‘I SHARED MY OXYGEN’

Two recovered COVID-19 patients have painted a terrifying picture of the operations at the Montego Bay-based Cornwall Regional Hospital as it comes under pressure as virus cases spike, a situation Western Regional Health Authority head Errol Greene recently likened to a war zone.

A spike in coronavirus cases since the start of the year has had the hospital administration scrambling to find more bed spaces, converting other wards to treatment areas for COVID-19. Despite this, the St James Type A hospital – the largest in the western region – remains under significant pressure, with talks under way to see if the newly opened COVID-19 ward at the Falmouth Hospital in Trelawny could help to ease the burden.

Carlton Crooks* told The Sunday Gleaner that his recent stay at Cornwall Regional – whose operations are also hamstrung by repair works currently taking place – makes him believe there are significant management issues which need to be addressed urgently.

After waking up feeling unwell one Saturday morning, 55-year-old Crooks visited his doctor and was given a referral to go to the Cornwall Regional Hospital immediately.

“The waiting area was lined with people waiting to get attention, but I could see the fear and uncertainty in the medical staffers, especially the Jamaicans,” he said of his observation upon arrival.

“The staff morale is one in which they are afraid because nobody fully understands the virus,” he continues. “I felt it for them because they were trying to administer care at the risk of their own personal health, but the atmosphere became even worse when news that one of their colleagues had contracted the disease began to circulate … . They did not want to come near us. Only the Cubans.”

He added: “The attitude of the nurses from Cuba was commendable. Our own Jamaican nurses need to be retrained. You are treated like you are a nobody. Only a few nurses have a little compassion.”

According to Crooks, who is renowned in the tourism sector, when he eventually saw a doctor, he was sent to the Accident and Emergency Department, where he spent the night on a plastic chair.

“The next day, I was sent to an area called the patio. I spent another night there with about 40 other persons suspected of having contracted the coronavirus disease seated side by side. No social distancing. People are falling asleep on your shoulder – all suspected of COVID,” he said, pointing to a situation which could have caused persons who were negative to contract the virus.

“It took two days for my COVID test to be done and I was then placed on a ward ... that had no ventilation and the nurses wanted the doors kept closed because they did not want us to spread the virus,” he recalled. “Just one door, and the room was so hot, I could hardly breathe. At one point, I called my family to tell them goodbye, given the way I was gasping for breath.”

Crooks told The Sunday Gleaner that during his 16-day stay there were instances in which patients had run out of oxygen, causing him to share his cylinder with other patients on several occasions.

“When the oxygen that they give you to help you breathe runs out, you have to do without. I saw persons forced to do without oxygen for over 12 hours. In fact, I took the oxygen off myself on several occasions to help save lives, because you are calling for help and no one is there to even talk to you,” he related.

“One night I even called a nurse about a man who was gasping for breath. When I went to check on him, his breathing level was 63. Long after, a doctor came and said he was okay, but within another hour and a half, the man was dead. That’s how bad it is there,” said Crooks, who also charged that Health and Wellness Minister Dr Christopher Tufton might not be in touch with the realities on the ground.

“When Dr Tufton goes to Cornwall Regional Hospital, he paints a picture as if things are okay, but it’s not. People are suffering and dying up there,” he said. “I tell you, something is dreadfully wrong with the administration at the Cornwall Regional Hospital.”

Crooks’ tale was very similar to that of 60-year-old Frederick Wilson*, who was turned away when he first visited the hospital.

“I went to Cornwall Regional Hospital because I was having a severe headache. My eyes felt as if they were popping out of my head and my body temperature was extremely high, but they turned me away, saying it was a simple flu,” he told The Sunday Gleaner.

A visit to his private doctor two days later confirmed his suspicion and he was given a document to return to the Cornwall Regional Hospital, where he was admitted.

A businessman who constantly handles cash and has several taxis, Wilson said he could not pinpoint how he caught the virus.

“I went back to Cornwall on Wednesday and they did the test, and by Saturday, my results came back that I am positive and they admitted me,” he said.

“When I was at the section before you go on the ward called First Trauma, I interacted with some fantastic doctors and nurses, but when I was taken to the Nine East ward, it was a different story,” he said. “When the Cubans working, it was a huge difference than when the Jamaicans are working. They (Cubans) are very professional, of a very high standard.”

