M.P.H.S.TOH1, L.W.ANG1, M.Z.TAY1, W.E.L.WEI1, V.J.M.LEE2, Y.S.LEO1
National Centre for Infectious Disease1, Ministry of Health (MOH)2
COVID-19 is caused by SARS-CoV-2 and has spread globally. Locally-acquired community cases emerged after the first wave of imported cases in January 2020 and these two groups may have different health-seeking behaviour affecting disease transmission. This study aims to investigate differences in health-seeking behaviour between locally-acquired cases and imported cases, and within the locally-acquired cases, those who consulted single versus multiple healthcare providers.
A retrospective study of 258 patients who were diagnosed with COVID-19 from 23 January to 17 March 2020. Variables related to health-seeking behaviour included number of visits prior to hospitalisation, timing of the first visit, duration from symptom onset to admission, and places where the cases had at least one visit. Analysis was conducted using SPSS and R.
: Locally-acquired cases had longer duration from symptoms onset to hospital admission (median 6 days, range 1-30) than imported cases (median 4 days, range 1-13) (p<0.0005). Singapore residents were more likely to have visited private clinics and/or government-subsidised public clinics than non-residents (84.0% vis-à-vis 58.7%, p<0.0005). Among locally-acquired cases, those who sought care from a single provider had fewer visits before their hospital admissions compared with those who visited multiple care providers (median 2 vis-à-vis 3, p=0.001).
Our study suggests the need to encourage individuals to seek medical attention early when symptomatic, particularly from their family physician or the same doctor. This would expedite the process of testing, confirmation and isolation, leading to quarantine and limiting local transmission so as to control spread of the COVID-19 pandemic in Singapore.