Michael Abrahams | The harsh reality of our COVID-19 crisis
My elective surgery cases are usually done on Thursday mornings. Last Wednesday, I received a call from the private hospital in St Andrew where I had an operation booked for the following day. I was supposed to be performing a myomectomy, removal of uterine fibroids, from a very pleasant but apprehensive lady who had finally decided to have the troublesome tumours excised. Thinking that the call was to confirm my case, I gleefully told the ward secretary that I will definitely be proceeding with the operation. Unfortunately, the call was not to confirm that the surgery will proceed as planned, but to inform me that my case, and all other elective cases for that day, had to be cancelled, as the hospital had no available beds. In over 23 years of admitting patients to that hospital, I have never had this issue before. I was disappointed, but I understood.
After the call was terminated, I called a senior colleague of mine, who also manages patients at that hospital, to inform her of the bed situation there. She told me that she was in the process of trying to get medical attention for her elderly mother at the University Hospital of the West Indies. Her mother has kidney disease, and is a dialysis patient, but had now gone into heart failure and needed urgent attention. Her condition would be best managed as an inpatient, but there were no available beds at the institution, and my colleague was told that she would have to be managed on a stretcher in a corridor until a bed became available. My friend thought the proposed arrangement would be too risky, and took her mother back home and managed her with oxygen and drugs. If my colleague were not an experienced anaesthetist, her mother would have likely died.
Realising the gravity of the situation, I called another colleague in a senior position at another private hospital in St Andrew to enquire about the situation there. He informed me that there were no available beds there, either.
So, this is what is happening. We are in the midst of a severe COVID-19 spike. With the rise in cases, not surprisingly, there is an increase in severely ill people. These ill people will present themselves at emergency rooms. Those who require admission will be admitted at facilities that manage COVID-19-positive persons as inpatients. These facilities are all public. When the wards become full, people end up being managed on stretchers and chairs in corridors and other spaces until beds can be found. When the inpatient beds and emergency rooms become full, sick people, including people with ailments other than COVID-19, get turned away, like an asthmatic teenager who died in her mother’s arms after being unable to receive treatment from an emergency room last week. If they are able to, some who cannot be seen at public hospitals will visit private institutions, which will then become overburdened. People have been literally, but inadvertently, embarking on hospital emergency room tours trying to get critically ill family members to be seen.
HEALTHCARE WORKERS INFECTED
In addition, with a significant rise in cases, healthcare workers will become infected, as was the case at the Mandeville Regional Hospital, where over three dozen members of staff in the operating theatre and high-dependency unit tested positive. When these workers test positive or become ill, they will need to be away from work, and there will be staff shortages, further compromising the ability of the system to manage those in need of medical care.
Our healthcare systems, both private and public, are buckling under severe pressure. To compound matters, we are yet to start vaccinating our population. Further worsening the situation are the ignorance, indiscipline and stupidity that is all to prevalent in our country. Two weeks ago, a patient told me that she does not believe that COVID-19 is real, and that people are dying from it. A few days ago, another patient told me that the taxi driver who transported her to my office berated her for wearing a mask, telling her that we are being forced to wear masks, and believe that the virus exists so that “they can force us to take the vaccine and kill us off”.
If you and your loved ones are well, be grateful. In the meantime, please, me beg oonu, adhere to the COVID-19 protocols: wear masks properly when appropriate, practise regular handwashing and sanitising, and proper respiratory hygiene (such as covering your face when you cough or sneeze), clean and sanitise regularly touched surfaces, practise physical distancing as best as you can, and avoid large gatherings.
Also, do everything you can to avoid having to visit an emergency room. Eat healthily, exercise regularly, and if you have chronic illnesses such as diabetes and hypertension, and take medication to control them, please be compliant with your medications.
This crisis is more serious than many of us realise. We are all at risk. Every single one of us.