This study examined the feasibility of screening all patients with respiratory symptoms for COVID-19.
Between Feb 5-March 18, 2020, researchers from Singapore General Hospital (SGH) introduced a “respiratory surveillance ward” (RSW) to segregate all patients with respiratory symptoms in designated areas, where appropriate personal protective equipment (PPE) could be utilized. Patients were transferred when COVID-19 tests were negative on 2 consecutive occasions, 24 hours apart.
Over the 6-week study period, 1178 patients were admitted to the RSWs. The mean length-of-stay (LOS) was 1.89 days (S.D=1.23). Among confirmed cases of pneumonia admitted to the RSW, 1.61% (5/310) of patients tested positive for COVID-19. A total of 126 HCWs were potentially exposed to these cases; however, only 3 HCWs (2.38%, 3/126) required quarantine as the majority used appropriate PPE. A total of 13 inpatients overlapped with the index cases during their stay in the RSW; of the 13 exposed inpatients, 1 patient subsequently developed COVID-19 post-exposure.
No patient-HCW transmission was detected despite intensive surveillance.
The authors conclude that, although resource-intensive in terms of testing and bed capacity, RSWs can successfully contain patients with COVID-19 in designated areas where enhanced PPE and infrastructural enhancements could potentially reduce nosocomial transmission.