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On the front line against the disease


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10, 20 years from now, we want to remember the faces behind the success of defeating COVID-19. No doubt about it, we will win the fight against the virus.

Here's a thread out of the many COVID-19 ones, to remember the people behind our success. From Doctors, Nurses, Cleaners, Social Distancing Ambassadors, SPF, SAF, SCDF, NEA, ICA, MFA ... Let's share stories about these angels.

Here's one from NCID to start.

 

Inside Singapore’s COVID-19 screening centre, on the front line against the disease

As the number of cases continues to rise, it is all hands on deck at Tan Tock Seng Hospital and the National Centre for Infectious Diseases, where doctors, nurses and other healthcare workers screen hundreds of patients daily.

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SINGAPORE: At the National Centre for Infectious Diseases (NCID) screening centre, one important part of the defence against the pandemic has been none other than ice cream.

Charmaine Manauis is hardly joking when she says that. She is the lead consultant in infectious diseases at Tan Tock Seng Hospital’s emergency department, which is in charge of the screening effort.

“Ice cream is important; it makes us happy. You see everyone — they have ice cream, they perk up,” the doctor said about her colleagues, and herself.

“Plus, it’s hot inside the personal protective equipment. So they love eating ice cream (in the pantry) during their break.”

She is certainly not kidding about feeling the heat under their yellow gowns, shower caps, gloves, goggles and N95 masks, which they wear throughout their seven- to 10-hour shifts, except during breaks.

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“When I remove my yellow gown, I’m usually drenched. It’s really hot,” she said. “When I remove (my mask), then I feel as if I can breathe again.”

That is how it has been for the staff running both the TTSH emergency department and the NCID screening centre in the time of the coronavirus.

And it is not just emergency doctors who are seeing to the suspected COVID-19 cases.

While their department used to have about 20 doctors on shift at any time in the day, it has been a whole new ballgame since Chinese New Year.

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Hundreds of doctors across different specialities in the hospital — from urology to ENT (ear, nose and throat) to plastic surgery — are being mobilised for training so they can carry out COVID-19 duties too.

Since Singapore’s first confirmed case on Jan 23, more than 400 doctors from the hospital have been rostered to work at the NCID screening centre across the road.

And the one co-ordinating their training is Manauis, the senior consultant leading the screening efforts — as CNA Insider finds out in an inside look at the frontline battle against COVID-19.

GETTING WIND OF THE VIRUS ON HOLIDAY

The 42-year-old as well as her boss — Adjunct Assistant Professor Ang Hou, head of the emergency department — were on holiday in December when they first heard of a mysterious disease in Wuhan.

“I said, ‘Hm, this might be something.’ So when I came back, the department had already started screening,” recounted Manauis. “We started screening for (travellers from) Wuhan on Jan 2.”

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That was the day Singapore’s Ministry of Health (MOH) announced that it was monitoring the pneumonia outbreak closely, and sent a circular to medical practitioners here.

Whispers of the severe acute respiratory syndrome (SARS) started “floating around” TTSH. “We were SARS central back in 2003, so that’s never left the DNA of the department,” said Ang.

“You can’t help but relive memories that you’ve been through, especially when you know your colleagues and your friends had been affected very deeply.”

The possibility of a second coming did not surprise him, however. “We were always anticipating something like COVID-19 ...  We knew that it wouldn’t be a matter of if, but when,” he said.

“We knew that by the time it were to come from Wuhan to Singapore, it would’ve been ... a significant outbreak in the world or at least in this part of the region.”

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The department started screening for the novel coronavirus (SARS-CoV-2) in a “very small, dedicated space”.

But even “way before” Singapore’s Disease Outbreak Response System Condition alert was raised to orange, the number of people coming every day “was growing to a scale that we had to move out of (that) physical space”, he added.

As the rest of the country wound down for Chinese New Year, furniture had to be moved in, and computers set up, for the NCID screening centre to be activated.

“It was a very busy Chinese New Year for a lot of people, not because we were going around celebrating but because we were preparing for the next phase in screening,” said Ang.

