong
and wellness for doctors and other healthcare workers
31 March
13 March
• Time-limited extension of CHAS chronic subsidy and
• “Bring Your Own Bottle” Hand Sanitiser Distribution Exercise
MediSave to video consultation
April 2020
01 April
• Exclusive food & beverage promotions for healthcare workers
07 April
03 April • In line with circuit breaker, SMA closes physical office
• Announcement of circuit breaker but continues to provide support and services for
10 April Members remotely
• Changes to childcare arrangements during circuit breaker 10 April
21 April • SMA writes to Multi-Ministry Taskforce on childcare
• Circuit breaker extension and tighter measures arrangements for healthcare workers
13 April
• SMA writes to SMC to suggest fine-tuning measures for
CME requirements
May 2020
05 May
• SMA aids in distributing donated face shields to PHPC,
SASH, ILI and private clinics
13 May
22 May
• SMA clarifies with MOH and our three preferred indemnity
• End of circuit breaker phased approach to resuming
partners regarding coverage for doctors volunteering
healthcare services
during the COVID-19 pandemic
15 May
• SMA’s survey on impact of COVID-19 on doctors in the
private sector
JUN 2020 SMA News 13OPINION
Preparing For COVID-19 has been a greatest leveller
of society. Dr Chew has learnt to be
grateful for the simple things in life.
Covid-19
While he does not take bubble tea,
he is excited with the re-opening of
McDonalds. He is also very proud
of all the enormous sacrifices many
healthcare workers have contributed in
this war. He wishes everyone well and
to stay safe.
Pandemic
Perspectives and Lessons Learnt from the Surgical Department
Text and photos by Adj A/Prof Chew Min Hoe
14 JUN 2020 SMA NewsIntroduction some of the key components in the disease behaviour was and what
the initial phase were focused on measures were needed for the safety
COVID-19 originated in late
managing the individual surgeons. of staff. As collective analysis of the
December 2019, from Wuhan in
data was done by all members, there
Hubei province, China, and has
since rapidly spread throughout Task force creation was better understanding of the
situation, and the corollary effect was
the planet, resulting in the World A department task force (TF) was the
that confidence was disseminated
Health Organization declaring it an first important conceptualisation
among our staff members as well.
international pandemic on created. While many departments
Having confidence was vital for staff
11 March 2020. At the time of relied entirely on the head of
attendance and workforce unity
writing this article, over 509,164 department (HOD) to organise and
despite the fears of the disease. This
people had been infected worldwide implement measures enforced by the
effect is still present today. More
with 23,335 deaths (case fatality-rate hospital administration, there were
importantly, a business continuity
4.6%).1 Currently, there are more several benefits in having a TF.
plan (BCP) within the department
than 4,000,000 confirmed cases with
Information gathering and could be organised effectively to
over 280,000 deaths (case fatality
confidence building ensure that work could continue
rate 6.9%).2, 3
even if a staff member was to be
Singapore confirmed its first case In the SARS-CoV 2003 era, information quarantined or infected, with 100%
of COVID-19 on 23 January 2020,4 and was mainly disseminated through confidence among all staff that
local transmission was subsequently traditional newspaper print and
everyone was unified in response.
reported on 4 February 2020. The broadcast media such as radio and
Disease Outbreak Response System television mediums. Medical infor- Messaging and communication
Condition alert level was raised to mation was also only available via
The TF consisted of staff across ranks.
Orange on 7 February 2020. When this hardcopy journals and thus reporting
Messaging and communication
article was prepared in March, the pace new advances was slow with a time-
within the TF was bi-directional
of disease was slow and the milestone lag bias, with a limited reach among
rather than a pure top-down
of 1,000 infections was crossed more medical personnel due to access
approach. Measures implemented
than two months after, with majority issues. In the year 2020, the presence
had been discussed with the junior
due to importations. The epidemic’s of social media and internet availa-
staff, with feedback sought and
bility on all smart devices meant that
trajectory, however, surged thereafter opinions heard, and changed where
everyone would be receiving informa-
with outbreaks noted in foreign worker necessary. This was important, but
tion at the same time. Online medical
(FW) dormitories. At the time of managed within a tight bandwidth
journals also ensured that quality
writing, there are 23,787 local to avoid laborious and prolonged
information from high impact journals
COVID-19 cases.5 discussions with delayed conclusions.
were quickly and readily available.
