HOSPITALS IN CRISIS

With the local health sector on crisis footing as a spiralling rate of infections slam under-resourced hospitals, the health ministry on Friday suspended elective surgeries and other crucial medical procedures in public facilities as it went into emergency mode amid a raging COVID-19 third wave.

In a press release, the Ministry of Health & Wellness advised that public hospitals would now be seeing only emergency cases as the sector buckles from the sheer number of COVID-19 patient admissions as the coronavirus pandemic – largely believed to be driven by the Delta variant – sweeps the country.

It is a crisis like never before, veterans in the health sector have noted.

Since the start of the month and up to Thursday, August 26, Jamaica recorded 269 COVID-19 deaths, almost a quarter of the tally for the previous 16 and a half months, dating back to March 2020, when the island recorded its first case. Some 145 other fatalities are being investigated and another 172 have been ruled coincidental.

Hospitalisations have also quadrupled since the start of the month, up from 187 patients on July 31 to 739 on Thursday, with 189 patients being moderately ill, 92 assessed as severely ill and a further 61 said to be critically ill.

Doctors have expressed concern that this wave is more worrying because it has risen more swiftly than prior ones, with a larger share of the patients this time being young adults and even children.

Add to that the frustration of healthcare workers, who have been under pressure trying to make-do with limited resources to try save the lives of mainly unvaccinated Jamaicans overflowing into some hospital parking lots under tents. Scores of patients spend days sleeping on benches, in wheelchairs, and on stretchers awaiting bed-spaces in overwhelmed wards where many others battle respiratory distress amid a rising demand for oxygen.

Kevin Allen, CEO of the St Andrew-based University Hospital of the West Indies, sighed with exhaustion on Friday, recalling arriving home on a rainy Thursday night just shy of midnight. For him and others, the Government’s declaration may ease the heart-rending juggle for healthcare workers balancing life, death, resources, and an unending fear for their own safety.

“Our COVID bed capacity is 70, and all beds are taken. There are 37 patients in Accident and Emergency (A&E) waiting on admission in the tent on the outside,” Allen told The Gleaner on Friday. “It’s rough, I just got in, everybody is just tired, but our staff is just awesome. The team has been there plugging and plugging away. Patients are coming in non-stop,” he emphasised.

“We have been using our A&E as a ward, but we just don’t have the space to see other non-COVID patients,” he lamented, revealing that the hospital had 112 confirmed COVID-19 patients at latest count when he spoke with our news team on Friday.

In the third wave of the local outbreak and with three strains of the virus confirmed in the island – with 64,899 of roughly three million Jamaicans infected on paper up to Thursday, according to the authorities – the health system has all but buckled in the western end of the island as well.

GRIM PICTURE

Delroy Fray, clinical coordinator at the Western Regional Health Authority (WRHA), painted a grim picture when contacted by our news team.

“Let’s start with the big hospital, Cornwall Regional Hospital. Our bed capacity is 354 currently, plus 36 from an infirmary in Falmouth,” explained Fray, who has been in the health system since 1985 and describes this as the most troubling period he has seen.

“Currently, we have 331 patients in, and that is because this morning I gave out a note that the surgeons, the gynaecologists, the interns must go through the wards and send home patients who can be sent home,” he said. “We anticipate more COVID cases. We are currently awaiting 49 results of patients in the A&E. So that puts it into the perspective of where we are in terms of capacity,” he told The Gleaner.

Our newsroom understands that a tent will be erected at the Mount Salem-based Cornwall Regional Hospital to accommodate any overflow of patients from that facility’s A&E, while an additional 30 rooms for COVID-19 containment are also in reserve at the El Greco resort, with plans to secure another 60 rooms there.

The capacity of the Falmouth Hospital in Trelawny is 144 and on Thursday, it was housing 121 patients, including two babies, Fray calculated. That hospital has 48 suspected COVID-19 patients in addition to others in the larger A&E space awaiting to be moved to the wards.

“So they are overcapacity,” he concluded, taking into account a field hospital in Falmouth with 36 COVID-19 beds – all booked.

The capacity of Noel Holmes Hospital in Hanover is 60, but it had 76 patients, which includes 48 diagnosed with COVID-19 although it had only 11 beds designated for treatment of the illness.

At the Savanna-la-Mar Hospital in Westmoreland, Fray said, full capacity is 205. Nonetheless, on Thursday, it had 284 patients, inclusive 85 being treated for the coronavirus. This, while the hospital holds only 16 designated COVID-19 beds.

WRHA Regional Director St Andrade Sinclair told The Gleaner on Friday that an additional 20 beds should be ready at the institution by this weekend. This, as inclement weather stalled the setting up of a field hospital with 30 bed-spaces

“We should have started breaking ground for the field hospital already but because of the weather, that did not happen. I understand that the tent is going to be delivered between today and Wednesday. In the meantime, the other section that is being retrofitted for the 15-20 bed-spaces will be ready over the weekend,” he relayed.

“For the field hospital, I cannot say how long it will take to complete, but things being constant, it may be another two weeks,” he continued, noting that retrofitting work at a nearby church building, where it is expected that additional space will be provided, has also been delayed.

“Every day that I go out, it is like I am watching a movie and I’m hoping that the movie will end soon. It doesn’t feel like reality to me,” Fray bemoaned, relaying the devastating impact on staff, which, for years, has been below required numbers.

“Staff here is stressed beyond capacity,” he noted.

It was a fact driven home by nurses across the island, who staged a sick-out this week in protest of working conditions, insufficient resources, burnout, poor wages and a declaration from the Government that they would not get priority treatment if they are exposed to the virus on the job and fall ill.

THE CRIME FACTOR

St James, like Kingston and St Andrew, is among the parishes with the highest number of homicides and shootings since the start of the year.

While the emergency cases-only declaration for public hospitals brings some reprieve for medical practitioners, avoidable cases such as gunshot victims, who cannot be turned away, will still bog down an already-stressed system strapped for resources, noted Burknell Stewart, CEO at the Kingston Public Hospital, the island’s largest.

“The average youngster who comes into our A&E with a gunshot wound in the upper torso, it takes about $1.2 million for A&E alone; and when they go to the theatre, it’s close to $1 million – if not more – depending on the extent of the damage and how long the staff has to be there. Then you may also need to go to the high-dependency unit because you are critical for days, or maybe some weeks. This is just one patient,” Stewart noted on Friday, listing the various technicians and hospital staff required in each instance.

All COVID wards at the facility are filled to capacity, said Stewart. So, too, is are step-down wards which are used to give final care before patients are released from the facility. He noted there are well over 100 COVID-19 beds in addition to a field hospital that holds 36 people, and several others on the isolation ward. There are roughly 530 beds at the hospital, he explained.

“And remember, we assume that everybody is positive. So then this is where the PPE (personal protective equipment) come in, and the poor porters on the front line, who have to just spring into action when these vehicles roll in, taking victims on the stretchers into position ... . Yes, they have on the gowns and the masks, but you don’t know. It is really risky,” he noted.

“[What’s] worse is that the average Jamaican who is creating the problem, they don’t have any kind of understanding of what goes into play,” Stewart said, listing the social and economic costs to Jamaica, both from COVID-19 and crime.

Up to Thursday, Jamaica had recorded 64,899 COVID-19 cases, of which there are 15,058 active cases.

Christopher Thomas contributed to this story.

corey.robinson@gleanerjm.com