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Effective response strategy to a hospital cluster of the B.1.617.2 delta variant of concern during the COVID-19 pandemic
In Singapore a hospital cluster of COVID-19 occurred owing to the highly transmissible SARS-CoV-2 B.1.617.2 variant. To contain the outbreak, a three-pronged response strategy of containment, segregation and reset was adopted. These strategies resulted in the successful control of the cluster within a month. The cluster was followed by a review process, which yielded two important insights. The first was to strengthen lines of defence by early identification of COVID-19 cases through the principles of test, monitor and protect. The second was to develop an enhanced preparedness protocol, categorised into contingency, communications and care (3Cs), that could be readily activated should another hospital cluster of COVID-19 occur.
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Eugene Fidelis Soh Prof Eugene Fidelis Soh is the Deputy Chief Executive Officer (Integrated Care) of the National Healthcare Group and Chief Executive Officer of Tan Tock Seng Hospital and Central Health in Singapore, serving a population of 1.4 million. He is a medical doctor by training with a Master of Public Health (Healthcare Management) degree from Harvard University and is an alumnus of the senior executive programme at the London Business School. Eugene holds the position of Adjunct Professor at the Lee Kong Chian School of Medicine, a partnership between Nanyang Technological University, Singapore, and Imperial College London, UK. He is also the Chairman of the Centre for Healthcare Innovation (CHI) Co-Learning Network, which comprises local and international partners from across healthcare institutions, agencies, academia and industry.
Deborah Lee is the Management Executive at the Tan Tock Seng Hospital and concurrently holds a secondment as Manager of the Health Services and Integrated Division at the Ministry of Health, Singapore. She drives and support the development of Population Health and Child and Maternal Health national strategies and roadmap. She also coordinates multi-level engagement across clusters, institutions, and agencies to ensure alignment to the national frameworks. Prior to the role at the Ministry, Deborah helmed several portfolios at the cluster-level finance and hospital’s operations and clinical standards and improvement. She holds a bachelor’s degree in life sciences with a minor in psychology from the National University of Singapore.
Chia Siong Wong Dr Chia Siong Wong is the Director of Population Health Office, Division of Central Health, Tan Tock Seng Hospital. He has received training in public health and general practice. His current interests are population health management methods, epidemiology, and health promotion.
Stephenie Grace Liew is the Management Executive of Tan Tock Seng Hospital and concurrently holds a secondment at the National Healthcare Group (NHG) as the partnerships account manager for Group Integrated Care. She conducts environmental scanning, develops and executes engagement and communications strategy to build strong and sustainable relationships with NHG zones and partners to integrate care to meet their population needs. In her time with TTSH, Stephenie had planned and delivered projects relating to improvement and transformation through the practice of LEAN, design thinking, change management and co-creation with stakeholders.
Pei Xuan Chua is the Management Fellow at Tan Tock Seng Hospital and Manager of the Population Health Office. She leads the population health management effort for Central Integrated Care Organisation (ICO) which spearheads efforts such as population profiling, population segmentation, population health registry and performance outcomes and measures. Prior to her role in Population Health Office, she has taken on multiple lead roles in the hospital’s Operations and Corporate Planning departments. She holds a bachelor’s degree in life sciences with a minor in business from the National University of Singapore.
Edwin Phua is the Management Fellow at Tan Tock Seng Hospital and concurrently holds a secondment as Manager at the National Healthcare Group Integrated Care Office. Edwin coordinates over $400 million of investment budget to ensure adequate incentives and resourcing for healthcare providers to kick start population health efforts and oversees the governance and management of performance in the development of framework, design principles and strategic indicators. He is also responsible for the establishment of several strategic platforms for Senior Management’s planning and discussions. Prior to this position, he supported the Population Health Office to develop Integrated Care Networks through collaborations, engagement and partnerships with the community providers.
Glorijoy Shi En Tan Dr Glorijoy Shi En Tan is the Associate Consultant Infectious Diseases physician at the National Centre for Infectious Diseases (NCID) and Tan Tock Seng Hospital. Dr Tan graduated from the NUS Yong Loo Lin School of Medicine in 2012, gained Membership to the Royal College of Physicians of the United Kingdom in 2014, and completed her specialist training in Infectious Diseases in 2019. She has interests in Infection Prevention and Control and Public Health and is currently pursuing a Masters of Science in Public Health at the London School of Hygiene and Tropical Medicine.
Wei-Yen Lim Dr Wei-Yen Lim is a registered physician with specialization in public health (MBBS 1998, MPH 2005, PhD 2012). He has previously worked at the Ministry of Health, Singapore and Agency for Integrated Care, Singapore in health policy administration positions, and was Assistant Professor at the Saw Swee Hock School of Public Health, National University of Singapore, where he oversaw recruitment of a large population cohort and focused on research in epidemiology, in particular cancer epidemiology. He is currently senior consultant in the Department of Clinical Epidemiology at Tan Tock Seng Hospital, where he provides hospital infectious disease surveillance services (including, in the context of the COVID-19 pandemic, activity mapping and contact tracing of infected patients, staff and visitors), and conducts clinical epidemiologic and population health studies to support hospital operations and strategic initiatives.