Surgical safety has fallen under the In the department, discussions
An unpleasant consequence were efficiently conducted and
spotlight as the pandemic has shifted
however, was that this information conclusions made within 45 to 60
epicentres from China to Europe and
was also available to the general mins. The HOD reserved the right to
the US. Surgeons are called upon
public. As noted from worldwide make the final decision even against
to cancel elective procedures with
universal panicked hoarding of food popular opinion and consensus, and
a focus on maintaining emergency
and sanitation essentials by the the TF understood that some of the
operations and elective cancer
public with graphic imagery of long decisions were made with different
surgeries, with additional precautions
queues and fights in supermarkets, it considerations in mind.
needed for surgical staff.6-8
is apparent that fear of the unknown
The surgical department at Moreover, hospital operational
and self-preserving behaviour could
Sengkang General Hospital (SKH) instructions were rapidly evolving
rapidly degenerate into chaos. For
developed disease outbreak response as the intensity of disease outbreak
healthcare workers, reports of death
measures in coordination with of doctors and a high number of progressed. Timely and clear
hospital administration, the operating healthcare workers (3.8%, n=1,716 dissemination of information to
theatre management unit (OTMU), of 44,672)9 getting infected in the department was important to
nursing staff and other surgical China also initially sowed doubts avoid confusion or misinterpretation
departments. The aims were to ensure and uncertainty. YouTube videos of of instructions. In messaging and
that all staff were ready to perform overwhelmed hospital staff, family communication to the entire
surgery on any positive or suspected separations and tearful workers went department, there were several
COVID-19 cases, to reduce risk of viral and were shared repeatedly, principles adopted:
nosocomial infection for the surgical leading to a sense of dread and • All critical information was
teams and to ensure continuity of impending doom. disseminated via the HOD;
care for all surgical patients. The TF creation was thus • Information disseminated
While the hospital measures were instrumental in sieving much of the included explanation of the
being discussed and implemented, data available, determining what current international and national
JUN 2020 SMA News 15status to give context for the frequency identification tags to
hospital measures; track movement within the hospital
• Regular briefings were conducted setting. This would simplify contact
at a paced fashion (once every tracing if there were staff exposure
two weeks) to avoid information to COVID-19 patients. Staff were
fatigue. Frequency would be reminded to carry tags while on duty,
increased to weekly as the disease and those who developed a fever or
outbreak severity worsened; respiratory symptoms were screened
and advised to only seek medical
• Briefings were conducted to all consultation within the hospital staff
staff regardless of rank; clinic. Travel advisories and leave
• TF members would reinforce policies were adhered to strictly.
information and clarify directives
to ensure compliance after Staff preparation
briefing; and 1
PPE and PAPR training
• 360 degrees feedback was sought
from all ranks to ensure all concerns A hospital-wide mask fitting and
and blind spots were addressed. refresher of personal protective
of the virus beyond the OR. A unique
equipment (PPE) donning and
COVID-19 workflow and protocol
Discipline doffing was conducted by staff from
was designed by the OTMU team.
Infection Control. Refresher training
The best measures planned would A FDR was first conducted by the
for the use and maintenance of the
be irrelevant if staff attitudes did HOD, and two cases on real patients
powered air-purifying respirator
not view these measures seriously. It with consent – an elective surgical
(PAPR) by educators from the
was crucial for the senior staff in the procedure and endoscopy – were
Department of Occupational and
department to lead by example. Prior used to confirm the workflow. All
Environmental Medicine was also
experience in the SARS 2003 outbreak members of the surgical team then
provided to all staff. In our institution,
lent weight to the seriousness of this did a physical walkthrough of the
all healthcare workers were mask
outbreak and none of the measures isolation OR to ensure familiarity of
fitted with the PAPR CleanSpace®
were criticised by the senior staff. surroundings as surgery on infectious
HALO™ (CleanSpace Technology Pty
Ensuring senior staff compliance to cases are not routinely performed.
Ltd, Artarmon, NSW, Australia). All
measures, refraining from spreading FDRs were subsequently conducted
surgeons and junior staff completed
rumours and abiding with the by every consultant and associate
training within one week.
leadership of the department were
consultant over the following two to
key to a successful implementation. Full dress rehearsals (FDR) three weeks to reinforce workflows
The seniors would also supervise
SKH has a purposeful built operating and ensure familiarity.
juniors, provide feedback if needed,
and monitor staff health and welfare. room (OR) with a negative pressure
In this phase, it was also department environment designated as an BCP
policy that any positive or suspected isolation OR. This is in contrast to the
standard OR with positive pressure Staff segregation
COVID-19 cases would only be
reviewed and procedures performed relative to the surrounding air. The These were done on two tiers. At the
isolation OR reduces dissemination first tier, senior staff were advised
by senior staff.
on segregation between the tertiary
Department discipline also
hospital (Singapore General Hospital)
involved compliance with hospital
2 and our hospital. This was to reduce
measures of temperature monitoring
cross infection between hospitals
and all staff were reminded to do
and also ensured that there was no
so twice daily by administrative
confusion in adhering to institution
staff. Oral digital thermometers
workflows, policies and guidelines.
