employer-led supervised self-swab (esss)
TRANSCRIPT
Employer-Led Supervised Self-Swab (ESSS)
Guide for Private Tuition and Enrichment Centres
1
Overview1. Testing Requirements
a. Background
b. Exemptions from Fast and Easy Testing (FET) and Vaccinate or Regular Test (VoRT) regimes
2. Testing Operationsa. Onboarding Process
b. Rostering Supervised Self-Swab Sessions
c. ART Kits Inventory and Delivery
3. On-site Supervisiona. Preparation for On-site Swab Operations
b. SOP for On-site Swab Operations
4. Virtual Supervisiona. Key Considerations
b. Preparation for Virtual Swab Operations
c. SOP for Virtual Swab Operations
d. Selected FAQs
5. Treatment of AG+ and AG Double Invalid
Annexes
I. Roles and Responsibilities
II. ART Kits and Repacking Kits into individual kits
2
1. Testing Requirements
3
1(a) Background
❖ As part of Singapore’s national efforts to expand our vaccine coverage further and to mitigate the riskof transmission of COVID-19, Private Tuition and Enrichment centres are required to comply with theexpanded Fast And Easy Testing (FET) 7-day regime to more groups of staff and the implementation ofthe Vaccinate or Regular Test (VoRT) regime with effect from 1 October 2021.
❖ From 1 Oct 2021, under the COVID-19 (Temporary Measures) Act:
▪ All staff (regardless of vaccination status) working within the premises of private tuition andenrichment centres that have students aged 12 years old and below (i.e. born in 2009 or later) arerequired to undergo FET, regardless of whether the staff has any direct contact with thesestudents.
▪ All staff (regardless of vaccination status) working within the premises of private tuition andenrichment centres located in retail malls^ (regardless of age group of students) will also berequired to undergo FET.
▪ All unvaccinated staff under the FET regime are also required to undergo VoRT.
▪ Centres consisting of only one self-employed person have to also comply with the FET and VoRTrequirements.
❖ Centres should conduct Employer Supervised Self Swab (ESSS) for persons who are required toundergo testing under the FET or VoRT regimes. ESSS involves having these persons use an AntigenRapid Test (ART) kit to carry out a swab on themselves under the supervision of a trained supervisor.
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^ Retail malls are defined as a building with commercial space for business-to-consumer [B2C] businesses with at least 7,000sqm of net lettable area.
1(a) Background
❖ Centres should not allow entry of workers who do not comply with the testingrequirements.
❖ To ensure compliance, inspectors from MOE will be conducting inspections to checkon the proper implementation of the FET and VoRT. Centre’ Points of Contract (POCs)are responsible for maintaining offline records for the Swab Registration System (SRS).Inspectors will request for the record. If the POC is not stationed in the centre’spremise, please let your centre’s staff keep the record in the premise for ease ofshowing during site inspection.
❖ Centres who do not comply will be subject to penalties under the COVID-19(Temporary Measures) Act and may be ineligible for government grants, loans, taxrebates and other assistance, and may also be subject to temporary closures.
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1(b) Exemptions from FET and VoRT Regime
❖ MOH has exempted the following groups from the testing regimes:
▪ Persons who recovered from COVID-19 infection for less than 270 days;
▪ Persons with contraindications (i.e. nasal surgery in the last 4 weeks, facial injury in the last 8weeks).
▪ Persons with special needs and disabilities (e.g. Special needs such as autism, Disability such asvision loss, physical impairment).
▪ If staff falls into the above categories, please follow the process to seek exemption (see next page).
❖ The following groups do not need to undergo testing:
▪ Workers working in a separate worksite that is not part of the premises of the private tuition orenrichment centre.
▪ Workers working in a separate worksite that is not located in retail malls, and who do not interactwith students aged 12 and below (even if they do interact with students aged above 12).