By Jan 29, the screening centre was up and running round the clock.

FROM SCREENING CENTRE TO TENT

Those first few weeks of the centre’s operations were “really hectic” for Manauis.

“We were on call 24/7. Every Saturday, we’d train (staff). During the week, we’d look at protocols — we’d look at whether our processes were working well, whether we had to manage any choke points in the screening centre,” she recounted.

One of those choke points were the X-ray rooms. “If the screening centre was full, then there’d be a queue for X-rays. And so we’d need more efficiency, more radiographers,” she said.

Based on the travel history and the chest X-ray results, the doctors had to decide whether the patients had to be warded or could be discharged.

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For those who needed admission, those were uncertain times. They had many questions. “How long will I stay? What tests will they be doing for me upstairs? How about my family? Do they need to be admitted too?” cited Manauis.

The numbers coming for screening kept rising until the load “became quite difficult at one point”, said Ang.

That came about when the MOH changed the definition of a suspect case, following the transmission of the coronavirus at a health products shop visited by Chinese tourists.

“That led to a lot of patients being referred by their doctors for screening because they’d come into close and frequent contact with travellers from China,” said Ang.

“A lot of people in various industries came in, whether they were taxi drivers, tour bus drivers, people who worked in tourist attractions or hotels, airports and casinos. They were all flooding in.”

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So, after consulting the ministry, TTSH proceeded to swab and discharge these patients, “to conserve beds for patients who were really ill and needed treatment”.

Then there was “a strange point in time”, when the number of people coming for screening and the cases confirmed as positive slowed down, even as the numbers were picking up in the rest of the world.

“We knew that the numbers would go up sooner or later,” said Ang.

“We knew that the screening centre might not be able to cope ... so we made the decision together with the ministry to set up a tentage, to expand the number of places available.”

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That ended up being the case. On March 23, the TTSH team screened the highest number of people until now: More than 520. “We call it the most terrible Monday,” said Manauis.

“The patients came in the afternoon and at night. And at night, we have less manpower. We had to open the tentage until 3am, with a lot of patients having to wait a little bit longer. So that was a struggle.”

MIGRANT WORKERS A NEW CHALLENGE

There are still hundreds of patients screened daily, although the challenge as of late is not the numbers but the space needed, as the spike has been among migrant workers, and the tent outside the screening centre is “perennially full”.

“For these foreign workers, we need to wait for swab results before they can be discharged (if they test negative). So we need a bigger waiting area for them,” said Manauis.

“After that, they have to wait for transport also, to bring them back to their dorms. So they can wait for as long as, probably, 18 (to) 20 hours.”

WATCH: An exclusive look inside the NCID screening centre (Dur 5:20)

While there are now Swab Isolation Facilities like the CherryLoft chalets — where the workers can be sent after their nose swabs — these facilities “are quite full” nowadays, she added. The workers are otherwise unable to self-isolate.

"Every day, we’d have to ask whether there’s any vacancy, and then they still need to wait for an ambulance or dedicated transport."

While there is swabbing done at the dormitories now, some of the workers need to go to the screening centre depending on their symptoms.

If they complain of chest pain or have difficulty breathing, for example, then they need an X-ray, a blood test or an electrocardiogram.

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As long as they are symptomatic or have had close contact with a positive case of COVID-19, they should be swabbed.

An MOH circular sent on Thursday has also updated the swabbing criteria for everyone. Anosmia — the loss of the sense of smell, either total or partial — is now one of the symptoms to look out for, cited Manauis.

“There were (research) papers that came out, and there were positive cases which presented only with anosmia,” she explained.

The other symptoms still include fever, runny nose, cough, sore throat and gastrointestinal symptoms like diarrhoea or vomiting.

Since she started on TTSH’s clinical protocols and work instructions for COVID-19 screening and infection controls, Manauis has developed 61 versions for the staff to follow.

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There is also a workflow for the foreign workers from dormitories, which is at version 17 now.

