In April 2021, unlinked cases of COVID-19 were reported in Singapore. This came after many months of zero to one or two community cases a day. When healthcare workers were reported positive and a hospital closed temporarily to contain the spread, it became clear that enhanced measures were needed to reduce the risk of COVID-19 spread in public healthcare institutions. With guidance from Singapore’s Ministry of Health, the National Cancer Centre Singapore (NCCS) started proactive surveillance testing on all NCCS staff in May 2021.
As healthcare staff, I too was swabbed as part of surveillance testing. I recall as I walked up the hill to NCCS from Outram MRT station that I was sweating and nervous. My mind was preoccupied with worries – would it hurt? What if I was COVID-19 positive?
Proactive surveillance testing
At the time of publication, proactive surveillance testing using Polymerase Chain Reaction (PCR) swab is being conducted at NCCS.
All healthcare staff must do a one-time PCR swab including those who work in non-patient fronting areas, from home or off-site. Those with direct patient contact, including those who staff operating theatres, inpatient wards, outpatient clinics, etc., will subsequently be swabbed every 7 to 14 days as part of rostered routine testing.
Staff who are away for more than two weeks including those on annual leave, medical, hospitalisation and maternity leave, must be swabbed before commencing work.
Some might ask, why routinely swab when more than 90% of NCCS staff are fully vaccinated?
“Our previous assessment was that the risk of infection was mitigated as NCCS staff are trained in infection control and the proper usage of personal protective equipment (PPE). They had also been prioritised for COVID-19 vaccination,” said Dr Yap Swee Peng, NCCS’ Chairperson of the Infection Prevention and Control Committee.
“However, recent events show that we may be contending with a variant with higher transmissibility. So we cannot assume that COVID-19 will not spread even with stringent measures in place.”
The one-time swab establishes the first point of assessment, which ensures that no staff is infected and incubating the virus. Continuous surveillance through routine rostered testing then helps to detect potential asymptomatic infections amongst healthcare workers, enables early intervention, and prevents any cluster from forming.
The key goal of proactive surveillance testing is to preserve hospital healthcare capacity so that NCCS can continue to provide care for patients.
Post-swab reflections
I walked down the hill from NCCS to Outram MRT station, with a slightly runny nose and feeling a bit foolish. Turns out my anxiety was for nothing. A very kind, and completely unidentifiable colleague in full PPE, had taken less than 10 seconds to swab me and it was completely painless. The very next day, I logged into Health Hub to retrieve my swab test results. To my relief, the test result was negative.
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