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1. Positive COVID test record in HealthHub within 270 days (this should be the first C+from the last episode of confirmed infection/re-infection, a C+ from persistentshedding will not be counted), or
2. Doctors’ discharge memo
Process to Seek Exemptions from FET and VoRT Regime
Cases exempted from the FET and VoRT Regime are listed below:
1. Exemption due to contraindication • Nasal Surgery • Facial injury (that may affect the collection of nasal samples from the nostril)
2. Exemption due to special needs and disability • Special needs such as autism • Disability such as vision loss, physical impairment
3. Exemption due to past infection from COVID-19• Employees recovered from a previous COVID-19 infection less than 270 days ago
Supporting Documents: a) Positive Covid-test record in HealthHub within 270 days (this should be the first C+ from the last
episode of confirmed infection/re-infection, a C+ from persistent shedding will not be counted), or
b) Doctors’ discharge memo
Client/Employee:• To fill in, sign and submit the Declaration Form to Employer to seek exemption from FET
and VoRT Regime.• Only submit the Declaration Form if you fall under one of the three cases above. No
consideration will be made for other conditions.
Employer:• To check for accuracy and sign the Declaration Form.• To track the total number of exemption cases and keep a copy of each form.• Inform Sector Lead on the exemptions via https://go.gov.sg/tuition-enrichment-fet-
exemption.
Employee to submit
completed Declaration
Form to Employer
Employee exempted from FET and VoRT
Regime
Employer to check
Declaration Form, keep a
copy and inform Sector
Lead (via FormSG)
2. Testing Operations
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2(a) Onboarding Process
❖ Centres in the arts and sports sectors should refer to NAC’s and ActiveSG’s latest advisoriesrespectively to onboard.
❖ Centres that are located within retail malls; and cater solely to students aged above 18years old should onboard with Enterprise Singapore athttps://www.enterprisesg.gov.sg/covid-19/sector-testing.
❖ All other centres required to onboard the FET and VoRT Regime should:
▪ Submit their relevant information and Nominal Roll (Nominal Roll Template) using theform at https://go.gov.sg/v2-vort-nr-moe-tuition-registration, regardless of whethercentres already have a Swab Registration System (SRS) Account.
o After submission of the Form, a confirmation email and SMS from a third-partyvendor will be sent to your Point-of-Contact (POC) with the collection location anddate within a week or two.
▪ Centres that do not have an SRS Account should take note that the information that issubmitted on the Form will also be used to help centres set up an SRS account. Oncethe SRS account has been set up, your POC will receive an email notification informingthem about the creation of the SRS account. 9
2(a) Onboarding Process
❖ The Government will provide ART test kits to enterprises for persons who have beencertified by a medical practitioner in Singapore as medically ineligible to receive mRNACOVID-19 vaccines and are still required to undergo testing twice a week under the VoRTregime (“Medically Ineligible Workers or “MIW(s)) until 31 December 2021.
❖ Enterprises should verify a person’s status as a MIW by checking against the originalcertification or memo that was issued to that person by a medical practitioner inSingapore or the SMS notification sent to that person (more details can be found inAnnex A).
▪ Enterprises must not distribute, supply or sell the ART test kits provided by theGovernment to any third party.
▪ For avoidance of doubt, all other persons who are not Fully Vaccinated are ineligiblefor these Government-provided ART test kits and enterprises should makearrangements to comply with the requirements set out in the VoRT Notice.
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2(a) Onboarding Process
❖ Centres should be aware of the follow-up action required e.g. if a staff’s ART result is positiveor ‘double invalid’
❖ Centres should appoint*:
▪ Swab Supervisors (advised to have a minimum of 2 per centre) who will be trained to setup and supervise the self-swab process. Supervisors need to attend the ‘SupervisoryTraining in ART Self-Swab’ course by HMI Institute before supervising the self-swab process.
o If a Supervisor is above 50 years old, Enterprises must ensure that he or she is FullyVaccinated against COVID-19 before they can perform any swab supervisory role.
▪ Points of Contract (POCs) to receive and manage the inventory (includes replenishment)of ART Kits. He/ she will also see to the uploading of swab test results in HPB’s SwabRegistration System (SRS). (Note: The POC could double up as a Supervisor.)
o Centres may wish to open up the box of ART kits and “break the bulk” of items to groupinto individual test kits (see Annex II for details).
o After results are uploaded on SRS, staff will receive a text notification and theirHealthHub accounts will also reflect their ART results.
o For more information on the use of SRS, please refer to https://go.gov.sg/srs-guide-coyhr-esss.
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*See Annex I for more details on the roles and responsibilities of the supervisors and POCs
2(b) Rostering Supervised Self-Swab Sessions
❖ Centres have the autonomy to determine the timing of the sessions.