IN FOR THE LONG HAUL

She has also trained nine batches of doctors from various departments, with as many as 51 physicians in a batch.

They work a 10-day cycle as part of a group of more than 100 people, including nurses and other healthcare workers, running the screening centre.

Most of them, even senior specialists, are volunteers, and some have done more than one rotation, although each department is also supposed to contribute a certain amount of manpower.

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“Screening is very different from what they do every day. So it wasn’t a surprise that they were a little bit apprehensive. But they were very willing to help out,” said Manauis.

She is grateful for all the support. At one of the training sessions this month, she told the doctors: “We really need your help on the front line. On behalf of the emergency department, I thank you guys for volunteering.”

The thing is, her department is not only working at the screening centre, but also attending to the usual emergency cases. To do this, the staff have cancelled their leave and reduced their days off.

“You just have to do your work. I go day by day — whatever needs to be done, needs to be done,” she said with a shrug.

“Everyone’s made sacrifices, not only me or not only the doctors ... But we do this willingly because we know that this is our job.”

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The emergency cases are tended to in a different zone, although that does not mean the staff necessarily get to dispense with personal protective equipment. The forward screening triage nurses, for example, must wear the full equipment.

“Sometimes walk-in patients ... are close contacts (of a COVID-19 case), so we have to protect our frontline staff,” said Manauis.

To protect the patients as well, one of the changes made is to ensure that they queue at least two metres apart. This, and many of the current arrangements in the emergency department, could be in place for some time.

“For those of us who’ve been here for a while, who’ve gone through other outbreaks, we know that, potentially, it’s going to be long-drawn,” said Ang.

“It could affect some of our own members — that the memories of SARS come back — and I think it might hit those (employees) a little bit harder.”

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When asked on Friday about her team’s morale, Manauis, who has been with TTSH for 15 years, gave a cheerful reply.

“We’ll try our best to ... help the nation, especially now that (the number) of positive cases has been increasing,” she said.

“We’re still okay. We still have ice cream, so we’re happy. I mean, you’ll need to try and pace yourself because we know that this is going to stay for a few more months.”

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https://www.channelnewsasia.com/news/cnainsider/inside-singapore-covid-19-screening-centre-defence-disease-ncid-12656312?cid=fbcna&fbclid=IwAR2aRtq_Z2MAo0V4ZhWSMMaT9GnvC_-dupS3ZWBKls8QOzPkW7931n7Pa0M

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National University Health System - NUHS - OPERATION DORMITORIES 

Since early April, our clinicians, nurses, allied health professionals, administrative and ancillary staff, have started providing medical support and swabbing for COVID-19 in dormitories as part of a national effort to care for our foreign workers.

Our teams from NUHS - comprising National University Hospital, Ng Teng Fong General Hospital, Alexandra Hospital, National University Polyclinics, National University Centre for Oral Health, Singapore and our Regional Health System Office - have been planning, collaborating and stepping up training to support the Dorm operations in the West.

In anticipation of an increasing number of COVID-19 cases in the dormitories, we are heartened by the encouraging response that we received when we rallied for more staff volunteers to sustain these medical and mobile swabbing operations in spite of the need to manage the challenging situation in our Hospitals and Polyclinics.

Apart from playing an active role to contain the outbreaks, our healthcare colleagues are out in full force to reassure our foreign workers that we are standing by them in their time of need as they play an important role in building Singapore.

NUHS will continue to care for our workers.

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TTSH

Our staff have been on the frontline caring for patients within the NCID wards for the past few months, but the fight against COVID-19 is far from over. With cases on the rise in recent days, there is a need to ramp up our response to stay ahead of the situation.

Over the Good Friday weekend, our staff worked hard to make a few of our general wards and ICU at the main hospital COVID-ready. More beds, equipment and manpower have also been mobilised as part of the preparation to support any surge from NCID. Efforts included infrastructure retrofitting, manpower redeployment, workflow refinement, and orientation drills to ensure that we are prepped and ready.

