Challenges Faced

Modifications/Comments

Uncertainty in risk stratification of patients due to evolving case definitions

· Institution set up a Pandemic Response Planning Team

· Formation of dedicated Department workgroup to oversee Pandemic Response

· Updated case definitions based on national and global situation

· Recognition that case definitions will always lag behind actual cases

· Anaesthetist should and must take on an active leadership role in risk assessment of all patients presenting for surgery

· Creation of user-friendly, quick screening questionnaire for intra-Department usage (see Figure 1)

Timely dissemination of information

· Establishment of effective communication channels

² Detailed information disseminated through work emails

² Practical summaries disseminated real-time through encrypted mobile messaging systems

Manpower rostering

· Uncertainty of evolving global situation and need for preparedness for a surge in patients

· Prohibition of overseas leave for all staff to augment manpower

· OT Team segregated into 2 teams with each team working 7 continuous days and 12 h shifts to minimise risk of cross-transmission

· Simulation of contingency roster for 3 weeks to ensure workability, then down-triaging to routine roster to prevent burnout

· Use of shadow roster-routine roster ongoing with capability to implement contingency roster almost immediately should the need arise

Unfamiliarity with PAPR

· Staff education

² Regular refresher sessions for Anaesthetists and Nurses to increase familiarity with PAPR

² Donning and removing of PAPR to improve staff’s response time

² In situ Simulation training including resuscitation scenarios with the use of PAPR

Communication difficulties with PAPR

· Instructions to be brief and succinct

· Effort made to speak clearly and project your voice

· Acknowledgement and confirmation via read back and hand sign

· Maintain situational awareness and alertness

Sustainability of supply of PPE

· Centralised distribution to ensure close monitoring of supplies

· Diversification of procurement and establishment of reliable supply chain in advance

Healthcare worker fatigue

· Clear directives from Pandemic Preparedness Committee

· Reliable flow of communication to allay anxieties

· Allowance of rest days for staff while remaining contactable and on stand-by

· Anonymous hotlines for peer support or counselling services made available for all staff