Singapore Physiotherapy Association - Advisory for the Private Physiotherapy Sector (Version 3)
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Singapore
Physiotherapy
Association
Advisory for the
Private Physiotherapy Sector
(Version 3)
1ABOUT THE UPDATED ADVISORY (Version 2)
This updated advisory from the Singapore Physiotherapy Association, was adapted from the
MOH circular 32/2020, 39/2020, information for Primary Care Doctors (22nd Jan), the
Agency for Integrated Care (AIC) advisory to ILTC sector (6th Feb), information from the
Singapore government’s website (www.gov.sg), with addition of:
(i) AIC-MOH circular to community care partners (15th Feb),
(ii) MOH circular 54/2020 and 56/2020 on the revision of suspect case definition
(23rd Feb and 24th Feb)
(iii) MOH circular 60/2020 (27th Feb) and 62/2020 (3rd Mar)
(iv) MOH circular 76/2020 Revision of suspect case definition (10th Mar)
We have consulted prior to the writing of this Advisory, the Ministry of Health Chief Allied
Health Officer’s Office (CAHOO), with sensing performed amongst the physiotherapy private
practitioners.
This advisory aims to provide a guideline for private practitioners, as to the steps to take
during this period of DORSCON ORANGE, in response to the COVID-19 situation.
Along with this advisory, MOH circular 60/2020, 62/2020 and 76/2020, will be attached for
your reference.
Singapore Physiotherapy Association
First version, 16th Feb 2020
Second version, 24th Feb 2020
Third version, 10th Mar 2020
2SPA ADVISORY for the Private Physiotherapy Sector
On the COVID-19 situation
DEFINITIONS
• Suspect patient (as of MOH Circular 76/2020):
a) A person with clinical signs and symptoms suggestive of pneumonia or severe respiratory infection
with breathlessness AND who within 14 days before onset of illness had travelled abroad (i.e. to any
country outside of Singapore).
b) A person with an acute respiratory illness of any degree of severity who, within 14 days before onset
of illness had:
i. Been to any of the areas requiring heightened vigilance1 as listed on the Healthcare
Professionals Portal: https://www.moh.gov.sg/hpp/all-healthcare-professionals; OR
ii. Been to any hospital abroad; OR
iii. Close contact2 with a case of COVID-19 infection.
**Please note that: Transit only in an airport located in mainland China is not considered as having travelled
to mainland China.
1 Refers to affected areas with high disease load or high connectivity to Singapore. As of 9 March 2020,
these are: Mainland China, Republic of Korea, Italy, Iran, France, Germany, Spain, Japan and the United
Kingdom. Please check the Healthcare Professionals Portal regularly for updates.
2 Close contact is defined as:
• Anyone who provided care for the patient, including a health care worker or family member, or
who had other similarly close physical contact;
• Anyone who stayed (e.g. household members) at the same place as a confirmed person;
• Anyone who had close (i.e. less than 2m) and prolonged contact (30 min or more) with a
confirmed person (e.g. shared a meal).
• Stay Home Notice (SHN) (www.gov.sg website)
An SHN commences from the day of return to Singapore. People on SHN, including healthcare
workers must remain at home at all times. They are not to leave the residence, even if it is to
purchase food and essentials. Home delivery or help from others to purchase daily necessities should
be arranged.
Contact should be minimised with others, and avoid having visitors to your residence. A record of
persons you come in close contact with should be maintained. Monitor your health closely e.g. take
your temperature twice daily, and monitor other symptoms such as cough and breathlessness.
• Quarantine order (www.gov.sg website)
An individual on a quarantine order is isolated with the aim of limiting the spread of the virus in the
community. He or she will be isolated either at home, at Government Quarantine Facilities, or at a
hospital.
A quarantine order is a directive with legal force. It has severe penalties for non-compliance.
3SPA ADVISORY for the Private Physiotherapy Sector
On the COVID-19 situation
• Private Clinics
1) Whenever possible, clinics can consider phone triaging in order to minimise entry of patients who are
unwell, into the clinic premises.
E.g. Performing phone triaging prior to clinic visit to check for both symptoms, travel history as well as
close contact history (as defined under “suspect patient” definition on page 3 of this advisory).
o If the patient mentions that he/she are unwell, advise them not to come for their physiotherapy
appointment, and to visit the general practitioner (GP).
o Patients who have travelled from other countries back to Singapore, with inbound restrictions,
need to comply with Stay-Home Notice, and should not be coming to the clinic.
o If patient asks further questions about COVID-19, suggest for them to keep updated with
accurate information on the government website www.gov.sg, or sign up for the whatsapp
https://go.gov.sg.
2) As part of infection control, clinics should routinely screen for both symptoms, travel history as well
as close contact history.
o Provide patients with respiratory symptoms with surgical masks, if they do not have.
o Suspect patients should be placed in a separate area/room closer to the clinic entrance, to
minimize exposure to others.
o Please contact MOH Surveillance Duty Officer at 98171463 (available 24-hours), if you would
receive a suspect patient.
**Please note that this number is NOT for use for general enquiries. Please do not call the number
unnecessarily as you will be potentially depriving another person’s important call to the MOH.
3) Vendors should have limited entry into your clinics. It is suggested to limit to 1 visitor per patient at
the clinic. Keep a visitor log, with name, NRIC and telephone number, to facilitate contact tracing.
4) We would strongly advise to close group exercise classes, or other modes of group teaching/classes.
5) All staff including frontline triaging staff (e.g. receptionists) and staff managing patients in clinical
areas are advised to use the surgical mask with “extended use for 6 hours” as per MOH circular
39/2020. Please change your surgical mask if it becomes soggy or soiled.