Please help stem the spread of the virus: stay home, wear a mask when going out for essential errands, and practise safe distancing. While we stand ready here to care for those who need it, we are the last line of defence – you are the first.

 

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It is #BusinessAsUnusual for our Community Health Teams (CHT). As the #COVID19 situation evolves, so have their roles.

On a normal day, our CHTs care for patients within their communities through home visits, health programmes, and alongside partners. Over the past two weeks, our CHTs – nurses, doctors, medical social workers and operational support colleagues – have swapped their usual blue polos for the distinctive yellow PPE to support COVID-19 testing at Lee Ah Mooi Old Age Home, so that these vulnerable elderly could be treated as quickly as possible. They have also been training fellow nurses from Homage, Home Nursing Foundation and Jaga-Me Home Care to help carry out swab tests for the community where necessary.

The elderly remain the most vulnerable in this time of COVID-19. We call on all of you to play your part – stay home so that the older members of our community stay safe. We are #StrongerTogether

 

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A message from Singapore's frontliners in the fight against COVID-19: #StayHome, stay healthy.

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Conceptualised by Dr Valerie Tay, Consultant at our ENT clinic, she was one of the “conductors” to bring together 70 healthcare workers across Singapore to sing the heart-warming song, ‘Home' – a reminder that we are not alone in this fight against COVID-19. Thank you PM Lee Hsien Loong for sharing this effort.

As we commemorate World Health Day today, let's stay home, stay safe and united in solidarity. This is Home, truly.

#SGUnited #StrongerTogether

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We are moved by the echoes of the applause and know that we are not alone in the fight against #COVID19. #StayHomeStaySafe

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Tan Tock Seng Hospital (TTSH)

 

Our Emergency Department (ED) is our first line of response to outbreaks. When screening numbers for COVID-19 exceeded the capacity at TTSH ED, we activated the Screening Centre at NCID in late January. What was scheduled to take 3 days to be up took just 24 hours, complete with equipment, supplies, furniture and trained manpower.

Operated by our ED team and supported by the doctors and nurses from various specialties and colleagues from across the hospital, our 24/7 Screening Centre screens hundreds of patients daily.

With cases increasing globally, we constantly plan ahead for contingencies. Today, we have enhanced our capacity at the Screening Centre to allow us sufficient flexibility and buffer to manage any surge in attendance.

To all our colleagues who are tirelessly manning and supporting the Screening Centre, so that we stay ahead of the evolving situation quickly and continue to deliver care in full confidence, we thank you.

#StrongerTogether #COVID19 #HealthcareHeroes

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Tan Tock Seng Hospital (TTSH)

Our Department of Laboratory Medicine operates 24/7 round the clock every day to ensure rapid turnaround of COVID-19 testing. Their tireless work of testing and sending accurate and prompt results is crucial in providing timely care for confirmed cases and reducing anxiety amongst suspect patients. With 500 to 700 samples coming in for testing daily from TTSH, NCID and other institutions, we've had to train additional staff in running the COVID-19 tests, which involve numerous steps. While some services have been reduced to ramp up our support for NCID, our lab work still continues for tests such as Haematology, Biochemistry, Microbiology, Blood Transfusion, MERS, or Avian Flu. Even with this workload, our lab is scaling up through process re-design in anticipation of processing more COVID-19 tests in our fight against the virus.

Another team crucial in our battle is our Intensive Care Unit. They've been working their hearts out making critical decisions and care interventions to save a more vulnerable group of patients severely impacted by the virus while ensuring that more critical care is readily available with the evolving situation.

We are encouraged to have Minister for Health Mr Gan Kim Yong this morning at our Laboratories and Intensive Care Units, to thank our staff for their dedication and to listen to their needs. Thank you Minister for reminding us that we are #StrongerTogether.

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Our ambulance crew transport suspected COVID-19 patients for checks at hospitals. After each trip, they decontaminate the ambulance to reduce risk of transmission and virus spread. On stand-by, 24/7.

