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Covid Reflections: With Public Hospitals Accepting Emergencies Only, We Have Entered Another Phase in Our 3rd Wave

Yesterday Jamaica’s Ministry of Health and Wellness issued a press release stating that the country’s public hospitals would be accepting emergency cases only, until further notice. The large number of people confirmed with or suspected of having Covid-19 who need hospitalisation has resulted in the hospitals exceeding their Covid-19 isolation capacity. So other hospital spaces and resources have to be dedicated to treating people with Covid-19. General hospital service has been suspended, including elective surgeries, and people who can be cared for at home are being discharged. The Chief Medical Officer (CMO), Dr Bisasor-McKenzie, is quoted as saying that “The rising demand for oxygen also threatens to overwhelm the supply.”

Curiously, this press release has not (yet) been posted on the MOHW website.

This decision by the MOHW signals that the country has entered into a new phase in the 3rd wave of Covid infections in Jamaica but it does not come as a surprise if you have been following the news and numbers in the past couple of months. And the news and numbers over the last week or two have clearly shown the deepening crisis.

People in government and outside of government have been speaking about the increasing numbers of Covid-19 cases, the increasing numbers of hospital admissions, the pressure for space within the hospitals, the pressure on staff within the hospitals. These comments and information have come through official statements at government press conferences, through media interviews, in press releases, on social media.

A small sampling of examples…

Dr Melody Ennis of MOHW was speaking with Dionne Jackson Miller on RJR
Nurse Patsy Edwards-Henry, President of Jamaica Nurses Association, was speaking with Sanjay Lewis on Power 106
MOHW PS Dunstan Bryan speaking with RJR
Slide shown at OPM press conference on August 9, 2021, while PM Andrew Holness spoke & said “I want us to pay attention to this graph. It shows our daily confirmed cases of Covid-19 in blue, while the red line shows the 7-day moving average of new hospitalisations. You can see that our daily hospital admissions are now at the same level as our previous peak in March/April 2021. We now have approximately 500 of 700 beds allocated for Covid-19 occupied islandwide and a number of our large hospitals are over capacity.”
(Transcribed from PBCJ recording of OPM press conference, August 9, 2021.)
Slide presented at MOHW press conference August 12, 2021. CMO Dr Bisasor-McKenzie said: “We can see now, compared to last week, that our bed occupancy now is at over 600 beds occupied with both confirmed cases and suspected cases…Our peak, March/April, we were at just over 700 and now we are just over 600.”
(Transcribed from PBCJ recording of MOHW press conference.)
In a report on August 17, 2021, JIS covered this point made by Dr Bisasor-McKenzie, where she said “We are fast approaching that peak, which will put us in a very dangerous zone in terms of the care for COVID patients in our hospitals. It puts us in a very high level of pressure on the hospital system.”
Dr Andrew Manning, Medical Association of Jamaica President, in a news report on RJR, August 16-8-21 – MAJ Alarmed at Record High COVID Positivity Rate
Slide showing hospital capacity – OPM press briefing on August 19, 2021 – CMO Dr Bisasor-McKenzie said. ” And this is what is happening in our hospitals. Across the regions, what we are seeing is that the four regions are in an alert phase in terms of Covid capacity. For the southern region, we have gone over the capacity for Covid beds; we’re at 162% occupancy. For the western region, 142%. For the north east region, 125% and for the south east region at 97%. It means that most of our major hospitals, our main hospitals, are really full….As you can imagine, our health care workers are tired, they’re frustrated, they’re overworked, they’re stressed.”
(Transcribed from PBCJ recording.)
This week Wednesday (August 25, 2021) All Angles on TVJ did a special report about the Savanna-La-Mar Hospital, which is struggling with an influx of Covid-19 patients. Dionne Jackson Miller interviewed members of staff – doctors, nurses, a porter, the CEO – about conditions at the hospital. It was a harrowing and moving programme.

And today a number of media houses have carried reports that there is a severe shortage of medical oxygen in the country, which is now affecting the supply to hospitals, some of which are said to be out of oxygen. There has not at this point been an official statement on this from the Ministry of Health & Wellness.

