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5. Incubation Periods of SARS-CoV-2 Wild-Type, Delta, and Omicron Variants–Dominant Periods in Singapore.

Author

Conceicao, Edwin Philip, Xu, Yingqi, Chan, Sze Ling, Jin Yee, Shoon, Yue, Yang, Arora, Shalvi, Ong, Marcus Eng Hock, Sim, Jean Xiang Ying, and Venkatachalam, Indumathi

Subjects
*SARS-CoV-2, *SARS-CoV-2 Omicron variant, *INFORMATION technology, *ELECTRONIC health records, *CONTACT tracing
Abstract

This study in Singapore analysed the incubation periods of the following SARS-CoV-2 variants: Wuhan-Hu-1, Delta, and Omicron. Three pandemic waves were examined: Wuhan-Hu-1 (January 2020–March 2021), Delta (May–October 2021), and Omicron (January–June 2022). Data from the SingHealth COVID-19 registry, covering patients from 23 January 2020 to 10 June 2022, were used to calculate incubation periods during the three time periods. The study found median incubation periods of 11 days for Wuhan-Hu-1, 3 days for Delta, and 3 days for Omicron (p-value: <0.001). This study highlighted the impact of different containment measures and the importance of robust EMR systems for tracking and managing infectious diseases. Key challenges included accurate contact tracing and IT infrastructure capabilities. The findings support the use of EMR data for future infectious disease preparedness in Singapore. [ABSTRACT FROM AUTHOR]

Published
2024
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6. SG-APSIC1098: Impact of the COVID-19 pandemic on influenza vaccination uptake among healthcare workers

Author

Min Yi Gwee, Lim John Wah, Indumathi Venkatachalam, Jean Sim Xiang Ying, May Kyawt Aung, Yang Yong, Conceicao Edwin Philip, Shalvi Arora, Aung Myat Oo, and Shawn See Wee Jin

Subjects
Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
Abstract

Objectives: Influenza vaccination is encouraged for all healthcare workers (HCWs) to reduce the risk of acquiring the infection and onward transmission to colleagues and patients during the influenza season. Thus, vaccination was introduced at Singapore General Hospital (SGH) in 2007 and has been offered to all HCWs at no cost. The HCW influenza vaccination program is conducted annually in October and biannually during years with vaccine mismatch. However, influenza vaccine uptake remained low among HCWs. We sought to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on influenza vaccine uptake among HCWs. Methods: At SGH, 2 methods of vaccine delivery are offered: centralized (1-month drop-in system during office hours) and decentralized (administered by vaccination teams in offices or ward staff in inpatient locations). In the 4-year study period between 2018 and 2021, 6 influenza vaccination exercise campaigns were conducted during 8 influenza seasons. During each exercise, ~9,000 HCWs were eligible for vaccination. Results: Prior to the COVID-19 pandemic, vaccine uptake in the Southern Hemisphere was 77.6% (6,964 of 8,977) in 2018 and 84.2% (7,296 of 8,670) in 2019. During the COVID-19 pandemic in 2020, vaccine uptake in the Southern Hemisphere increased by 10% to 94.1% (8,361 of 8,889). In the Northern Hemisphere, vaccine uptake was 79.2% (7,114 of 8,977) in 2018, and this increased by 17.9% to 97.1% (8,926 of 9,194) during the COVID-19 pandemic in 2020. During the 2021 Southern Hemisphere influenza season, no vaccination program was conducted because the risk of influenza was considered low due to the closure of international borders and the implementation of public health measures. In addition, priority was given to COVID-19 vaccination efforts. Conclusions: Increased uptake of the influenza vaccination was observed during the COVID-19 pandemic. Anxiety created by the respiratory disease pandemic and debate surrounding vaccines likely contributed to increased awareness and uptake in influenza vaccine among HCWs.