Added Wilson: “They also ran out of oxygen very regularly, but while it affected others, it did not affect me as I have a niece who is in healthcare, who told me what to do to stay alive, so I did not rely fully on the oxygen.

“I shared my oxygen on three occasions with a man named Campbell, but he eventually died,” Wilson said. “But I did not want to totally depend on the oxygen because my case was not as severe as others, so I had my balloon that I blew to keep my lungs active. Plus, my bed was at a window, so I also got the natural air.”

Now two weeks after being discharged, Wilson says he has constant diarrhoea but he has been told that he should not worry as “it is the medication flushing me out”.

Crooks was discharged one week ago, but continues to experience similar symptoms as he had before being hospitalised, forcing him to visit his doctor on six occasions, but he is hopeful that the feelings in his body are merely a reaction to the medication, as the hospital staff has assured him, and not something more serious.

Greene acknowledges oxygen challenges; IGL highlights global shortage

Responding to issues raised by Wilson* and Crooks*, Western Regional Health Authority Regional Director Errol Greene rubbished suggestions questioning the commitment of his staff.

“I think they are doing a fantastic job in dealing with the issue. We must remember that we are dealing with something that the world has never seen anything like before. I am proud of the medical team.”

Turning to the oxygen situation, he told The Sunday Gleaner that under normal circumstances, the oxygen storage capacity at the Cornwall Regional Hospital is sufficient, but the respiratory illness has put a strain on supplies.

“We have adequate storage for normal times, but the demand has grown by 500 to 600 per cent of what we normally use in normal times,” he said. “COVID is an illness that places a great demand on oxygen, and even though we are supplied twice per day now, we are still running low, but even as we speak, I have biomedical engineers looking to see how that situation can be improved.

“I must admit that we run low at times. So yes, we have an issue because the demand is so great, so that the supply can hardly keep up with us,” Greene told The Sunday Gleaner.

All of Jamaica’s medical oxygen was imported prior to 2018, when Industrial Gases Limited (IGL) – the sole producer in Jamaica and one of only two such operations in the Caribbean – invested US$10 million to establish a production plant at Ferry, St Catherine.

Since then, IGL, which has been operating in Jamaica for over 50 years, has been the sole supplier to the health sector.

“Nobody knew about COVID at the time when we decided to expand our services, but the objectives of IGL was to stop import substitution, and a subsequent reduction on the demand for foreign exchange,” IGL General Manager Peter Graham told The Sunday Gleaner on Friday. “Moving us from full importation, the health sector was now being supplied by a locally produced source.”

However, the last four weeks have been very challenging for the company as demand across the healthcare sector has increased by as much as 500 per cent in some instances.

“We have seen a major surge, and as you will know, the hospital system has even ran out of bed space,” Graham said. “More people are being hospitalised and the consumption of the gas per person has increased, so the demand for oxygen has jumped each day at some institutions by as much as four times what was usually requested.”

“For example, we usually supply the Cornwall Regional Hospital every three days. Now we have to supply oxygen to Cornwall every day,” he revealed. “Spanish Town Hospital now requires supplies sometimes two and three times per day.”

Even as a producer, IGL would occasionally import a small amount to satisfy demand, but according to Graham, due to the pandemic, it is every man for himself.

“Medical oxygen is short around the world, so nobody is selling their oxygen readily,” he said. “You cannot just pick up the phone and call somebody and say sell me some oxygen because it is a global pandemic and no one is selling readily. So if it was not for this local production of medical oxygen, the conversation would be very different from what it is today.”

He said that despite the pressure on oxygen supplies, it is very rarely that medical facilities completely run out of gas.

“We are talking about shortage, but most medical institutions have a primary and secondary storage. So if the primary goes low, they switch over to the secondary. ... It is very rare that the primary and the secondary would be out at the hospital at any given point at the same time, because we get there on time to replenish the primary.”

He said that some hospitals rely heavily on the use of cylinders, while others have a piped system throughout the wards.

“The ones dependent on cylinders are the ones that are under more pressure and the Ministry of Health has accepted that, so the problem is twofold – the oxygen and the logistics of moving the cylinders around. So while the medical professionals would have liked to be running on higher inventories, we are running on lower inventories because the demand has increased by three or four times from everyone.”

Graham declined to provide a breakdown of the supply to the medical institutions, instead referring The Sunday Gleaner to the Ministry of Health and Wellness. Efforts to get the data proved futile.

*Names changed.

mark.titus@gleanerjm.com