❖ Enterprises should guide their Workers who are not Fully Vaccinated tomaintain a 3 to 4 day interval between their weekly tests (e.g. if a Worker’s firsttest of the week is carried out on Monday, his or her second test of the weekshould be carried out on a Thursday or Friday).
❖ If for valid reasons, the staff cannot perform the second swab test within 7 daysafter the first swab, a 1-day allowance (including weekends/public holiday) ispermitted for the staff to perform the second swab.
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2(c) ART Kits Inventory and Delivery
❖ For subsequent deliveries, HPB will automatically send the kits to centres. The number of kits willbe based on the test results uploaded onto HPB's system (SRS).
▪ Centres can look out for the SMS from the transporter on the scheduled delivery. Shouldcentres not receive the kit within the scheduled time frame/ delivery date, please contact therelevant transporter to check on the delivery status.
❖ Centres may edit the number of staff in their centres by submitting an amended nominal roll (NR)via MOE’s formsg at https://go.gov.sg/v2-vort-nr-moe-tuition-registration and also update HPB viahttps://go.gov.sg/fet-kits.
❖ For other matter related to the Kits, you can contact HPB Call Centre (+65 68765830).13
Transporter Contact No. Email Operation Hours
Park N Parcel +65 64286200 [email protected] – Friday10:00am – 7:00pm
Transnational +65 63795555 [email protected] – Friday9:00am – 6:00pm
Road Bull NA [email protected] – Friday9:00am – 6:00pm
Ninja Van +65 66028271 [email protected] – Friday9:00am – 6:00pm
ALPS +65 63778871 [email protected] – Friday9:00am – 5:00pm
3. On-site Supervision
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3(a) Preparation for On-site Swab Operations
❖ Swab-Site should preferably be an outdoor setting or indoor with ampleventilation (open windows/doors and fans) and smooth-finish flooring tofacilitate ease of cleaning.
▪ It is not ideal to have air-conditioning at the swab location and hence, air-conditioning to beswitched off (where possible) and fans used instead.
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Legend Description
Swab Station
Dustbin (double-lined, preferably with a lid/cover)
Supervisor
3m
3m
❖ Each Swab Station (1 chair + 1 table) should belocated 3m apart and equipped with thefollowing items:▪ A small standing mirror (for individuals to administer
self-swabs);▪ A box of 70% alcohol wipes for wipe down of the mirror
and the environment before and after swabbing;▪ A bottle of hand sanitizer; and▪ (Optional) Instructions*.
❖ A dustbin with lid should be located in closeproximity to dispose used kits and cleaningequipment for spillage may be prepared.
* Centres could also consider projecting the instructions/ videos on a screen.
3(b) SOP for On-site Swab Operations
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Staff arrives at Swab Site
1 3
Swab Supervisor records Staff’s ART results# and
shares it with the Point-of-Contact (POC)
4
* If staff has:• ARI-symptoms, redirect staff to nearest SASH-PHPC for ART-PCR swab;• Nose-bleed in the last 24 hours, schedule staff for next supervised swab session;• Contraindications (i.e. nasal surgery in the last 4 weeks, facial injury in the last 8 weeks), staff
should be exempted from ESSS.
# In the event of a AG-invalid result, POCs need to upload the second test result on SRS as well. If AG+ orDouble AG Invalid, Supervisor will need to (a) follow workflow (b) alert POC to key-in result for staff into SRSwithin 30 mins.
• Staff will be given an ART kit anddirected to the swab station to performself-swab.
• Staff to perform hand hygiene beforecommencing swab.
• Swab Supervisor to supervise self-swab.• After the testing is complete, Staff
should place the swab stick, reactiontube and the test device into a sealedZiploc bag.
2
Swab Supervisorchecks for ARI or
contraindications*
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Point-of-Contact (POC) will batch-upload results on HPB’s Swab
Registration System (SRS) using template on SRS (click for instructions)
by the end of the day.
• Staff’s ART result will be visible in approx.10 – 15mins
• Staff should dispose the Ziploc bag thatcontains the swab stick, the reactiontube, into the bin (double bagged andwith cover/ lid).
• Staff should wipe down the swab station(including the table and the mirror) andperform hand hygiene before leaving theswab station.
*https://www.who.int/publications/i/item/9789240021280
IPC Requirements for Swab Supervisors tonote
▪ Supervisors should don face shield &surgical 3-ply face mask.
