Desperate need for critical care expansion

The government of The Bahamas this week announced the international aid relief agency Samaritan’s Purse will provide a 28-bed COVID-19 isolation and treatment unit as part of the Ministry of Health’s strategy to increase patient capacity.

The tented inpatient facility will be adjacent to Princess Margaret Hospital (PMH). Samaritan’s Purse is also providing 30 staff members to operate for a three to six-week period. 

We also learnt that the facility will not include ICU treatment, but only step-down care. No ventilators will be provided or operated by Samaritan’s Purse.

Additional help to increase our capacity to fight COVID-19 is sincerely welcomed.

But while the Samaritan’s Purse operation will no doubt be valuable, it is not likely to have an impact on addressing our urgent need for the improvement in critical care at PMH and other public facilities.

We note also that after boasting about securing the Breezes hotel to help ease the burden on PMH, the government has yet to provide an explanation for why the facility is no longer being used and how patients who had been there were accommodated.

The healthcare system is overburdened. Our primary facility, PMH, has become a house of horrors as it does not currently have the capacity to deal with the strain placed on it by the pandemic.

It is understaffed. It has a shortage of ventilators and other life-saving equipment, and desperately-needed treatment to address symptoms and save lives is lacking.

The stories of patients going into PMH to be treated for other ailments and later contracting COVID-19 within PMH are growing. Some have died.

The hospital’s lack of capacity to test patients as they are admitted is creating nightmarish scenarios and worsening a crisis the facility is seeking to address.

Many patients are not being tested for COVID-19 unless they are about to have surgeries or are showing symptoms. They are being placed on wards with other patients. Some are causing the spread of the virus on open wards.

It is not an overstatement to conclude, as the leader of the opposition did yesterday, that we are headed toward catastrophe if we do not reverse course.

Former Minister of Health Dr. Duane Sands made a similar observation this week when he warned the country is “deeply in trouble” over the number of hospitalized COVID-19 patients.

“We are beyond capacity relative to COVID in the entire healthcare system of New Providence,” he said.

Sands added, “At a point last week, we had some 70-plus patients with COVID in Princess Margaret Hospital.”

By the time patients are isolated on wards, the damage is already done.

Not all whose conditions worsen have access to ventilators. The maxed out Intensive Care Unit means some are not getting the chance at survival they deserve.

The overworked and under-resourced health teams do what they can, but the death count just continues to rise.

There are 109 confirmed deaths, 22 non-COVID-related deaths and 15 deaths under investigation. 

Sands pointed out that it is a challenge for people with COVID-19 to get care, but it also means that people with heart disease, hypertension, diabetes, surgical problems and other ailments have difficulty getting care.

This could mean that the pandemic’s unofficial death count is much greater than the numbers we are seeing on the Ministry of Health’s daily dashboard.

The total COVID-19 case count has exceeded 5,000, with nearly 2,000 of those cases still active.

The vast majority of reported cases have been on New Providence. The virus is still rampant in our communities.

With so many in the population with comorbidities, the demand on PMH for critical care is evident. Increasing capacity in this area should be the government’s primary focus.

We stress again that testing capacity in the public arena needs to be expanded. Many will not pay the $100-plus to get tested at private facilities. 

No one should be admitted to PMH without a COVID test conducted upon admission. Failing to do so is putting the lives of many at risk.

We are continuing to see a toxic mix of bad policies, possible negligence and a lack of personal and collective responsibility on the part of citizens and residents. 

Bahamians need to understand that irresponsible behavior could land them at PMH, the last place they should want to be in the midst of a pandemic where access to quality health care has been substantially reduced.

The government is talking about a November 1 “reopening” of our economy, but the ravages of COVID-19 are far from over.

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