were issued to all staff and there
Surgical procedures that had been
were also easily accessible digital
forehead thermometers within pre-booked were allowed to proceed
department offices. All temperatures but non-essential clinic services were
were electronically recorded and suspended or transferred over to the
entered into a hospital server; tertiary hospital specialists for follow-
web-based forms were created up care.
to facilitate ease of entry using For the second tier, the department
personal smartphones. The hospital developed a “hot” and “cold” team
had also issued individual radio- concept. The risk assessment matrix
16 JUN 2020 SMA Newsdetermined that inpatients were replace the duties (ie, hot team A Conclusion
the highest risk. Thus, the hot team replaced by cold team A). The hot
The COVID-19 pandemic battle
was designated to handle all acute team would then undergo risk
affects all healthcare workers. There
admissions and to perform ward matrix assessment as per hospital
are multiple considerations in how
rounds on elective patients that were policy, and be quarantined and
a surgical unit functions and the
post-surgery. The cold team was undergo testing till given clearance
phases of planning will require hard
assigned to the specialist outpatient by hospital administration to decisions, strong leadership and
clinics. There were two subsets return to active duty. decisive communication. It is prudent
(team A and team B) of hot teams In addition, all large-scale meetings to maintain a robust BCP to ensure
that handled the emergency roster. were cancelled and department that surgical patients receive quality
These include the comprehensive education programmes, such as care especially during this difficult
coverage of acute admission, trauma, mortality rounds, tumour boards and time, and to reduce any compromise
bleeder and endoscopic retrograde journal clubs, were to be confined in care as best as possible.
cholangiopancreatography. It was within the hot or cold teams. All
also decided that a seven-day hot medical students, foreign fellow
and seven-day cold format would attachments and observerships were Information is accurate as of time of
be implemented with overall team also cancelled. writing
swapping after each seven-day
cycle. There were several planning Reduction in elective work Legend
rationales to this: Elective work is defined as elective 1. Elbow bump and thumbs up. Individuals,
• All surgical staff had undergone surgeries, elective endoscopies and departments, whole of Singapore prepared
the necessary PPE training and outpatient specialist clinics. There for COVID-19 war!
were expected to have minimal were several planning considerations 2. Step by step visual aids to remind
breaches that needed quarantine. to determine the extent of reduction donning and doffing protocols. In PPE and
stress, such reminders are important to
• There was a need for manpower in elective work: avoid mistakes and contamination
to be deployed to high need areas • Based on our initial hot/cold
in the event there was a spike of team divisions, there would be a References
cases (eg, ICU or the emergency reduction of manpower.
1. World Health Organization. WHO
department). • There was a need to anticipate a Coronavirus Situation Report 67. Available at:
• A 14-day cycle was felt to possible increase in admissions https://bit.ly/2z4TZ0g.
potentially lead to fatigue and from COVID-19 cases requiring 2. World Health Organization. WHO
burnout, which could lead to PPE ward, high dependency or ICU beds. Coronavirus Situation Report 112. Available at:
https://bit.ly/3bowQ6y.
breaches. Hence a seven-day work For elective surgery, all cancer
cycle was preferred. 3. Johns Hopkins University. COVID-19
cases and any benign cases that Dashboard by the Center for Systems Science
• In the event a hot team subset was were symptomatic or had justifiable and Engineering (CSSE) at Johns Hopkins
exposed and needed quarantine, indications were to proceed. Clinic and University (JHU). Available at: https://bit.
the cold team subset would endoscopy cases were also reduced. ly/2K5jLDM.
4. Abdullah Z, Salamat H. Singapore confirms
first case of Wuhan virus. Available at: https://
bit.ly/3ajfsQ9.
Preparation 5. Ministry of Health Singapore. Situation
report 11th May. Available at https://bit.
ly/35Sa7hN.
6. Pryor A. SAGES and EAES recommendations
regarding surgical response to COVID-19 cases.
Available at: https://bit.ly/2wGZlhh.
Task Force Staff Business 7. American College of Gastroenterology.
Creation Preparation Continuity Plan COVID-19 clinical insights for our community of
gastroenterologists and gastroenterology care
providers. Available at: https://bit.ly/2VyAsg5.
1. Information 1. PPE and PAPR 1. Staff segregation 8. Royal College of Surgeons. Guidance for
gathering and training 2. Reduction in surgeons working during the COVID-19
confidence pandemic. Available at: https://bit.ly/3epnji1.
2. Full dress elective work
building rehearsals 9. Wu Z, McGoogan JM. Characteristics of and
important lessons from the coronavirus disease
2. Messaging and 2019 (COVID-19) outbreak in China: summary
communication of a report of 72 314 cases from the Chinese
3. Discipline Center for Disease Control and Prevention.
JAMA 2020; 323(13):1239-42.