It’s hard work. Long hours in protective gear to maintain strict infection control discipline. I met our ambulance crew at Tan Tock Seng Hospital (TTSH) and National Centre for Infectious Diseases this morning.

They cast their fears and worries aside, stepping up to be counted. One of them shared with me his pride to do his part and serve his country.

I am glad I got to thank our Singapore Civil Defence Force, hospital and private ambulance crew, in person. I did not get to meet many of them as they were busy. I hope they get to see this and know they are deeply valued and appreciated by all of us here!

Thank you! #SGUnited

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Over the last few weeks, we have been ramping up efforts to manage the novel coronavirus and screening at the NCID. Across departments, our doctors, nurses, housekeepers, security, pharmacists, colleagues in the linen department, kitchen, etc. are stepping up to the frontline in this fight against the virus. To all our #HealthcareHeroes we are with you. #TTSHeartbeats #FightnCoV

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Unsung heroes: The NCID housekeeping staff fighting Covid-19 on the frontlines

Stories of Us: John Christopher Vega and Thinzar Aung are two housekeeping staff at NCID working more than 12 hours a day to keep patients and healthcare staff safe during this Covid-19 outbreak.

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As the Covid-19 pandemic in Singapore continues to rage on, our thoughts and support are with those on the frontlines fighting the outbreak.

Doctors and nurses have gotten much recognition for their important work in battling this global health crisis, and rightfully so.

However, one group of people, whose work is often less visible yet incredibly integral to the frontline response, has been more-or-less overlooked: the housekeeping staff at our hospitals.

Housekeeping staff are at the very front of the frontlines — they are frequently in contact with surfaces contaminated by suspected and confirmed Covid-19 patients in order to ensure they are properly disinfected, for the protection of other patients and healthcare staff.

To get a closer look into the lives of the important people keeping our doctors and nurses safe, I spoke with John Christopher Vega and Thinzar Aung, two of the housekeeping staff employed by ISS Facility Services who are working at the National Centre for Infectious Diseases (NCID), to find out more about their jobs, their motivations, and their fears.

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Housekeeping staff at NCID

Vega and Thinzar, both 26, have been working in Singapore for almost two years and six years, respectively.

Vega hails from Tuguegarao City in the Philippines, a city of only 153,502 people. Thinzar, on the other hand, is from Yangon, the capital city of Myanmar.

They both received university educations in their home countries — Thinzar in computer science and Vega in business administration — but came to Singapore in search of a better life and higher wages.

Here, Vega works as a housekeeping operative in the NCID screening centre. He has been working in the NCID building for the past nine months, previously doing the daily cleaning in the wards until he was transferred to the screening centre for Covid-19 when the outbreak started earlier this year.

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His role in the screening centre includes constantly wiping down the tables and chairs where suspected cases sit, cleaning the bathrooms after each use, sweeping and mopping the floors, and wiping down the high-touch areas of the centre five times a day.

"And of course the counter. We never forget the counter", Vega chuckles, reiterating the importance of wiping down one of the highest-touch areas in the NCID premises.

His constant close contact with suspected (and possibly later-to-be-confirmed) cases requires him to wear full personal protective equipment (PPE) at all times.

The full PPE includes eye protection such as goggles, a face shield or a mask with a visor, an N95 mask, a long-sleeved plastic gown, gloves made of synthetic rubber, and a shower cap.

Thinzar, on the other hand, is a housekeeping supervisor. In her role, she manages 100 staff members, one of whom is Vega.

Her responsibilities include conducting morning briefings, overseeing the housekeeping roster, and deploying staff to the different areas of the centre, such as the wards where Covid-19 patients are held and the screening centre.

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She also ensures that the housekeeping protocol and strict standard operating procedures are followed, according to the hospital’s infection control standards.

This includes making sure that the chemicals the staff use to clean are diluted and used accurately and that waste is disposed in the correct way.

These measures are also important for ensuring that her staff are safe and protected from contamination as they carry out their work.

