A Case Study in Stratified Health: Hospitalized in Singapore!

by Sophia Coulter…

I’m in the National University Hospital in Singapore, in Ward 43, bed 8 until I test negative. I am case # 576. 

I have COVID-19, the novel coronavirus, the rona, or whatever else people are calling it.

I’m 21, could go to the gym more, but relatively healthy. 

Being isolated in the hospital on a 12 hour time change from friends in the US has given me more than enough time to observe, reflect, overthink, and research the different ways in which countries are handling the pandemic. 

March 24, 2020 at 7:00 am, I went to National University Hospital (NUH) to get tested. I was immediately put into an isolation room that was a small concrete box. I got a chest x-ray and the typical nose swab that felt as if they were trying to reach my brain. My chest x-ray came back clear, so I was allowed to go home at 9:30 am. At 3:30 pm I received a call saying I tested positive for COVID-19. An ambulance was at my house within an hour, and the EMT’s were in full gear to ensure no part of them were exposed to the virus, to me. 

One of the most traumatic experiences I’ve ever had was the adventure of getting from the ambulance to Ward 43. I had a full security team around my wheelchair who were screaming down hallways for everyone to clear out. I had already felt sick from the virus, but this truly made me feel like a disease. I eventually made it to my ward, and wheeled to bed 8 where I am sitting now writing this. 

There are a total of 6 beds in my room. Three of us are in our early 20’s, one bed is empty as of yesterday (she went to the isolation hotel), someone that is around my moms age, and the other is around my grandma’s age. 

It was incredibly interesting being in the same room with 5 other patients also with the virus. All 6 of us came from such different backgrounds and stories, including how we got the virus, but we had this common denominator of testing positive in such a strict environment. It was kind of like we all felt sorry for each other, yet also somewhat relaxed because we knew the treatment we were receiving was the best. 

March 24th continued to be a hectic day even after the arrival to my new living situation. I was on the phone with the Ministry Of Health (MOH) for hours as they combed through every step I had made since landing in Singapore. Contract tracing is unfortunately only happening in a few countries, yet is incredibly needed in order to both monitor and stop the spread of this virus. 

Singapore’s national health care system, policies, and strict enforcement of rules are an example of how every country should be handling this pandemic. One of the major reasons those infected with the virus are sent to the hospital is to ensure the virus cannot be spread. This also means all of us sick folk are able to be closely monitored by teams of doctors and nurses. Vitals are checked 3 times a day – morning, afternoon, night – and we are tested for the virus everyday. All treatment of cases is free to both residents and citizens of Singapore. Families of those infected are also closely monitored. Each is given a quarantine order (QO) notice that instructs all members to stay in the house for 14 days, so no grocery shopping, no walking pets, not a single foot is allowed to step out the front door. The MOH video calls a member of the family three times a day to ensure they are inside the home, and each member of the household must take their temperature also three times a day. If any member feels symptoms, they must immediately go to the hospital for a test. If any resident violates this, their residency is revoked. Any citizen that violates this is jailed, fined or both. There is strict monitoring during this time, yet it is the only way to ensure the virus does not spread. As of March 28th, there have only been 618 cases nationwide, 420 cases remain active in hospitals, 182 cases have been discharged to isolation (a hotel), and there have only been 2 deaths.

Overall, this is probably the safest place to be and I feel fortunate to be here. This is drastically different to the patchwork approach being implemented in the US, who, even though is also a wealthy country, has a private health care system. The global approach to COVID-19 is stratified, which has resulted in substantial differences in containment of the virus. 

Being a part of this has given me a perspective I think most in the US don’t have. Although I believe most are acknowledging this as an issue, I believe there’s a lack of strictness and severity surrounding almost all aspects of the spread of COVID-19. By this I’m not referring to the lack of health care available – which obviously is a serious issue – but I am alluding to how the virus becomes a part of our bodies and its level of contagiousness. I blame this on the lack of information and spread of misinformation. 

There was a moment in the hospital that this became incredibly real and my heart absolutely broke. I sent my friends the following text: “guys my heart is breaking, the doctors just brought in a phone so the old women next could ft her little sister who is hooked up to some wires, and she was comforting her because she was crying and scared, and she just kept telling her it was going to be okay and she just hung up and now she’s crying.” I later learned that her daughter was in the ICU unable to breathe on her own. 

Some information our age group is not being told but should: even though symptoms can be incredibly mild (even just loss of taste (most common symptom for our age)) – you can still spread the virus to everyone around you. Once you are infected, it takes young bodies longer to fight the virus in an attempt to remain as stable as possible, this can take up to a month (contagious the entire time !!). You should not leave self-isolation until you are completely, 1000% asymptomatic for two days. It scares me to think that those with mild symptoms go back to interacting with family and potentially those with compromised immune systems so quickly. My mind immediately goes to my roommate in bed 7 facetiming her sister. It makes me angry that people aren’t taking this seriously. I see people going about regular daily activities, out drinking with family members, when this directly puts people at risk. I’ve even seen my close friends interact with family members that are incredibly immunocompromised when they most definitely have the virus, even though there isn’t a test to confirm. I just want to shake them so they realize the potential harm they are causing and tell them to take isolation more seriously. There is a reason this has been labelled a pandemic – its highly contagious and incredibly dangerous disease. 

It is very surreal to have those taking care of you incredibly covered up, while all of us infected were just in some hospital gowns without masks or anything. I’m finding it hard to put into words what it feels like. The majority of people’s faces are covered (due to masks, googles, hair nets), which takes away a large part of human communication. They won’t touch you without cleaning the medical tools both before and after use. Each patient has their own stethoscope, blood pressure velcro cuff, and blood drawing band. I am incredibly grateful to have access to treatment and amazing doctors – but I definitely feel like a sick person in this situation. If we don’t feel infected by all this, everything we touch, regardless of what it is, goes into biohazard waste. All patients are told to dispose of all things given to us, so no medical professional has to touch it after we have. It seems a bit extreme for me to throw my plastic silverware into biohazard waste, but one must always follow the rules here. 

On this note, everything we are given is in plastic. The amount of plastic used for just me is shocking. Every meal is served in plastic boxes, with plastic utensils in plastic wrapping. The first few days I was there, we only got plastic water bottles too. Eventually they started giving us pitchers that they are able to refill, but I must have gone through 15 water bottles myself (in the first 2 days) and there were hundreds of patients throughout Singaporean hospitals also receiving this form of water.

Even with the unlimited amount of time I have on my hands, I have found it difficult to fully process everything. I find my mind constantly jumping from thought to thought – graduation? People don’t have food. Senior spring cancelled. Anxiety: “you’re gonna die from this.” I miss friends. I’m so lucky to have docs. Stratified healthcare. Etc… 

Though, to end on a lighter note, we are all given hospital wardrobes. And boy are they a fantastic look! Mint green is for sure my color!

P.S. I was moved to the isolation hotel today (March 28) to free up beds in the hospital. This meant I was stable enough to leave constant monitoring from doctors and nurses, so now I just wait till I test negative!