Singapore is a densely populated island-state. During the COVID-19 pandemic, large-scale institutional isolation units were implemented in the country, known as Community Care Facilities (CCFs), to combat the community’s outbreak by housing low-risk COVID-19 patients from April to August 2020. This article shares the experience of operating these massive-scale isolation facilities while prioritizing safety for all and ensuring holistic patient care in the face of a public health crisis. A team of administrators operated CCFExpo, involving pharmacists, 26 doctors, and 72 allied health staff (affectionately called “angels”).
Although several patients were considered low risk, those chosen for admission to CCFExpo generally were young and had no severe symptoms, no medical severe comorbid conditions, typical vital signs, and a NEWS score of 4 or less. Chest radiography was performed in all patients older than 35 years. Patients were evaluated by a team of angels for severe medical comorbid conditions and abnormal vital signs. Two medical consultation rooms were staffed by physicians daily and a hotline created to answer any urgent queries from patients.
Patients who required further investigations were transferred to a general hospital via an ambulance explicitly dedicated to patients with COVID-19. Under MOH authority, patients were discharged from all isolation facilities after day 21 of illness. The start of illness was determined by the date of onset of the first symptoms or, for asymptomatic patients, the first positive swab test result. Most of the patients stayed at CCFExpo for around two weeks, after which they were discharged to other step-down facilities to complete the remaining isolation period.