Published
2023
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8. Containment of COVID-19 and reduction in healthcare-associated respiratory viral infections through a multi-tiered infection control strategy

Author

Wee, Liang En, Venkatachalam, Indumathi, Sim, Xiang Ying Jean, Tan, Kenneth Boon-Kiat, Wen, Ruan, Tham, Chee Kian, Gan, Wee Hoe, Ko, Kwan Ki Karrie, Ho, Wan Qi, Kwek, Grace Teck Cheng, Conceicao, Edwin Philip, Sng, Chong Yu Edwin, Ng, Xin Hui Jorin, Ong, Jie Yi, Chiang, Juat Lan, Chua, Ying Ying, Ling, Moi Lin, Tan, Thuan Tong, and Wijaya, Limin

Published
2021
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9. Unintended consequences of infection prevention and control measures during COVID-19 pandemic

Author

Wee, Liang En Ian, Conceicao, Edwin Philip, Tan, Jing Yuan, Magesparan, Kamini Devi, Amin, Ismawati Binte Mohamad, Ismail, Bushra Binte Shaik, Toh, Hui Xian, Jin, Pinhong, Zhang, Jing, Wee, Elaine Geok Ling, Ong, Sheena Jin Min, Lee, Gillian Li Xin, Wang, Amanda En-min, How, Molly Kue Bien, Tan, Kwee Yuen, Lee, Lai Chee, Phoon, Poh Choo, Yang, Yong, Aung, May Kyawt, Sim, Xiang Ying Jean, Venkatachalam, Indumathi, and Ling, Moi Lin

Published
2021
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10. COVID-19 among healthcare workers of a tertiary-care hospital in Singapore

Author

Aung Myat Oo, Indumathi Venkatachalam, Xiang Ying Jean Sim, May Kyawt Aung, Conceicao Edwin Philip, Yang Yong, Shalvi Arora, Shawn See Wee Jin, Wai Leong Lester Lee, Fong Yuke Tien, Lai Chee Lee, and Moi Lin Ling

Subjects
Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
Abstract

Background: Singapore General Hospital (SGH) is the largest acute tertiary-care hospital in Singapore. Healthcare workers (HCWs) are at risk of acquiring COVID-19 in both the community and workplaces. SGH has a robust exposure management process including prompt contact tracing, immediate ring fencing, lock down of affected cubicles or single room isolation for patient contacts, and home isolation orders for staff contacts of COVID-19 cases during the containment phase of the pandemic. Contacts were also placed on enhanced surveillance with PCR testing on days 1 and 4 as well as daily antigen rapid tests (ARTs) for 10 days after exposure. Here, we describe the characteristic of HCWs with COVID-19 during the third wave of the COVID-19 pandemic. Methods: This retrospective observational study included all SGH HCWs who acquired COVID-19 during the third wave (ie, the 18-week period from September 1 to December 31, 2021) of the COVID-19 pandemic. Univariate analysis was used to compare characteristics of work-associated infection (WAI) and community-acquired infection (CAI) among HCWs. Results: Among a workforce of >10,000 at SGH, 335 HCWs acquired COVID-19 during study period. CAI (exposure to known clusters or household contact) accounted for 111 HCW infections (33.1%). Also, 48 HCWs (14.3%) had a WAI (ie, acquired at their work places where there was no patient contact). Among WAsI, only 5 HCWs had hospital-acquired infection (confirmed by phylogenetic analysis). The sources of exposure for the remaining 176 HCWs were unknown. Weekly incidence of COVID-19 among HCWs was comparable to the epidemiology curve of all cases in Singapore (Fig. 1 and 2). The mean age of HCWs with COVID-19 was 39.6 years, and most were women. At the time of positive SARS-CoV-2 PCR test, 223 HCWs were symptomatic, and 67 (20.0%) of them had comorbidities. Only 16 HCWs (4.8%) required hospitalization, and all recovered fully with no mortality (Table 1). Being female was associated with community COVID-19 acquisition (OR, 4.6, P Conclusions: During the thrid wave of the COVID-19 pandemic, a higher percentage of HCWs at SGH acquired the infection from the community than from the workplace. Safe management measures, such as universal masking, social distancing, and robust exposure management processes including prompt contact tracing and environmental disinfection, can reduce the risk of COVID-19 in the hospital work environment.

