This cross-sectional study evaluated the effectiveness of a staff protection and surveillance strategy in Tan Tock Seng Hospital (TTSH), a 1600-bed multidisciplinary acute-care hospital in Singapore.

Since 2003, TTSH has routinely fit-tested staff for high filtration N95 respirators, and established web-based staff surveillance systems. These routine systems were enhanced in response to Singapore’s first imported COVID-19 case on January 23,2020. Specifically, the hospital adopted a multi-pronged approach to protect and monitor staff with potential COVID-19 exposures: (1) Risk-based personal protective equipment, (2) Staff fever and sickness surveillance, and (3) Enhanced medical surveillance of unwell staff.

In order to evaluate these effectiveness of these systems, the authors examined outcomes among healthcare workers from January 23,2020 to February 23,2020. As of February 23,2020, TTSH has managed 76% of confirmed COVID-19 cases in Singapore.

During this timeframe, there were 10,583 staff were placed on hospital-wide fever and sickness surveillance, with 1,524 frontline staff working in COVID-19 areas under close surveillance. Among frontline staff, a median of 8 staff illness episodes was seen per day, and almost 10% (n=29) resulted in hospitalization. None of the staff was found to be infected with COVID-19.