Brenda Ang Prof Brenda Ang is the Senior Consultant in the Department of Infectious Diseases, National Centre for Infectious Diseases, Tan Tock Seng Hospital and Director of Infection Prevention and Control. As one of the first persons in Singapore to specialise in Infectious Diseases, she has seen the growth of the specialty in Singapore over the last few decades. She holds faculty appointments in both the Yong Loo Lin and Lee Kong Chian Schools of Medicine (NUS and NTU respectively) and is a member of the Chapter of Infectious Disease Physicians, Academy of Medicine, Singapore, and Chairman of the Specialist Training committee for two terms. As Chairman of the Infection Control Committee, she has led infection prevention and control efforts on the campus for more than 25 years, including overcoming emerging infectious disease outbreaks, from Nipah in 1999, SARS in 2003, H1N1 in 2009, to COVID from 2021. She is also the Chairman of the Infection Control Committee of the National Healthcare Group, and a member of the National Infection Prevention and Control Committee of the Ministry of Health.
Shawn Vasoo Dr Shawn Vasoo is the Clinical Director and Senior Consultant at the Department of Infectious Diseases at Tan Tock Seng Hospital and National Centre for Infectious Diseases in Singapore. He graduated from the National University of Singapore in 2001, and completed his residency training in Internal Medicine and his fellowship in Infectious Diseases at Rush University Medical Centre in Chicago and following that, a Clinical Microbiology Fellowship and Orthopaedic ID fellowship at the Mayo Clinic in Rochester, Minnesota. He also leads the Infectious Diseases Research Laboratory at NCID. He is active in undergraduate and postgraduate medical education and as Clinical Director oversees clinical and outbreak preparedness activities at NCID and chairs the COVID-19 therapeutic workgroup in Singapore.
Habeebul Rahman Prof Habeebul Rahman graduated from the National University of Singapore in 1998, and has been a Consultant Psychiatrist for 11 years, having trained in Singapore and UK. He has an interest in psychotherapy and medical education. He has also investigated resilience and burnout amongst healthcare workers during his training and has an interest in organisational psychology affecting individual performance. He has been appointed Adjunct Associate Professor with Lee Kong Chian School of Medicine and provides psychological and psychiatric input to a range of professional committees and boards. He sits on the National Examinations Board for Psychiatry in Singapore and has recently been appointed to the Workplace Safety and Health Council of Tan Tock Seng Hospital, looking at wellbeing of hospital staff.
Angela Chow Prof Angela Chow is Head and Senior Consultant at the Department of Clinical Epidemiology and the Clinical Director of the Office of Clinical Epidemiology, Analytics, & Knowledge (OCEAN) at Tan Tock Seng Hospital. Angela leads the clinical surveillance of emerging infectious diseases, including avian influenza, MERS, and COVID-19, in the hospital. Her research interests include antimicrobial resistance, infection prevention, infectious disease surveillance, and emerging infectious diseases. During the COVID-19 pandemic, Angela led research investigating the effectiveness of personal protective equipment for healthcare professionals, healthcare worker surveillance, and within hospital contact tracing systems. She graduated in Medicine from the National University of Singapore and holds a PhD in Epidemiology degree from the University of California, Los Angeles.
Mark Chan Dr Mark Chan is the Senior Consultant at the Department of Geriatric Medicine. He also serves as the Divisional Chairperson for the Division of Intermediate and Continuing Care in Tan Tock Seng Hospital.
Shu Yin Hoi Dr Shu Yin Hoi is the Chief Nurse at Tan Tock Seng Hospital and Central Health, Singapore. She is acquainted with healthcare quality and patient safety and believes in designing the work environment to empower and enable every staff to improve and innovate and is a strong advocate for nurturing and proliferating point-of-care innovations. Shu Yin continues to seek to introduce system-level initiatives to connect and grow people, and strengthening relationships to deliver care that goes beyond quality to adding value.
Jamie Mervyn Lim Dr Jamie Mervyn Lim is the Chief Operating Officer at Tan Tock Seng Hospital and Central Health, Singapore. He oversees the daily operations of the hospital. A strong advocate of systems thinking, he introduced a more systems-based approach in resource management at the hospital. He incorporated Systems Dynamics thinking, artificial intelligence and spearheaded the development of a Command, Control and Communications (C3) system to successfully manage a 1700-bed hospital. Dr Lim chaired hospital level committees leading the transformation of the clinics and the wards recognised locally and regionally for their best practices. Dr Lim graduated from King’s College London, UK, and attended the Development Programme at Wharton Business School, USA. He pursued his doctorate in Physiology at Nanyang Technological University Singapore. Professionally, he has authored a book chapter in Sports Physiology and in professional journals on Physiology.
Kong Choong Tang Dr Kong Choong Tang is the Assistant Chief Executive Officer (Hospital Services) of Tan Tock Seng Hospital and Central Health in Singapore. He is an anaesthesiologist by training and received his Master of Medicine (Anaesthesiology) from National University of Singapore in 2010. Prior to his appointment as Assistant CEO, Dr Tang had served in the Singapore Armed Forces from 1998 to 2019 and held the appointments of Chief Naval Medical Officer from 2010 to 2015 and Chief of SAF Medical Corps from 2015-2019.
Jing Jih Chin Prof Jing Jih Chin is the Chairman, Medical Board and Senior Consultant Geriatrician at Tan Tock Seng Hospital and Central Health in Singapore. He chairs the NHG Research Ethics Committee and Co-chairs the Strategic Governance Committee. Professor Chin holds teaching responsibilities at both NTU Lee Kong Chian School of Medicine and the NUS Yong Loo Lin School of Medicine, and serves in several committees in the Ministry of Health and the community, including the Board of Directors for the Agency for Integrated Care, Singapore Bioethics Advisory Committee, the National Medical Ethics Committee. He also chairs the HSA Complementary Health Products Advisory Committee and the Medical Advisory Board of Ang Mo Kio-THK Hospital.