Published
2022
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13. Favorable outcomes of COVID‐19 in vaccinated hematopoietic stem cell transplant recipients: A single‐center experience

Author

Tan, Jing Yuan, primary, Wee, Liang En, additional, Tan, Yi Hern, additional, Conceicao, Edwin Philip, additional, Lim, Francesca Wei Inng, additional, Chen, Yunxin, additional, Than, Hein, additional, Quek, Jeffrey Kim Siang, additional, Nagarajan, Chandramouli, additional, Goh, Yeow Tee, additional, Hwang, William Ying Khee, additional, Phua, Ghee Chee, additional, Chung, Shimin Jasmine, additional, Tan, Thuan Tong, additional, Linn, Yeh Ching, additional, Ho, Aloysius Yew Leng, additional, and Tan, Ban Hock, additional

Published
2023
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15. Environmental contamination and evaluation of healthcare-associated SARS-CoV-2 transmission risk in temporary isolation wards during the COVID-19 pandemic

Author

Wee, Liang En, primary, Arora, Shalvi, additional, Ko, Karrie Kwan-Ki, additional, Conceicao, Edwin Philip, additional, Coleman, Kristen K., additional, Tan, Kwee Yuen, additional, Tohid, Hatijah Binti, additional, Liu, Qinnan, additional, Tung, Grace Li Teng, additional, See, Shawn Wee Jin, additional, Suphavilai, Chayaporn, additional, Ling, Moi Lin, additional, and Venkatachalam, Indumathi, additional

Published
2022
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16. Nosocomial severe acute respiratory coronavirus virus 2 (SARS-CoV-2) transmission arising from a case of N-gene dropout on reverse-transcription polymerase chain reaction (RT-PCR) testing

Author

Wee, Liang En Ian, primary, Ko, Karrie Kwan-Ki, additional, Conceicao, Edwin Philip, additional, Aung, May Kyawt, additional, Aung, Myat Oo, additional, Yang, Yong, additional, Arora, Shalvi, additional, Suphavilai, Chayaporn, additional, and Venkatachalam, Indumathi, additional

Published
2022
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19. Linking sporadic hospital clusters during a community surge of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) B.1.617.2 delta variant: The utility of whole-genome sequencing

Author

Wee, Liang En, primary, Ko, Karrie Kwan-Ki, additional, Conceicao, Edwin Philip, additional, Sim, Jean Xiang-Ying, additional, Rahman, Nurdyana Abdul, additional, Tan, Shireen Yan-Ling, additional, Cao, Delphine Yan-Hong, additional, Chan, Kenneth Xing-Long, additional, Aung, May Kyawt, additional, Aung, Myat Oo, additional, Yong, Yang, additional, Arora, Shalvi, additional, How, Molly Kue Bien, additional, Tan, Kwee Yuen, additional, Lee, Lai Chee, additional, Tan, Thuan Tong, additional, Wijaya, Limin, additional, Sim, James Heng Chiak, additional, Suphavilai, Chayaporn, additional, Venkatachalam, Indumathi, additional, and Ling, Moi Lin, additional

Published
2022
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23. Healthcare-associated multispecies outbreaks of OXA-48–positive carbapenemase-producing Enterobacteriaceae in a Singapore tertiary-care hospital

Author

Venkatachalam, Indumathi, primary, How, Molly Kue Bien, additional, Ko, Karrie Kwan Ki, additional, Abdul Rahman, Nurdyana Binte, additional, Conceicao, Edwin Philip, additional, Aung, May Kyawt, additional, Aung, Myat Oo, additional, Yang, Yong, additional, Tan, Kwee Yuen, additional, Sim, Jean Xiang Ying, additional, Lee, Lai Chee, additional, and Ling, Moi Lin, additional