Vega and Thinzar come into close contact with Covid-19 cases but both express that they do not feel afraid because of the extensive training (for example in wearing PPE) they go through to protect themselves.

"The first time, really, we think like that. But, we are trained in this. We are trained already in this, so we are ready for it", Vega tells me.

Thinzar adds on, "We always standby for the outbreak. In any time, outbreak may happen. That's why we always conduct training".

Longer hours, sometimes can't take breaks

Both Vega and Thinzar work unimaginably (to me, at least) long hours, six days per week and the hours have gotten especially long now that the intensity of the Covid-19 situation has risen.

Thinzar explains that prior to the virus outbreak, her role had three shifts: 7am to 3pm, 1pm to 9pm, and an overnight shift from 7pm to 7am.

Now, however, the two daytime shifts have been combined, forming only two shifts: a 14-hour shift from 7am to 9pm, and a 12-hour overnight shift from 7pm to 7am.

While Vega’s shifts haven’t necessarily gotten longer, compared to before the outbreak, he does spend more of his 12-hour workday (from 7am to 7pm) on his feet cleaning all of the different areas while donning the full PPE, which also makes his work all the more difficult.

And while they are each given a one-hour break for lunch and for dinner, they sometimes have to forgo them depending on the busyness of the day and patients' needs.

"But now, sometimes we don't have enough rest time. We just... eat also sometimes cannot eat", Thinzar shares. "Sometimes breakfast also don't have, lunch also don't have. Only in the dinner, altogether eat".

"Even sometimes cannot pass urine also!", she adds, laughing.

"It’s our duty and our responsibility"

Given the difficult manual work, long hours, and being far away from home, I ask Vega and Thinzar what keeps them going.

"It’s tiring, but it’s our duty and our responsibility, so we can do it", says Thinzar.

“Sometimes it’s tiring, but when we think about our family and all our loved one and all the patient, it really formed a big part of the motivation. Just thinking about them give us the energy to fight this virus."

Vega adds, "I just always think that it's for the community. We can, in our own way, we can help."

In addition, Thinzar says that the appreciation they receive from their superiors and patients through "appreciation goodies" and words of encouragement makes them very proud to be part of the housekeeping team.

They are also motivated when they see that their work is integral to keeping the hospital running and keeping everyone safe.

"We provide the patient and the staff the clean environment, safe environment. Seeing the patient, because of us, they can stay safe and clean, it's really help motivate us", Thinzar tells me.

Vega feels similarly, keeping in mind that the job is bigger than just himself:

"Aside from, it’s my job, I’m just thinking that in this way I can help. This is not only for us, it's also for the patient, the nurses, and the doctors here, keeping the area clean. And then all of us inside the same."

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Not just an "easy cleaning job"

When I ask Thinzar and Vega if they feel that the public sometimes forgets that housekeeping staff like themselves are also working on the frontlines, Vega answers, with some hesitation:

"I really observe that, like, sometimes just the doctors and nurses are being… are being recognised."

"But… how do I say...?" he trails off.

Thinzar jumps in with her thoughts, pointing out that the appreciation goodies and thank-you cards are proof that people do recognise housekeeping staff as frontline workers.

"So I think everybody in Singapore, they recognise our housekeeping also as a frontline".

However, she does point out that some people may have misperceptions about the scope of their jobs, and think that it’s "just an easy cleaning job":

"Some people may not know how our housekeeping job is important. Because when they hear housekeeping, they think we are just only collect rubbish, washing toilet — they may think like that.

Actually, our job is also very important because we have to make sure to provide the safe and clean environment for all the patient and staff around here. We have to make sure that this patient room is 100 per cent clear for the next patient to come in safely."

Vega agrees, adding:

"They might think that we only do wiping and mopping floors, but they don't know that we are following some infection control procedures, standard operating procedures.

We are doing the terminal cleanings (an intense disinfection procedure), the high-level cleaning."

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Unsung heroes: The NCID housekeeping staff fighting Covid-19 on the frontlines

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Another thing that the public might not be as aware of, says Thinzar, is that the housekeeping staff at NCID also have to wear the PPE during their course of work.

