INTRODUCTION
The Coronavirus Disease 2019 (COVID-19) outbreak which was first reported in Wuhan, China, was declared by the World Health Organization to be a Public Health Emergency of International Concern on January 30, 2020, and a pandemic on March 11, 2020.1
In Singapore, the first case of human COVID-19 infection was reported on January 23, 2020. Singapore has a land area of 721.5km2 and is served by less than 20 acute hospitals. As of March 31, 2020, this small city-state with a population of 5.6 million, has a total of 926 confirmed cases.2
Rapidly accumulating anecdotal reports from China identify otolaryngologists as high-risk healthcare workers (HCW) who are more susceptible to the COVID-19 infection due to the anatomy we treat.3,4 The first documented physician death due to COVID-19 nosocomial infection, on January 25, 2020, was that of an otolaryngologist in Wuhan.5
We report the adaptations of Singapore’s largest tertiary Otorhinolaryngology – Head and Neck Surgery department in preserving operationality while navigating the heightened risks during this outbreak. This was carried out via a four-pronged approach, taking into consideration our experience from the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003. Temporal adaptations were implemented as we continually gain understanding of the disease.