▪ Supervisors should keep a 3m distancefrom staff conducting self-swab.
▪ The swab station should be sanitizedbefore and after swabbing. Thesupervisor should also ensure that thewipe down of each station is doneproperly
▪ The swab site should be properlycleaned at the end of the supervisedself-swab session for the day.
▪ Test kits must be disposed of in closedbins (e.g. pedal bins) and waste must bedouble-bagged and cable-tied.
• Wash your hands with soap and water(via the 8 simple steps)
OR• Rub hands with hand sanitizer for at
least 30 seconds
Handwashing
3(b) SOP for On-site Swab Operations
❖ Infection Prevention Control (IPC) Guidelines
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3(b) SOP for On-site Swab Operations
❖ Biohazard Waste Disposal
Note: Procedure applies in the case of AG+/ Double Invalid tests.
1. All swab sticks/ ART cassettes/ spillage/ items containing bodily fluid are to bedisposed in a normal trash bag and tied.
2. The bag in (1) is then placed in a second trash bag (double-bag) and securedwith cable-tie.
3. Ensure that the trash bag in (2) is not more than 2/3 full and placed at thedisposal holding area which must be located away from human traffic andpublic access to prevent unintended exposure and cross contamination.
4. Perform 8-step hand hygiene process.
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3(b) SOP for On-site Swab Operations
❖ Spill Clean-up Procedure
Note: Procedure applies in the case of AG+/ Double Invalid tests.
1. Cordon off spill area and put-up notices to warn people of the presence ofbiohazardous materials.
2. Wear gloves and protective clothing, including face and eye protection.3. Cover the spill with cloth or paper towels to contain it.4. Pour an appropriate disinfectant over the paper towels and the immediate
surrounding area (generally, 5% bleach solutions are appropriate).5. Apply disinfectant concentrically beginning at the outer margin of the spill area,
working toward the centre.6. After waiting an appropriate amount of time (e.g. 30 mins), clear away the
materials; If there is broken glass or other sharps involved, use a dustpan or apiece of stiff cardboard to collect the material and deposit it into a puncture-resistant container for disposal.
4. Virtual Supervision
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4(a) Virtual Supervision – Key considerations
❖ Centres may conduct ESSS via on-site and/ or via virtual supervision.
❖ Swab Supervisors have been trained by HMI to supervise self-swabs conducted on-siteand virtually.
❖ Centres have the flexibility to determine (i) which staff may undergo virtual supervision,(ii) a suitable rostering schedule and timing for virtual supervisions and (iii) the number ofstaff scheduled for each virtual supervision self-swab session.
❖ Virtual supervisions for self-swabs can be hosted on video-conferencing (VC) platformssuch as Zoom or WhatsApp video call.
❖ Depending on the VC platform used*, Centres can schedule concurrent virtualsupervisions with a one-to-many supervisor to staff ratio, as long as the supervisor is ableto visually check that the self-swab is done properly.
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* Gallery View in Zoom displays up to 25 participants per screen by default when used on a desktop. However, thenumber of participants visible on Gallery View will be reduced if screen-share is enabled and/ or if the Zoom MobileApplication is used (via iPad, Tablet or Mobile Phone – max 9 participants). WhatsApp allows up to 8 people in a videocall.
4(a) Virtual Supervision – Key considerations
❖ Centres could consider the following to determine the most suitable modality for ESSSsupervision:
▪ Staff Readiness. Centres could consider an initial on-site supervision to introduce staffto the self-swab process and work towards transiting to partial/ full virtual supervisionfor staff. Centres may choose to retain on-site supervision self-swab sessions forselected staff(especially those who are less tech-savvy) and for those who may feelmore comfortable with on-site supervision.
▪ Impact on Staffing and Centre Operations for AG+/Double Invalid. In the event a stafftests AG+/Double Invalid, the impact to centres is minimized as the swab supervisorand other staff undergoing self-swab in the same virtual supervised self-swab sessionneed not be placed on Quarantine Order.
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4(b) Preparation for Virtual Swab Operations Centres
❑ Determine the number of staff undergoing ESSS via virtual supervision.
❑ Pack and distribute ART kits for staff undergoing virtual supervision – 3 per staff (2 cycles + 1spare in case of an AG Invalid result – staff may request for additional kits if necessary).
❑ Be familiar with SOP for virtual swab operations and the AG+/Double AG Invalid Workflow.