JUN 2020 SMA News 17OPINION
Keeping the
Mobile Phone
CHARGED
During a Blackout
Text by Dr Christopher Cheok
Dr Cheok is a senior
consultant with the
Maybe it was just me, but I was fairly that lions and tigers were infected in a
Department of Forensic positive at the start of the circuit New York zoo. When was all this going
Psychiatry in the Institute of breaker (CB). At that time, SARS-CoV-2 to end? We all need to take a deep
Mental Health. He is also the was just thought to cause a respiratory breath, collect our thoughts and look
President of the Singapore illness and little else. Then came the at the sky.
Psychiatric Association and
community CB and continued bad
Chairman of Clarity Singapore, Doctors, like everyone else, have
a mental health charity news – the virus could cause an auto-
immune reaction in children, affect been impacted in some way by the
providing psychotherapy.
the brain, emerge through different coronavirus, the extent of which
fluids below the navel from our bodies, depended on the place of practice.
and the last straw came when the New Junior doctors were redeployed to
England Journal of Medicine published roles they did not choose, specialists
a letter reporting that the virus could were redeployed to emergency
transmit between domestic cats and rooms to help screen patients and
18 JUN 2020 SMA Newsprivate practitioners were affected expenses of the business and source there are lots of other good things
by the CB. One of the things that hit for PPE, and he was getting really happening in the world. Spending
us, but was not spoken much about anxious about the depressed financial time to watch videos on cute animals,
was the impact of the reduced social markets. Although still able to work, nature or just non-COVID-19 news can
interaction between friends and he had no choice in the matter, so be very therapeutic. For those who
colleagues, and also how strange he felt more irritable, on edge and have significant depressed mood,
people sounded with voices muffled without peace of mind. He wanted to irritability, anxiety or insomnia, the
by their masks. Luckily for Singapore, know what he could do about it as his SMA and Singapore Psychiatric
the number of deaths from COVID-19 wine collection was disappearing at a Association (SPA) have collaborated
has been relatively low and personal faster rate than usual. to organise a list of our mental health
protective equipment (PPE) has been There are many ways to keep our colleagues who are willing to help
available to healthcare workers, spirits up for the long COVID-19 run doctors and self-help resources. The
which reduced the risk of burnout and different strategies may work list can be found on their respective
from having to worry about being for different people. One of the most websites.
infected while making tough choices effective ways is to call someone While we await the end of the
for patients. Doctors who have gone to chat and keep the chat positive. pandemic, as doctors, we need to
through our training and selection Exercise is also important, but in acknowledge our own humanness
are a resilient bunch. The Achilles reality not for everyone, though and attend to our physical as well
heel is our sense of responsibility to anyone can walk in a park. Acts of as psychological needs. While
the patient and need for control of a kindness bring hope to others and uncertainty is the new normal, what
situation. The coronavirus disrupted many have been moved by well is certain is we can choose to care for
that order. To keep performing at our wishes, small tokens of appreciation, ourselves and those around us. And
best in this marathon COVID-19 fight, and food. When one can find quiet when self-care is not enough, we have
we really need to pay attention to our time, focusing on our spirituality is family, friends and colleagues that we
mental health and resilience. essential. While some have drunk can turn to, who can care for us.
No one knew better about being more alcohol, others have snacked
lit on two ends of the candle than more – moderating snacking and
Alice* who called me the other day. drinking is part of self-care. While the *Names used in the article have been
As a resident in training with primary news is inundated with COVID-19, changed
school-aged children, she had to cope
with seeing patients in the day and
powering up again when she got
home to help her young kids with Mental health support for our HCWs
home-based learning. She candidly Consolidated below are some resources healthcare workers can tap on during the
admitted to me that screaming did COVID-19 pandemic for psychological wellness and support.
happen from time to time, and that
she sometimes just answered the Taking care of my mental health
https://bit.ly/3csawt0
questions for the kids so she could (courtesy of Woodlands Health Campus)
get to sleep on time. She felt fatigued
Burnout infographics
yet could not stop worrying about https://bit.ly/2Xod33d
(courtesy of Woodlands Health Campus)
whether she brought any bugs home
from work and whether her kids were Mental health tips
keeping up with their education. It (courtesy of Tan Tock Seng Hospital Staff https://bit.wly/2Koj9cI
did not help that after two weeks of Support Staff Programme)
this punishing routine, she started
waking up at 3 am before falling List of psychiatrists/counsellors who can
asleep again at 5 am to catch some see doctors either for informal support or https://bit.ly/3dqtMsi
more sleep before work. Another medical consultation
ex-colleague, Ronald*, also messaged List of psychologists and workshops relating
me on the pretext of asking for advice https://bit.ly/2AvYcL0
to COVID-19:
for a patient. He had opened his
general practice two years ago and National Care Hotline 1800-202-6868
business has dropped significantly
during CB. He had to grapple with the To find out more about the resources and
https://www.sma.org.sg/covid19
support available
JUN 2020 SMA News 19You can also read
