Among the 160 frontline healthcare workers manning the 24-hour screening centre at NCID are two Advanced Practice Nurses who are members of City Harvest Church (CHC).

Xanthe Chua, 43, and Audrey Wong, 42, volunteered to serve on the frontlines when they learned of the urgent need.

“I feel it’s natural to volunteer when you see the hospital’s needs,” Audrey, a psychiatric APN in Tan Tock Seng Hospital (TTSH) explains.

Xanthe is an APN in the rheumatology department of TTSH. Seventeen years ago, she also volunteered to do screening during SARS. “I was very junior then,” she recalls. “Mentally it was very different for me – I was more afraid, there seemed to be a lot of unknowns.”

The mother of three explains that she is now volunteering at the screening centre because she knew NCID “really needed people. But also because I wasn’t scared – we are more prepared as a hospital. Having gone through SARS, MERS-Cov, Ebola, we know the procedures.

“Also, being Christians, we are well-protected through prayer.”

The screening

Audrey summarises the screening procedure: “We screen anyone who walks in or comes via referral. We screen them to determine if they are of low or high risk. Then we triage them to determine their physical health status. Every patient gets a chest X-ray.

“Depending on the doctor’s review, we will do procedures on patients such as taking blood, setting up an intravenous infusion, run an electrocardiogram (ECG), conduct urine tests and swabs to test for COVID-19.”

Most of those that go for screening do not test positive for COVID-19. The ones that are go to the isolation wards, and contact tracing begins.

Xanthe marvels at the timeliness of the NCID building, which was only officially opened in September 2019. The isolation wards were set up for such an emergency.

“Initially screening was at the TTSH A&E. When more and more people were affected and came for screening, the hospital decided to open up the screening centre with 130 nurses to run it 24 hours a day,” describes Xanthe.

“This number barely runs three shifts. The hospital had to source from every department in TTSH. We’re at 160 frontline workers now and we need more people.”

The adjustments

The frontline workers do shift duties: Night duty, morning and afternoon duty. They get the day after a night duty to sleep. This is a challenge for APNs like Audrey and Xanthe, as their jobs usually have regular hours. “There is some physical adjustment to be made,” explains Xanthe, “because your body clock needs to adjust.”

“It’s intense,” says Audrey. “You see between 100 and 300 persons daily. You work with people you never worked with before. You have to adjust to working shifts.

“People who come through the screening centre have different expectations. Some face a language barrier. Some are worried, and many are sick, coughing away. You have to manage each person differently.”

Xanthe notes that each time there is a new case from a new location, the screening centre will swell with numbers coming to be tested.

“Some people walk in demanding to be swabbed,” she says. “But we will look first to see how closely they have been in contact with the confirmed case.”

“You are of God”

Though they are in the hot zone, neither Xanthe or Audrey entertain fear of bringing the virus home to their families. The personal protective equipment (PPE) worn by frontline staffers are left behind before they go home, and laundered specially for them.

Frontline workers go through disinfection procedures when they exit the screening centre.

It is an exhausting job. 

But when the situation gets demoralising, Audrey holds on to 1 Samuel 30:6: “But David strengthened himself in the Lord his God.”

The worship song, Way Maker, also gives her strength, she adds.

Xanthe admits that there is some discrimination when people see them in their protective gear, or when people find out they are healthcare workers.

But she draws strength from 1 John 4:4: “You are of God, little children, and have overcome them, because He who is in you is greater than he who is in the world.”

She adds: “The prayer that Pastor Kong and Sun prayed for us which was sent to us by WhatsApp is awesome. I play it every day before I start my shift.”

Love expressed

They also feel the love from the community.

Over 1,000 notes of encouragement, penned by members of several organisations and churches, now adorn the walls of NCID and TTSH. The initiative was led by social justice advocacy group, Micah Singapore. Photo by saltandlight.sg.

“We have received many forms of help and kind gestures,” says Audrey. “One cell group initiated getting coffee for us (with the #BoosterShot movement). Some sent us sweets and nuts.”

“A member of the public sent 120 doughnuts to the screening center,” shares Xanthe. “A church pastor came with muffins and cards with encouraging verses – even the non-Christians felt blessed. We also get liang teh (herbal drinks) and one caterer offered to provide lunch for two weeks.”

The PPE includes N95 masks and balaclava-style goggles, which are worn tightly to prevent infection. These leave bruises or even broken skin on the face. “Some doctors who are not on the frontlines buy us skincare to treat our faces,” says Xanthe.

“All these little things make us feel we are not alone.”

Our main hope

COVID-19’s arrival has meant certain restrictions that affect every hospital worker, not just the ones in the frontline. Radiation therapist, Mabel Lee, explains that across the board at public hospitals, all staff leave has been canceled until at least March 31, including leave that was approved prior to the outbreak.

All workers have their temperature recorded twice a day, wear masks at all times in all work areas, keep good hygiene, learn processes pertaining to what to do should they suspect a patient might be infected with COVID-19, among other measures.

But it is all for the greater good.

Mabel adds: “I feel reassured that the hospital is taking all precautions to ensure that the staff are protected from unnecessary exposure, which also in turn ensures that we are able to give the best care to our patients.”

It is not just the frontline healthcare workers who are affected by the outbreak. A CHC member who is a doctor working in the A&E department of a hospital shares that, at the A&E, he often comes into contact with suspected cases.

“But thank God these cases have all been negative so far.”

The A&E is busier since the onset of COVID-19.

“We have seen a surge in the number of people coming in or being referred by polyclinics or private GPs to us for fever and flu cases.

“We also have to constantly stay updated on the virus’s characteristics and infective process as scientists and clinicians learn more about them. This plays a huge role in how we identify suspected cases and manage them accordingly.”

Work is physically and mentally exhausting, says this doctor. “In this present time and situation, I think one of the greatest challenges is to always stay vigilant and alert in order to accurately pick up those who are or could be infected with COVID-19, to be on our toes to manage and treat them swiftly, especially when patients’ conditions acutely deteriorate.

“I thank God for a strong unity between the healthcare workers, good leadership from the government and cooperation with the general public to work together harmoniously.

“Several new protocols and existing arrangements were adjusted adequately to enable a swift and effective response to try to curb disease spread and provide the right treatment to those who are sick.

“Ultimately God is still our main hope. And as believers, we don’t have to fear, for He is with us. He will carry and rescue us, He will sustain us.”

Pray for us

“Pray for strength to sustain us and wisdom in managing the situation,” says the A&E doctor.

“Also it’s important to pray for us to have God’s supernatural protection from the viral infection and all illnesses so that we can remain fit and healthy to continue treating and providing help, not just those who are affected by the virus, but also the rest of the patients who are in hospital for various other medical conditions.”

Audrey adds: “Pray for us to have strength, grace, mercy and compassion.”

Xanthe says: “Please continue to pray for the frontline people. Pray for protection, especially, that none of the medical staff get infected, because that can be scary for the frontline workers.

“During SARS, we lost colleagues. So please pray for our safety and protection.”

This story was written for City News of City Harvest Church. An excerpt is republished with permission.

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