Supervisor
❑ Schedule virtual supervised self-swab session with staff (~30 mins per session)
❑ Prepare VC link (e.g. Zoom Meeting Link) and share it with staff before the virtual supervisedself-swab session.
❑ Prepare Videos/ Slides with Step-by-Step Instructions and Referral Letter for AG+/Double AGInvalid.
Staff
❑ Determine a well-ventilated site to conduct self-swab (with smooth flooring, desk or flatsurface, mirror if necessary). Avoid air-conditioned rooms, or close- proximity shared spaces(e.g. office work stations) where there may be risk of exposure and cross contamination.
❑ Go through self swab instructions, AG+/Double AG Invalid workflow and find out the locationof the nearest SASH-PHPC clinic.
❑ Test site should be sanitized before and after the self-swab and test kits must be disposed ofin closed bins (e.g. pedal bins) and waste must be double-bagged and cable-tied.
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4(c) SOP for Virtual Swab Operations
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▪ Swab Supervisor starts VC (e.g. ZoomMeeting Room) and prepares self-swab instructions/ video, if necessary.
▪ Staff should have ART kit(s) on-handand prepare to join the VC.
1 3
Swab Supervisor records Staff’s ART results and
shares it with the Point-of-Contact (POC)
4
• Staff are reminded to perform hand hygiene before commencing swab.
• Swab Supervisor to virtually supervise self-swab and provide verbal cues/ share instructions via screen share.
• After the testing is done, Staff should place the swab stick, reaction tube and the test into a sealed Ziploc bag.
2
Before the start of the session, Swab Supervisortakes attendance, reminds Staff to start their video and checks for ARI or contraindications*
• Staff’s ART result will be visible in approx. 10 – 15mins.
• Staff shows ART result# to the Swab Supervisor via video or photo (if video is unclear).
• Staff should dispose the Ziploc bag that contains the swab stick, the reaction tube, into bin (double bagged and with cover/ lid).
• Staff are reminded to wipe down the swab location and perform hand hygiene.
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* If Staff has:• ARI-symptoms, redirect staff to nearest SASH-PHPC for ART-PCR swab;• Nose-bleed in the last 24 hours, schedule staff for next supervised self-swab session;• Contraindications (i.e. nasal surgery in the last 4 weeks, facial injury in the last 8 weeks), Staff should
be exempted from ESSS.
# Staff with AG-/AG+ may leave the call and those with AG Invalid would need to undergo a second supervised self-swab. POCs need to upload the second test result for those with AG Invalid on SRS as well.If AG+ or Double AG Invalid, Supervisor will need to (a) follow workflow (b) alert POC to key-in result for staff intoSRS within 30 mins
Point-of-Contact (POC) will batch-uploadresults on HPB’s Swab Registration System(SRS) using template on SRS (click forinstructions) by the end of the day.
4(d) Selected Frequently Asked Questions
[3.6.1] What are the key differences between on-site and virtual supervision?
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On-site VirtualWorkload • Significant, especially if staff need to
undergo ESSS and multiple supervisors,
venues and sessions need to be offered
• Low as there is no need to set-up a swab
site in centres and each session can
accommodate a larger number of staff.
Modality • Supervised self-swab on-site in centres for
up to maximum of 5 staff at a time
• Supervised self-swab virtually via
videoconferencing platform with the
possibility of a higher one-to-many
supervisor to staff ratio.Scheduling • Less flexibility as it would depend on venue
availability in centres
• Greater flexibility as it would not be
constrained by venue availability in centres
Logistics Required • Swab-Site Set-up, Wipe down and disposal. • Repack and distribute ART kits to staff
Impact on Centre
Operations in the
event of an AG+
case
• The Swab Supervisor and other staff
undergoing self-swab may be placed on
LOA/ QO.
• In the event a staff tests PCR positive, the
impact to centres is minimized as the swab
supervisor and other staff undergoing self-
swab in the same virtual session would not
need not to be placed on LOA/ QO.
