Singapore could add more hospital beds amid overcapacity woes, concerns about possible Covid-19 surge

Singapore is seeking to pre-emptively boost its number of public hospital beds in the next few years, as an expected Covid-19 surge in the coming Lunar New Year adds to overcapacity woes and other challenges that have recently gripped emergency departments.

Health Minister Ong Ye Kung said on top of the goal of adding 1,900 beds over the next five years, there were short-term strategies to alleviate the stress on hospitals, such as activating more transitional care facilities and for hospitals to move away from reserving beds for Covid-19 patients.

With most of the population fully vaccinated or having already recovered from the virus, Ong said in a speech in parliament on Tuesday that the country now had "good levels of hybrid immunity against severe illnesses" and hence should consider allowing hospitals the flexibility to optimise the use of beds during a crunch situation.

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However, he stressed that the pandemic was "certainly not over for our hospitals and healthcare workers".

"Why are the hospitals still experiencing heavy workload given that life has gone back to pre-Covid? The simple and fundamental reason is that the pandemic is not over," he said.

Some hospitals were also overwhelmed with patients seeking treatment for other viruses, Ong added.

"The emergency department (at KK Women's and Children's Hospital) has been experiencing very high [numbers of] visits every day at levels that they used to experience only during Chinese New Year when all other clinics are closed," Ong said. "So come Chinese New Year, I don't know what kind of numbers they are going to get."

He said this was due to an "immunity debt" in children, who were shielded from viruses due to safe management measures such as mask wearing, but many were contracting Covid-19 and other infections now that life had returned to normal.

Ong urged citizens to "do our part" to ease the burden on the healthcare system, after local media reports highlighted the long waiting time for admission to wards at certain hospitals. A high number of patients at public emergency departments across the country last month meant some waited for as long as 50 hours to be warded.

While attendances at emergency departments had fallen, Ong called for Singaporeans to "exercise social responsibility" and use alternatives such as visiting a general practitioner clinic or family doctors instead of heading to the emergency department.

The median waiting time for admission to wards from emergency departments was between one and 21.7 hours for the week of October 23, according to official data.

Ong said there was a need to diagnose "where exactly is the operational bottleneck" and "[match] the demand and supply of hospital beds", adding that the demand for hospital beds had dropped since 2019, from an average of 75,000 emergency department attendances per month to 63,000 this year.

However, there was an increase in the number of patients with serious medical conditions from 8 per cent in 2019 to 11 per cent this year, which added to "the operational burden of hospitals", he said.

Construction disruptions due to the pandemic have also caused delays in the establishment of healthcare facilities, such as the Woodlands Health Campus and the Integrated Care Hub at Tan Tock Seng Hospital, which would have added 100 beds to the system.

"Whether due to demand or supply factors, we need to recognise this - that is we run a very high throughput hospital system and in such a system, even a small mismatch of demand and supply, a couple of hundred beds, will cause waiting times to spike very significantly," Ong said.

He likened the situation to an expressway with a heavy flow of traffic. "All you need is one branch to fall on one lane or half a lane and you have a massive traffic jam."

This article originally appeared on the South China Morning Post (SCMP).

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