Published
2022
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24. Detection of viable SARS-CoV-2 in deep respiratory specimens despite negative nasopharyngeal SARS-CoV-2 RT-PCR: Occult COVID-19 as an unsuspected cause of pulmonary infiltrates in immunocompromised patients

Author

Wee, Liang En, primary, Tan, Jing Yuan, additional, Ko, Karrie Kwan-Ki, additional, Wan, Wei Yee, additional, Lai, Deborah Chooi Mun, additional, Oon, Lynette Lin Ean, additional, Tan-Garcia, Alfonso, additional, Yeong, Joe Poh Sheng, additional, Pena, Angela Maria Takano, additional, Lim, Tony Kiat Hon, additional, Conceicao, Edwin Philip, additional, Venkatachalam, Indumathi, additional, Wijaya, Limin, additional, and Tan, Thuan Tong, additional

Published
2022
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25. Linking sporadic hospital clusters during a community surge of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) B.1.617.2 delta variant: The utility of whole-genome sequencing

Author

Wee, Liang En, Ko, Karrie Kwan-Ki, Conceicao, Edwin Philip, Sim, Jean Xiang-Ying, Rahman, Nurdyana Abdul, Tan, Shireen Yan-Ling, Cao, Delphine Yan-Hong, Chan, Kenneth Xing-Long, Aung, May Kyawt, Aung, Myat Oo, Yong, Yang, Arora, Shalvi, How, Molly Kue Bien, Tan, Kwee Yuen, Lee, Lai Chee, Tan, Thuan Tong, Wijaya, Limin, Sim, James Heng Chiak, Suphavilai, Chayaporn, Venkatachalam, Indumathi, and Ling, Moi Lin

Abstract

AbstractSporadic clusters of healthcare-associated coronavirus disease 2019 (COVID-19) occurred despite intense rostered routine surveillance and a highly vaccinated healthcare worker (HCW) population, during a community surge of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) B.1.617.2 δ (delta) variant. Genomic analysis facilitated timely cluster detection and uncovered additional linkages via HCWs moving between clinical areas and among HCWs sharing a common lunch area, enabling early intervention.

Published
2023
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28. Healthcare workers as a sentinel surveillance population in the early phase of the COVID-19 pandemic.

Author

Venkatachalam, Indumathi, Conceicao, Edwin Philip, Aung, May Kyawt, Kue Bien How, Molly, Liang En Wee, Jean Xiang Ying Sim, Ban Hock Tan, Moi Lin Ling, Bien How, Molly Kue, Wee, Liang En, Ying Sim, Jean Xiang, Tan, Ban Hock, and Ling, Moi Lin

Abstract

Introduction: Healthcare workers (HCWs) are a critical resource in the effort to control the COVID-19 pandemic. They are also a sentinel surveillance population whose clinical status reflects the effectiveness of the hospital's infection prevention measures in the pandemic.Methods: This was a retrospective cohort study conducted in Singapore General Hospital (SGH), a 1,822-bed tertiary hospital. Participants were all HCWs working in SGH during the study period. HCW protection measures included clinical workflows and personal protective equipment developed and adapted to minimise the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. HCW monitoring comprised staff contact logs in high-risk locations, twice-daily temperature monitoring, assessment of HCWs with acute respiratory illnesses (ARIs) in the staff clinic and, in the event of an exposure, extensive contact tracing, detailed risk assessment and risk-based interventions. HCW surveillance utilised monitoring data and ARI presentations and outcomes.Results: In the ten-week period between 6 January 2020 and 16 March 2020, 333 (17.1%) of 1,946 HCWs at risk of occupational COVID-19 presented with ARI. 32 (9.6%) screened negative for SARS-CoV-2 from throat swabs. Five other HCWs developed COVID-19 attributed to non-clinical exposures. From the nine COVID-19 exposure episodes investigated, 189 HCW contacts were identified, of whom 68 (36.2%) were placed on quarantine and remained well.Conclusion: Early in an emerging infectious disease outbreak, close monitoring of frontline HCWs is essential in ascertaining the effectiveness of infection prevention measures. HCWs are at risk of community disease acquisition and should be monitored and managed to prevent onward transmission. [ABSTRACT FROM AUTHOR]