Staff Well-being • Face-to-face support would be more
assuring for some staff, especially if new to
ESSS
• Staff may not be familiar with the self-swab
process
5. Treatment of AG+ and AG Double Invalid
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Staff undergoes swab & waits for results at
swab site(~15 - 30 mins)
AG+ (Positive)
AG-(Negative)
Staff proceeds to work
On-Site SupervisionCentre to:• Issue Notification of
Positive/ Double InvalidCOVID-19 ART Result andreferral note (hardcopy ordigital)
• make an appointment forStaff at SASH PHPC(flu.gowhere.gov.sg)
• arrange private transportto send staff to SASH PHPCfor confirmatory PCR test
Staff to:• bring NRIC, a clear photo of
their ART results & referralnote (signed by centre) forverification
PCR+
PCR-
• Public Health Actions commence
(Contact tracing, conveyance to Hospital/CCF etc.)
Staff arrives at centreswab site/ virtual
meeting room for ESSS
2nd ART swab is invalid=
AG double invalid
No ARI Symptoms
Centre to:• conduct contact
tracing• arrange for MOH
CMTGconveyance toSwab IsolationFacility (SIF) forisolation andconfirmatory PCRtest. Tel: 6435-4060.
No ARI Symptoms ARI Symptoms DETECTED
ARI Symptoms DETECTED
Staff should consult a doctor for medical
treatment immediately.
AG Invalid
Staff self-isolates at home until PCR results return.• If staff is unable to self-isolate at own place of residence, SASH PHPC will help
arrange for CMTG conveyance to SIF.• If staff is found to be symptomatic, SASH PHPC will provide consultation &
treatment (if necessary), and arrange for CMTG conveyance if individual is AG+.Payment will be based on prevailing patient payables & subsidies (e.g. Flu SubsidyScheme).
For AG DoubleInvalid, 2 invalidresults have to beuploaded on SRS
Legend:CMTG: Case Management Task GroupSASH PHPC: Swab and Send Home Public Health Preparedness Clinic (For swab at SASH-PHPCs, clients/ centres MUST call to make an appointment prior) RSC: Regional Screening CentreSIF: Swab Isolation Facility
5. AG+ and AG Double Invalid Workflow
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Note: For AG+ and Double Invalid cases, POC to:• Ensure results are keyed into SRS within 30 mins• Centre to ensure that staff go for a confirmatory
PCR swab and monitor these individuals andoutcome of the PCR test closely.
Upload results on SRS within 30 mins
Note: For AG Invalid, 2 invalid results should
be uploaded for a staff.
Virtual SupervisionCentre to:• Issue Notification of
Positive/ Double InvalidCOVID-19 ART Result andreferral note (digital)
Staff to:• make an appointment at
SASH PHPC(flu.gowhere.gov.sg)
• arrange private transportto SASH PHPC forconfirmatory PCR test
• bring NRIC, a clear photo oftheir ART results & referralnote (signed by centre) forverification
S/N Service Provider Contact Number / Mobile Application Est Booking Fees on top of metered fare1 ComfortDelGro Taxi (Comfort & CityCab taxis) 6333 1133 or via ComfortDelGro app Add Booking Fee $2.30 to $4.502 Trans-cab 6213 09973 SMRT 6477 59714 Prime 6776 75535 Premier 6681 94626 GrabSHN, Go-Jek, Ryde, MVL(TADA) via respective providers’ app Flat fare based on app
5. AG+ and AG Double Invalid Workflow
❖ Centres should ensure that all staff with an AG+/ AG Double Invalid go for a confirmatory PCRswab.
1. Staff will be asked to present the following documents for verification at the SASH-PHPC clinic.
a. A photo of their ART result(s) + ID.
b. Referral note for Confirmatory PCR Test (signed by centre) – hardcopy or digital copy.
2. For SASH PHPCs, Centre or staff must call the clinic to make an appointment and confirm that they are able toobtain a confirmatory PCR test during their visit, before heading down to the clinic. The list of SASH PHPCs can befound at http://phpc.gov.sg.
3. AG+/Twice AG Invalid individual should travel via private transport (car or taxi) with the windows wound down(switch off air conditioning). In addition, individual should wear a surgical mask and sit alone in the back seat(on the other side from driver). Seats should be wiped down at the end of the trip.
Note: If clinic is within walking distance of the centre / staff’s home, staff may walk to the SASH PHPC.
4. The following list of private transport service providers are available for booking.
a. Centres / staff are required to inform the hotline operator that the worker is going to a SASH PHPC for a swabtest.
b. For booking through mobile app, Centres / staff must key “SHN” in the chat/note/comment box or check theSHN checkbox (if provided within the app).
