Introduction
Singapore was one of the earliest countries affected the Novel
Coronavirus-2019 (COVID-19) outbreak. In times of infectious disease
outbreak, the country utilizes the ‘Disease Outbreak Response System
Condition’ (DORSCON), a colour-coded framework to show the current
disease condition. On 7th February 2020, the Ministry of Health in
Singapore stepped up its alert level from Yellow to Orange – signifying
that the disease is severe and spreads easily from person to person,
although the disease is being contained1.
Following the escalation to DORSCON Orange, the Department of Obstetrics
and Gynaecology at KK Women’s and Children’s Hospital, the largest
women’s hospital in Singapore, which delivers more than 11000 babies
annually, established isolation teams consisting of dedicated doctors
and nurses assigned to care for patients with suspected or confirmed
COVID-19 infection following screening at triage and during admission to
hospital. Each team comprised of two doctors (one registrar and one
medical officer) and between one to two nurses dependent on patient
volume per shift. Two teams were on-site at all times, caring for two
main clinical areas; the labour ward and urgent obstetrics and
gynaecology centre (UOGC) which provides combined emergency gynaecology
and early pregnancy care while additionally caring for isolated ward
patients. These teams rotated on 12-hour shifts, over seven consecutive
days and segregated themselves from other colleagues and clinical areas.
Healthcare workers (HCW) face intense demands daily, from arduous shifts
to constant pressure to perform, and increasing levels of
responsibility. It is unsurprising that HCW experience a higher
prevalence of burnout than the general population. This psychological
pressure and emotional stress among HCW appeared to be heightened during
a pandemic, as seen from studies conducted following the outbreak of
severe acute respiratory syndrome (SARS) in 20032.
Burnout is a syndrome characterized by emotional exhaustion,
depersonalization, and a diminished sense of personal achievement.
Resilience, defined as the ability to adapt successfully in the face of
trauma, adversity, tragedy, or significant threat, may be critical in
helping to combat trainee and physician burnout3.
Resilience building becomes critical especially in the face of COVID-19
pandemic. Understanding the emotional and psychological effects of
working during the COVID-19 outbreak can improve the well-being of large
numbers of HCW. Additionally, this information has wider relevance to
health systems in planning for emerging infections and potential
bioterrorism2.
This study aims to explore the impact of COVID-19 outbreak on the
resilience and emotions of frontline HCWs in obstetrics and gynaecology
during this pandemic.