Published
2022
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30. Utilization of rapid antigen assays for detection of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) in a low-incidence setting in emergency department triage: Does risk-stratification still matter?

Author

Wee, Liang En, primary, Conceicao, Edwin Philip, additional, Sim, Jean Xiang-Ying, additional, Venkatachalam, Indumathi, additional, Wan, Paul Weng, additional, Zakaria, Nur Diana, additional, Tan, Kenneth Boon-Kiat, additional, and Wijaya, Limin, additional

Published
2021
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34. Healthcare-associated multispecies outbreaks of OXA-48–positive carbapenemase-producing Enterobacteriaceae in a Singapore tertiary-care hospital

Author

Venkatachalam, Indumathi, How, Molly Kue Bien, Ko, Karrie Kwan Ki, Abdul Rahman, Nurdyana Binte, Conceicao, Edwin Philip, Aung, May Kyawt, Aung, Myat Oo, Yang, Yong, Tan, Kwee Yuen, Sim, Jean Xiang Ying, Lee, Lai Chee, and Ling, Moi Lin

Abstract

AbstractObjective:To describe OXA-48–like carbapenem-producing Enterobacteriaceae (CPE) outbreaks at Singapore General Hospital between 2018 and 2020 and to determine the risk associated with OXA-48 carriage in the 2020 outbreak.Design:Outbreak report and case–control study.Setting:Singapore General Hospital (SGH) is a tertiary-care academic medical center in Singapore with 1,750 beds.Methods:Active surveillance for CPE is conducted for selected high-risk patient cohorts through molecular testing on rectal swabs or stool samples. Patients with CPE are isolated or placed in cohorts under contact precautions. During outbreak investigations, rectal swabs are repeated for culture. For the 2020 outbreak, a retrospective case–control study was conducted in which controls were inpatients who tested negative for OXA-48 and were selected at a 1:3 case-to-control ratio.Results:Hospital wide, the median number of patients with healthcare-associated OXA-48 was 2 per month. In the 3-year period between 2018 and 2020, 3 OXA-48 outbreaks were investigated and managed, involving 4 patients with Klebsiella pneumoniae in 2018, 55 patients with K. pneumoniae or Escherichia coli in 2019, and 49 patients with multispecies Enterobacterales in 2020. During the 2020 outbreak, independent risk factors for OXA-48 carriage on multivariate analysis (49 patients and 147 controls) were diarrhea within the preceding 2 weeks (OR, 3.3; 95% CI, 1.1–10.7; P = .039), contact with an OXA-48–carrying patient (OR, 8.7; 95% CI, 1.9–39.3; P = .005), and exposure to carbapenems (OR, 17.2; 95% CI, 2.2–136; P = .007) or penicillin (OR, 16.6; 95% CI, 3.8–71.0; P < .001).Conclusions:Multispecies OXA-48 outbreaks in our institution are likely related to a favorable ecological condition and selective pressure exerted by antimicrobial use. The integration of molecular surveillance epidemiology of the healthcare environment is important in understanding the risk of healthcare–associated infection to patients.