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5. AG+ and AG Double Invalid Workflow
❖A hardcopy or digital copy of the Referral Note should be issued by thecentre.
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Pls indicate the name of trained supervisor who supervised the self-swab
Pls indicate centre name
Pls indicate centre name
To be signed off by POC
Pls indicate centre name and the name, email address and phone number of POC
Annexes
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Roles Checklist of ResponsibilitiesPoint of Contact (POC)
(x2)
(Note: The POC could
double up as a
Supervisor.)
Upload Results on SRS Prepare template and uploads into Swab Registration System (SRS) based on the
timeline advised by HPB, e.g. for negative, positive and double-invalid results.
Receives ART kits from HPB and ensures proper storage.
ART Kits and Inventory
Oversees the unboxing of ART kits and repacking into individual/ smaller quantities.
Monitors the utilization rate of ART kits and requests for more test kits where
necessary. Supervisors
(advised min 2 per
branch)
Completes the training offered by HMI institute.
Ensures that the self-swab site and Infection and Prevention Control (‘IPC’) processesfollow guidelines, and that safe management measures are observed.
Before staff performs self-swab, ensures none has ARI symptoms or contraindications -nosebleed (past 24hrs), or facial surgery (last 8 weeks), or nasal surgery (last 4 weeks).
Ensures staff conduct self-swab correctly, verifies result, and records the results. Ensure staff performs wipe-down/ disinfection of swab-site before and after self-swab. Alerts the POC immediately if any result is positive or double invalid. Submits the results to the POC promptly.
Roles and Responsibilities Annex I
• Centres may sign up with HMI directly at VirtualCampus (wizlearn.com). • Upon successful registration and confirmation of the course, HMI will send an
email notification with the web link for supervisors to attend the virtual training session. Please visit HMI’s website at https://hmi-ihs.com/supervisory-training-in-art-self-swab/ for latest details on the ESSS training details.
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Technical Information on ART
❖ Compared to PCR tests, ART’s sensitivity and specificity are generally lower. ARTalso differ in sensitivity and specificity across test kit models.
❖ Sensitivity: Probability that the test produces a positive result for an individualwho has COVID-19. A test with lower sensitivity will produce more “falsenegative”.
▪ Given the possibility of false negatives, staff with negative ART results should not havea false sense of security. They should continue to practice social responsibility, e.g. ifthey or their household member have ARI symptoms, they should not report for workand they/ the relevant household member needs to see a doctor.
❖ Specificity: Probability that the test produces a negative result for an individualwho does not have COVID-19. A test with lower specificity will produce more“false positive”.
▪ Given the possibility of false positives, for staff whose ART results are positive butwhose PCR tests turn out to be negative, centres will need to do slightly more reliefthan before.
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E.g. For an ART with sensitivity of 85% and specificity of 99%:
o 15 out of every 100 tests will be a false negative.
o 1 out of every 100 tests will be a false positive.
o Assuming 34 staff are tested over a 7-day cycle, ~1 staff may have a false positive over three cycles.
Annex II
Technical Information on ART
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Annex II
AG NEGATIVE
AG POSITIVE AG INVALID
ART Test Results
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Annex II
Storage Guidelines for ART kits
❖ Storage temperature requirements - 2-30 degree Celsius
❖ Indoor, within an air-conditioned room where available
❖ Pallet size 40 x 48 inch / 122 x 108 cm (height clearance – approx 1.8-2M)
❖ Per Pallet –
▪ BD - 4,320 Tests
▪ Bio Sensor – 9,000 Tests
▪ Pan Bio - 9, 600 Tests
❖ Per box - 25 Tests for SD BioSensor & PanBio; 30 Tests for BD35
BD Veritor Plus System SD Biosensor Standard Q Panbio Covid-19 AG
[Majority Stock for Workplace ART Operations]17 x 7.1 x 23.5 cm (~0.39kg)
Annex II
Unboxing and repacking ART kits
❖ART kits are typically packed in boxes of 25 – 30 kits.
❖ Centres may wish to open up the box and ‘break the bulk’ of items intoindividual test kits (e.g. zip lock bag of 1 test device, 1 swab stick, 1nozzle cap and 1 reaction tube required for ART.).
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Annex II
Unboxing and repacking ART kits
❖Recommended steps for packing of ART kits can be found in the Figurebelow.
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Annex II