6) All staff should continue to adhere to strict personal hygiene and hand hygiene practices. Please use
your personal protection equipment (such as surgical mask), appropriately and responsibly.
7) All staff who have travelled from countries with in-bound restrictions should comply to Stay Home
Notice of 14 days. Please continue to keep updated on the outbound travel advisories as well.
8) All staff should be monitor their own temperature twice a day. If they are feeling unwell, they should
wear a mask, seek medical attention, rest at home and inform their organizations promptly.
9) Staff should limit their outpatient practice to up to 2 clinics if necessary (MOH circular 60/2020, 7d).
10) There should be frequent cleaning of equipment and premises carried out regularly with use of 70%
alcohol
o Do not spray cleaning agents as it may aerolise infective agents.
o Cleaning agent should be applied using a damp cloth, left for at least 10 minute but no longer
than 30 min, thoroughly rinsed off and the area dried.
11) As per latest consult with MOH CAHOO, if a clinic happens to receive a suspect patient, there is no
requirement currently to close down for cleaning. MOH will defer to the clinic if they want to so, in
their accord. If a staff came in contact with suspect patient, no self-quarantine is required as contact
training will be activated if it is a confirmed patient.
4SPA ADVISORY for the Private Physiotherapy Sector
On the COVID-19 situation
• Private Home Physiotherapy Providers
1) All home physiotherapy providers must perform phone triaging prior to home visit, in order to
minimise the risk of community spread through close contact.
2) Phone triaging should check for both symptoms, travel history as well as close contact history (as
defined under “suspect patient” definition on page 3 of this advisory).
o If the patient mentions that he/she are unwell, advise them to visit the general practitioner (GP).
o If patient asks further questions about COVID-19, suggest for them to keep updated with
accurate information on the government website www.gov.sg, or sign up for the whatsapp
https://go.gov.sg.
o DO NOT visit the home if either the patient and/or close contact has symptoms and/or travel
history/close contact history. Advise them to take action as above.
o If you find that the patient or a close contact in the household is a possible suspect patient,
please contact MOH Surveillance Duty Officer at 98171463 (available 24-hours).
o If you are unsure after your phone triage whether to proceed with the home visit e.g. patients
with recent or existing pneumonia or acute respiratory symptoms, please seek medical advice
from a physician for further clarification and assessment.
**Please note that this number is NOT for use for general enquiries. Please do not call the number
unnecessarily as you will be potentially depriving another person’s important call to MOH.
3) When you arrive at the home, whenever possible, please check the temperature for your patient and
any close contact in the house. Screen your patient and close contact (if present in house) for any
signs and symptoms such as:
o Fever and/or Cough, and/or Sore throat (common presenting symptoms of COVID-19 locally)
o And/or Running nose, and/or Breathlessness
4) At patient’s home, reconfirm the patient’s and close contact’s travel history and close contact history.
o If you find out that patient and/or close contact presents with symptoms, advise them to visit the
general practitioner (GP). Call the GP in advance to inform them of the situation.
o You may also contact the home medical doctor you are working with, to assess the patient
and/or caregiver/close contact.
o If you find that the patient or a close contact in the household is a possible suspect patient,
please contact MOH Surveillance Duty Officer at 98171463 (available 24-hours).
5) Surgical masks is advised for “extended use for 6 hours” as per MOH circular 39/2020. Please change
your surgical mask if it becomes soggy or soiled.
6) For chest physiotherapy, please abide to standard precautions due to risk of fluid splash. Please put
on your surgical mask, gloves, apron and visor/googles (for eye protection).
7) In addition, please use your personal protection equipment (such as surgical mask), appropriately and
responsibly. Continual adherence to strict personal hygiene and hand hygiene practices is crucial.
8) If you have travelled from countries with in-bound restrictions, please comply to Stay Home Notice of
14 days. Please continue to keep updated on the outbound travel advisories as well.
9) You should monitor your own temperature twice a day. Do not attend to patients, if you are unwell.
Wear a mask, seek medical attention if you feel unwell and rest at home.
10) There should be frequent cleaning of your equipment and environment with use of 70% alcohol.
o Do not spray cleaning agents as it may aerolise infective agents.
o Cleaning agent should be applied using a damp cloth, left for at least 10 minute but no longer
than 30 min, thoroughly rinsed off and the area dried.
5SPA ADVISORY for the Private Physiotherapy Sector
On the COVID-19 situation
• What happens if I come in contact with a patient with confirmed COVID-19?
There is a risk assessment framework that MOH uses to assess healthcare workers’ exposure to confirmed
patients, and inform follow-up actions.
The follow-up actions that need to be taken by the healthcare workers’ and/or the employer will depend on
the contact type/procedure, as well as PPE worn by the healthcare worker during the patient encounter/s.
Please refer to MOH circular 62/2020, attached for further information.
• HELPFUL RESOURCES & CONTACTS
1) MOH website for updates on COVID-19
https://www.moh.gov.sg/2019-ncov-wuhan
2) MOH website for advisories for various sectors including healthcare.
https://www.moh.gov.sg/2019-ncov-wuhan/advisories-for-various-sectors
3) MOH circular no. 39/2020
https://www.healthprofessionals.gov.sg/docs/librariesprovider11/default-document-library/moh-cir-
no-39_2020_7feb20_pte_dental_ppe-guidance.PDF
4) Gov.sg WhatsApp: Sign up with https://go.gov.sg/whatsapp.
5) List of areas requiring heightened vigilance included in suspect case definition
https://www.moh.gov.sg/hpp/all-healthcare-professionals
6) Please contact SPA at secretary@physiotherapy.org.sg, if you would require further clarifications. We
will do our best to support you.
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