Published
2023
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43. Experience of a Tertiary Hospital in Singapore with Management of a Dual Outbreak of COVID-19 and Dengue

Author

Wee, Liang En, primary, Cherng, Benjamin Pei Zhi, additional, Conceicao, Edwin Philip, additional, Goh, Kenneth Choon-Meng, additional, Wan, Wei Yee, additional, Ko, Kwan Ki Karrie, additional, Aung, May Kyawt, additional, Sim, Xiang Ying Jean, additional, Wijaya, Limin, additional, Ling, Moi Lin, additional, and Venkatachalam, Indumathi, additional

Published
2020
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44. Early Recognition of Coronavirus 2019 Disease (COVID-19) Infection in Surgical Inpatients: The Importance of a Risk-Stratified Approach for Early Testing and Isolation

Author

Wee, Liang En, primary, Sim, Xiang Ying Jean, additional, Conceicao, Edwin Philip, additional, Aung, May Kyawt, additional, Wong, Hei Man, additional, Teh, Yii Ean, additional, Tan, Kwee Yuen, additional, Wijaya, Limin, additional, Tan, Tan Ban Hock, additional, Ling, Moi Lin, additional, and Venkatachalam, Indumathi, additional

Published
2020
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45. A comparative study on the clinical features of COVID‐19 with non‐SARS‐CoV‐2 respiratory viral infections

Author

Tan, Jing Yuan, primary, Sim, Xiang Ying Jean, additional, Wee, Liang En, additional, Chua, Ying‐Ying, additional, Cherng, Benjamin Pei Zhi, additional, Ng, Ian Matthias, additional, Conceicao, Edwin Philip, additional, Wong, Tzu‐Jung, additional, Yang, Yong, additional, Aung, May Kyawt, additional, Ling, Moi Lin, additional, and Venkatachalam, Indumathi, additional

Published
2020
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48. Containment of COVID-19 cases among healthcare workers: The role of surveillance, early detection, and outbreak management

Author

Wee, Liang En, primary, Sim, Xiang Ying Jean, additional, Conceicao, Edwin Philip, additional, Aung, May Kyawt, additional, Goh, Jia Qing, additional, Yeo, Dennis Wu Ting, additional, Gan, Wee Hoe, additional, Chua, Ying Ying, additional, Wijaya, Limin, additional, Tan, Thuan Tong, additional, Tan, Ban Hock, additional, Ling, Moi Lin, additional, and Venkatachalam, Indumathi, additional

Published
2020
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50. Breast Cancer Prediction using Feature Selection and Ensemble Voting

Author

Misha Singh, Kelly Chen, Hung N. Pham, Yijing Wang, Wei Hao Max Ang, Quang H. Nguyen, Conceicao Edwin Philip, Trang T. T. Do, Binh P. Nguyen, Matthew Chin Heng Chua, and Sin Swee Heng

Subjects
020205 medical informatics, business.industry, Computer science, Pattern recognition, Feature selection, 02 engineering and technology, Feature scaling, medicine.disease, Random forest, Support vector machine, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, 030220 oncology & carcinogenesis, 0202 electrical engineering, electronic engineering, information engineering, medicine, AdaBoost, Artificial intelligence, Breast cancer classification, business, Precision and recall
Abstract

Breast cancer is the most common cause of cancer among women worldwide. This paper analyses the performance of supervised and unsupervised models for breast cancer classification. Data from Wisconsin Breast Cancer Dataset is used in this paper. Feature selection is processed through scaling and principal component analysis. Final results indicate that Ensemble Voting approach is ideal as a predictive model for breast cancer. The raw data has 569 cases of breast cancer. The data is split into training and testing sets in the ration 70:30, respectively. The benchmark model is then created using Random Forest method. Various models are trained and tested on the data after Feature Scaling and Principle Component Analysis. Cross-validation is performed which showed that our model is stable. Among all the evaluated models, only four models, i.e., Ensemble - Voting Classifier, Logistics Regression, SVM Tuning and AdaBoost returned with accuracy of at least 98%. Based on results of the precision and recall, ROC-AVC, Fl-measure and computational time of the models, the Ensemble showed the most potential in breast cancer classification of the given dataset.

Published
2019
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