There is an urgent need for a press conference to be held focusing on the dire crisis in the hospitals. Despite the many warnings that this was where we were heading, now that we are here, the public of Jamaica deserves a full update. This is particularly urgent in light of the fact that the Dr Karen Webster-Kerr, National Epidemiologist, has said that this 3rd wave won’t peak for another two weeks. That thereafter it is likely to take several months to come down from that peak. That, although she is reluctant to give predictions about deaths, we are likely to see 140-150 deaths over the next week and an additional 10-20 on top of that number the following week. (She was speaking in an interview on Nationwide News Network on Thursday, August 26, 2021). This means that the pressure on the hospitals is likely to continue for weeks to come, increasing further before it decreases.

It is Saturday night. The curfew started at 6pm. For the next 3 days, Jamaicans are under 24-hour curfews, with the curfew ending at 5am Tuesday morning. Tomorrow – Sunday – would be a good time to hold a press conference. Let us know what time. Most of us will be at home…


Jamaica: Increased #Zika Numbers & Some Questions

I wrote about zika on Tuesday (July 5) and here I am writing about it again, primarily because I heard Minister of Health Christopher Tufton talking with journalist Cliff Hughes on his programme on Power106FM yesterday, and there was some updated information that caught my attention.

Minister Tufton MOH photo

Minister Tufton

Cliff Hughes NNN photo

Cliff Hughes

Additionally, some other questions and concerns have been milling around in my head for a while, and I thought I would transfer them from brain to blog.

 

Ministry of Health Zika Update, as of July 1, 2016

At the beginning of the interview, Minister Tufton shared that his son now has zika, with mild symptoms so far, and he reiterated that the World Health Organization (WHO) projection is that approximately 70% of the population will get zika. He also noted that the majority of zika cases have mild symptoms, with approximately 1% being severe.

The updated figures for zika that he gave stood out for me, particularly the number of pregnant women with suspected zika infection, which was significantly higher than the figure he had given at the Ministry of Health (MOH) press briefing two days before. This sent me to the MOH website, but I didn’t seriously think I would find the new data there. O ye of little faith! The website had been updated today, and there was a document entitled Zika Update as at July 01, 2016. (Is a trend in posting regular updates now underway? That would be good.)

The following  changes are reflected between the June 25 & July 1 reports:

  • Number of notifications                      – from 2825 to 3088
  • Number of suspected cases                – from 2135 to 2183
  • Number of confirmed cases               – from 24 to 26
  • Number of suspected cases in pregnant women    – from 88 to 142
  • Number of notifications for GBS      – from 42 to 53

The most striking change was the reported number of suspected cases of zika infection in pregnant women, which had gone from 88 to 142.

MOH zika in pregnant women 1-7-16

Minister Tufton said it is expected that there will be cases of zika-related microcephaly in babies born later this year. With the first confirmed case of zika in Jamaica being in late January, it is thought that such cases may affect some babies born in September and beyond. He reminded that not all babies born to mothers who have had zika are affected by microcephaly, though he gave a possible figure of 10%. He said that the hospital system was being prepared for this eventuality and that counselling was being and would be provided to pregnant women.

MOH GBS 1-7-16

Speaking about the cases of Guillain-Barre Syndrome (GBS), the Minister told Cliff Hughes that not all cases of GBS require treatment in Intensive Care Units (ICU), but that there have been some severe cases requiring ICU care. He said that during a visit he made to Kingston Public Hospital (KPH) this week, there had been 2 or 3 patients with GBS in ICU there.

Some Questions for the Minister

 

 

 

In speaking with Mr Hughes, Minister Tufton indicated that he and others at the MOH were committed to handling the zika outbreak with transparency, having learned lessons from the handling of the chikungunya epidemic in 2014. He said:

Jamaicans need to know what they are confronting, what the risk factors are and what they need to do in preventing and, if they can’t prevent, how they need to follow up…We shouldn’t hide anything from the public; we should go out of our way to explain to the public the issues at hand. – Minister Tufton (transcribed from recording of interview with Cliff Hughes on Power106FM, July 7, 2016)

The MOH has been providing more information about zika than it did for ChikV and the Minister certainly seems to be committed to providing such information. With that in mind, I ask the following questions:

Blog questions 1

blog question zika

blog questions 2

(Click for copy of MOH Zika-update-of-as-at-July-1-2016)