ICU bed occupancy rises to 53% amid 'exponential rise' in COVID-19 cases

SINGAPORE: Bed occupancy in the intensive care units (ICU) of public hospitals has risen from 26 per cent to 53 per cent over the last three months, said Senior Minister of State for Health Janil Puthucheary in Parliament on Monday (Oct 4).

It is one of the ways in which the recent "exponential rise" in COVID-19 cases has impacted Singapore’s healthcare capacities, he said.

Singapore has seen more than 2,000 daily infections in recent days, with the daily caseload reaching a record 2,909 cases on Friday.

Along with the rise in cases, more COVID-19 patients have been admitted in hospital. As of noon on Sunday, 1,337 COVID-19 cases were warded in hospital, with 250 cases requiring oxygen supplementation, and 35 in critical condition in the ICU.

STRAIN ON HEALTHCARE CAPACITIES

Dr Puthucheary noted that overall, about 15 per cent of hospital beds in acute public hospitals are used for around 10 per cent of all COVID-19 cases.

Those requiring oxygen supplementation or ICU care make up 2 per cent of total cases – most of whom are unvaccinated or elderly.

Apart from ICU occupancy rates, the occupancy of isolation beds has also increased from 58 per cent to 86 per cent in the last three months.

In community care facilities (CCF), bed occupancy has more than tripled from 10 per cent to 35 per cent, he said.

“Public hospital emergency departments have seen up to an eight-fold increase in the number of patients with ART (antigen rapid test) or PCR (polymerase chain reaction) positive results seeking medical attention,” noted Dr Puthucheary.

He added that prior to the past two weeks, authorities took a maximum of 12 hours from the time of a positive PCR test to take COVID-19 patients aged above 70 years old to the hospital.

But with the current high case load, the average time taken has gone up to 48 to 72 hours.

WHAT AUTHORITIES ARE DOING

Since Singapore Civil Defence Force ambulances are reserved for patients with emergency conditions, the Health Ministry has set up a dedicated fleet of 95 more ambulances to take COVID-19 patients to different healthcare facilities, he said.

As for ICU cases, Dr Puthucheary noted that authorities are “closely monitoring” trends.

In addition, hospitals have added 74 ICU beds, increasing capacity to a total of 187 beds for COVID-19 patients with severe conditions.

“More ICU beds can be opened at short notice, if needed,” he said.

Dr Puthucheary added that the manpower situation in hospitals is also being closely monitored, given that close to 400 healthcare workers have been infected.

“Our hospitals will continue to dynamically cross-deploy their resources to ensure that manpower needs are met.

"We are also working with private healthcare providers to augment our manpower.”

To preserve healthcare capacity in case there are future waves of infections, more sustainable health protocols are also needed – which is why home recovery has been made the default protocol for many, he said.

Responding to a question by MP Xie Yao Quan (PAP- Jurong) on how many beds would be set aside for COVID-19 "in a new equilibrium of elevated daily case numbers", Dr Puthucheary said such a strategy may no longer be feasible in future.

He noted that bed space is currently separated to isolate COVID-19 patients from the rest of the healthcare facilities. But when COVID-19 becomes endemic, it will have to be treated like any other infectious disease, he said.

"In an endemic situation, we don't have influenza beds or dengue beds or chicken pox beds."

"What we have is beds on the basis of patient needs, and increasingly the COVID-19 patients in hospital will have other types of needs.

"They will have kidney problems and heart problems and neurological problems, so it's a bit hard to then delineate in a steady state - once we're done with the surge and these current strategies."