Some people have noticed that the MOH’s daily updates for the COVID-19 situation have different numbers for the ICU. Why are there 2 different numbers for the ICU, they asked.
Because we are kiasu, said Mdm Ho Ching.
In many countries, covid cases are hospitalised only after they are very seriously sick. But here in Singapore, we admit a large number of them to hospitals out of an abundance of caution just to observe them and see who may become seriously sick so that doctors can intervene early to treat them.
And then we have 2 ICU numbers because we preemptively admit to the ICU, those who we think may need critical care so that they can be closely monitored in case they deteriorate suddenly and need to be intubated fast, Ho Ching explained. These are the ones whose oxygen needs are already very high and may need mechanical assistance in breathing.
In other words, they are put in ICU out of precaution.
“Mechanical assistance means putting a tube down the windpipe, and carefully directed either using ultrasound machine or a stethoscope to make sure it is going to the lungs. This process is called intubation,” Mdm Ho Ching said.
“Because it is very uncomfortable, the patients are sedated while they are on intubation, when putting in the tube, for so long the tube is in there, and when taking out the tube. Then the ventilator machine pumps air into the lungs at higher pressure with a richer mix of oxygen, and extracts air mechanically as well,” she added.
Those who are intubated are critically ill.
“These folks essentially die within minutes from lack of oxygen if they are not out on mechanical or electromechanical ventilator support. There are the milder ones, where there is no intubation needed, but the patient wears a sealed face mask so that oxygenated air is delivered at higher pressure.
“So the 2 numbers added together give a sense of the ICU beds used up for Covid care.
The critical illness number shows the number who are in real critical condition, while the ones for close monitoring may potentially become critical over the next few days,” said Mdm Ho Ching