Both gamely agree to demonstrate the donning of their PPE, a process that usually takes about three to five minutes:

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Wearing PPE for long hours can be very uncomfortable and it shows.

As Thinzar and Vega take off their PPE after wearing it for a mere 15 minutes, I see that their masks had already produced visible marks on their faces.

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And similar to the discrimination that some nurses and other healthcare professionals have faced in Singapore, Thinzar also has an experience to share.

She tells me that at the beginning of March, she moved into a new flat, as the lease of her old one had finished.

However, one day after moving in, the owners of the flat found out that she is working at Tan Tock Seng Hospital and NCID.

Even though they didn't live in the same flat with her, the owners demanded that she move out, for fear of being infected, says Thinzar.

"So within one day, I have to move house. Then I don’t know where to get the new house, it’s only one day. Luckily, my contract manager, he helped me out. He asked me to stay at the hostel for a while. So now currently I stay at the company hostel."

That was a month back and Thinzar is still in the process of looking for a place to stay.

Unfortunately, it is still a difficult process her. Many landlords are unwilling to rent her a room in their flats because of their misdirected fears.

Vega has been luckier, he says, and has not faced such backlash from those around him, as he is living with family members in Singapore who also work in the healthcare industry.

Don't want families to worry about them

Yet, despite the hardships and the long hours that come along with their work, neither Vega nor Thinzar have told their families back home that they work directly with Covid-19 patients, for fear of causing them anxiety.

Vega usually speaks to his family once a week for about an hour, but sometimes isn’t able to because the internet connection back home is quite slow.

Thinzar, on the other hand, calls her family two or three times a week, usually spending between half an hour to an hour on the phone with them.

Both their families are aware that they work at NCID. However, they do not know that Vega and Thinzar are in contact with Covid-19 cases.

Thinzar’s family is worried for her, she says:

"They ask so many question — how have I been here? Is it so many patient? Is it safe for me? They ask so many question.

I say, here in Singapore, here facility are different from our country, so no need to worry and everything is safe here."

"We don’t want our family worry for us, that’s why we didn’t talk [tell them]", she explains.

Instead, she says, she gives them advice on how to stay safe back home in Myanmar, where the healthcare system is not as robust as Singapore’s:

"I tell my parents to stay at home, drink more water, watch hands frequently. I teach them seven-step handwashing, how to wash hand also from the video call".

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Vega also tries to encourage his family back home to be careful, as the province that he is from, Cayagon Valley, had reported its first case (and as of Apr. 1, the number of cases had risen to 20):

"It’s really crazy there [in the Philippines]. And then, they really don't have the facilities like here. That's why when I call up home, I just have them stay at home, don’t go out. You have enough food there, you just stay there."

I ask them if they might consider telling their families about the realities of their work one day, once the Covid-19 outbreak has passed and they are no longer working so closely with infected patients.

"Maybe I can, I can tell them already, after the outbreak. I will be proud for myself when I tell them, 'I've been there'", says Vega.

By then, he adds, "I think they will not be scared. I think they will be proud of me."

Thinzar shares similar thoughts:

"They may worry. First, when I talk, they may worry, but in the end, I will explain how we fight this Covid-19 — not only our housekeeping team, all the nurses and the doctors, all these people around us — how we fight this virus.

And I'm sure my parents, they will be proud for us."

And sitting here across from these two individuals who are just about my age, who left their homes in search of better jobs overseas, and who are now working more than 12 hours a day at the frontlines of this crisis in Singapore, I can say with certainty that I am sure their families will be proud too.

https://mothership.sg/2020/04/ncid-housekeeping-staff-unsung-heroes/?fbclid=IwAR0l25k5ayWoPmFu_CxI-yhf4IthIVdMNVjknsx3IXe-h-wI6G6kLAXBFec

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Army medical personnel provide healthcare for foreign workers @ Westlite & S11 dormitories

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