Singapore

How Jurong West nursing home prevented Covid-19 cluster after 2 residents got infected


SINGAPORE – When nurse manager Teo Ai Lian learnt that a resident had contracted Covid-19 on Sept 1 in the Jurong West nursing home she works in, she felt sad.

“Everyone was worried because our residents are elderly and vulnerable. There is also disappointment that despite the many measures we put in, Covid-19 still crept into our nursing home,” she said.

But the news also injected urgency to ring-fence cases and avoid a cluster at the premises.

Over the next few weeks, Ms Teo, 39, and her team at NTUC Health (Jurong West) Nursing Home tested all the residents. They tended to anxious seniors in divided zones while keeping concerned relatives updated after visits were suspended.

The home has about 180 staff and 250 residents at present.

The staff also tried their best to boost residents’ spirits with simple gestures.

“We gave out sugar-free mooncakes, set up a vanity corner so residents could dress up or put on some nail polish, and volunteers brought radios for the residents to listen to music. Moving freely within their zones helped the residents feel occupied,” said Ms Teo.

On Sept 5, four days after 92-year-old Mr Kwai was detected as the first Covid-19 case, another resident, Mr Tan, 86, who was from the same ward, tested positive.

Both have been identified by their last name to protect their identity.

Mr Tan was isolated and swab tests were stepped up at the nursing home, with daily antigen rapid tests (ART) conducted for the residents.

Behind the scenes, the staff relied on one another and their families for support.

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Ms Teo said: “Most of the staff have to put in extra hours and some of the staff took on 12-hour shifts. As nurses, we are very mindful of practising safe distancing and monitoring our own health.

“It’s a challenging situation for everyone, particularly foreign nurses who have not seen their loved ones for a long time.”

A mother of four boys aged 5 to 13, Ms Teo said her husband helped to supervise home-based learning for the children while she was working.

“There are times when I have to work through the weekends, and my family was mindful that we do not go out in the community too often and risk being infected,” she added.

After nearly a month of heightened precautions, the nursing home reported no new cases.

Mr Tan was discharged from the hospital on Sept 22 and welcomed back at the facility. “We had a celebration with our residents at the end of our surveillance period and when Mr Tan returned to the nursing home.

“Mr Tan’s son called us and said even though he could not visit his father, he was thankful for our constant updates and glad his father was in our care. That was a heartwarming moment for us,” she said.

Mr Kwai was discharged from the hospital on Oct 8.

While staff and residents are relieved that they were able to prevent a Covid-19 cluster, the daily number of cases in the community is a grim reminder that the risk of further transmission persists in nursing homes.

Dr Goh Siew Hor, head of clinical services at NTUC Health, said the five nursing homes it runs continue to engage residents and their relatives, and encourage seniors to opt for two doses of the vaccine or a booster shot.

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Going forward, he noted that it is prudent for nursing homes to continue practising infection control measures, even as the Republic heads towards a Covid-19 endemic road map.

He said: “While we try our best to prevent our cases from coming into the nursing homes, we know that it could happen. We hope that the preparations that we have made will help us to identify cases early, contain them and minimise the impact on the residents.”

Fight against Covid-19 in nursing homes

Nursing homes have adopted several measures including dividing premises into distinct zones for staff and residents to safeguard senior residents. This comes as Covid-19 cases continue to rise in the community.

On Oct 12, the Ministry of Health (MOH) reported 99 total cases at United Medicare Centre in Toa Payoh involving 85 residents, 13 staff and a household member of a case.

Cases were reported at a number of nursing homes last month including Man Fatt Lam Elderly Joy Day Centre in Bedok, Windsor Convalescent Home in Pasir Panjang and Woodlands Care Home in Woodlands.

To detect cases early and prevent clusters, the nursing homes began testing all residents for Covid-19 from Sept 27.

While residents diagnosed with the infection are mostly taken to hospitals, the Agency for Integrated Care (AIC) said suitable residents may be admitted to the MOH’s community treatment facilities. The latter provide “more comprehensive medical coverage than nursing homes, and can manage seniors who are stable or have mild symptoms”.

The Government has been working closely with nursing homes to facilitate vaccination. Inoculations are carried out by either the home’s nursing team or mobile vaccination teams.

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AIC urged all unvaccinated residents to take the jab as soon as possible as they are among the most vulnerable, and the vaccine can increase their protection against severe illness.

On Oct 5, MOH extended a suspension on visits to nursing homes till Oct 24. It was previously set to be lifted on Oct 11.

The delay seeks to buy more time for seniors to get vaccinated or receive booster shots.





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