OXYGEN ALARM - Hospitals running low on supplies as COVID admissions climb
Hospitals running low on supplies as COVID admissions climb
Jamaica’s major hospitals are teetering on the very thin edge of collapse as some have either run out oxygen stock or are dangerously low amid rising COVID-19 hospitalisations and the resulting demands for the life-preserving chemical. “There is...
Jamaica’s major hospitals are teetering on the very thin edge of collapse as some have either run out oxygen stock or are dangerously low amid rising COVID-19 hospitalisations and the resulting demands for the life-preserving chemical.
“There is a problem with the supply of oxygen,” admitted Wentworth Charles, the chairman of the South East Regional Health Authority (SERHA), which is responsible for public hospitals in Kingston, St Andrew, St Catherine and St Thomas.
Those parishes form the base of the country’s industrial and commercial economy, accounting for almost half the population and 51 per cent of the 25,303 confirmed coronavirus cases on the island over the past year.
The region is also home to nine hospitals, with the public ones accommodating COVID-19 patients now full, but ordered not to turn away patients.
Now it’s not just beds but oxygen that is threatening to be in short supply in efforts to treat patients for the respiratory illness.
“There is a heavy demand presently and we have only one supplier, who is supplying all the hospitals in the island, and, therefore, every effort has to be made by the region and the ministry to seek to bring in an alternative supplier at this time,” Charles added.
Industrial Gases Limited (IGL) is the sole local producer of medical-grade oxygen.
“What happens now,” Charles continued, “is that the supplier has to be retrieving the empty tanks from the hospital to have them refilled and that has caused some serious concern.
The problem is compounded at hospitals where some wards do not have adequate piping to facilitate ease of access. The National Chest, Kingston Public and Spanish Town hospital are among the SERHA institutions having oxygen problems.
“So, where we don’t have pipes, we have to use cylinders in the wards and this is where we have challenges,” the SERHA chairman said.
Low levels of oxygen supplies have also been reported in western Jamaica, especially at the Cornwall Regional Hospital in St James.
Noting that there has been no report of a hospital “running completely out of oxygen”, IGL General Manager Peter Graham said the company was doing all it can to meet demand, which he added “has increased three to fourfold in the past two weeks”.
“The challenge is for those hospitals that rely heavily on cylinder,” he said, a reminder of images last week of corridors crowded with patients armed with cylinders at Cornwall Regional.
“Those that can accept liquid, they are in a better place. It’s more a logistics challenge to move cylinder back and forth,” Graham explained.
Charles, meanwhile, said he could not give a timeline for getting a second supplier to ease the burden on IGL, but “we have to move expeditiously”.
The Government is now exploring “options” to supplement IGL, confirmed Health and Wellness Minister, Dr Christopher Tufton who said the situation is now a “major cause for concern”.
“A number of the significant hospitals are either out of stock or low stock based on usage and also the dependence of one supplier in the country for medical oxygen,” the health minister said.
“We have no choice but to work with that one, sole supplier. We will continue to do so. They have indicated they are making adjustments to improve, and we hope they will,” he said, noting the hazard with having a single provider in a market when problems develop.
Dr Andrew Manning, president of the Jamaica Medical Doctors Association, said a “quick and successful roll-out” of the island’s vaccination plan is now critical.
“Given the surge that we’re seeing, if we can protect those who are most vulnerable in short order, even with the spread of the virus, we should be able to decrease the number of hospitalisation,” he said.
Vaccines arrive tomorrow
The first set of vaccines expected for the island is a gift of 50,000 from the Indian government that is due to arrive tomorrow, after which it is expected to take another 48 hours for the first jab to be administered.
Some 16,000 health professionals will get the vaccine first after the Holness administration bowed to pressure to de-prioritise government officials and allow front-line workers in the healthcare system to go first.
Latest health ministry COVID-19 data up to March 5 indicated that there were 287 persons hospitalised of which 29 were moderately ill and 30 at the critical stage.
A record 527 persons tested positive out of a sample of 2,484 on Friday for a 21 per cent positivity rate, within the range the country has consistently been averaging in recent weeks and which prompted the tightening of restrictions for the next two weeks.
The active case count is at 10,469 while deaths increased by three to 446.
The mounting problems for the ailing health sector come as Jamaicans struggle to come to grips with two controversial deaths and accusations of negligence at two SERHA institutions – the University Hospital of the West Indies (UHWI) and the Kingston Public Hospital (KPH).
Days into learning details about how the cries of asthmatic 17-year-old Jalisa McGowan for oxygen at the UHWI were allegedly ignored came the story of how 32-year-old Shanay Spencer’s appeals for assistance from her bed at the KPH were similarly ignored, forcing her to turn to relatives miles away before passing.
“The situation is very troubling; worrisome; alarming. Events like these send shock waves through the community,” said Public Defender Arlene Harrison Henry, acknowledging the “great strain” on the healthcare system currently.
“In spite of the pandemic, hospitals are required to continue to provide basic services to us,” insisted the public defender.
“It’s almost a year now since Jodian Fearon has passed and the country is still left up in the air without answers. What’s the situation now with this young schoolgirl, Ms McGowan? And there are others that may not have reached prominence. The situation is gravely worrying.”
Fearon died last April, hours after giving birth following a series of bungling involving the private-run Andrews Memorial Hospital, where she turned up at first but later transferred to the Spanish Town hospital, where she gave birth, and then at the UHWI, where she died on the floor.
In the case of McGowan, her mom took her to the UHWI with complaints of chest pains, but it’s alleged that despite gasping for air for more than an hour, medical personnel refused to give her oxygen forcing her to go to the nearby Andrews, where she was pronounced dead shortly after.
The health minister said he is now awaiting the final report from Chief Medical Officer (CMO) Jacquiline Bisasor McKenzie, having received the UHWI’s report and convened meetings with the institution’s senior leadership.
“I’ve asked the CMO to follow up with other meetings if necessary and to write me a report, which should include some recommendations as to how we proceed on this matter,” he said, reiterating his “regret” at the death of McGowan, who had dreams of attending the Edna Manley College of the Visual and Performing Arts.
“If it means taking action against those who may be responsible, we should not hesitate so to do,” asserted Tufton.
“If it is about systemic failures, then those systems have to be corrected. Whatever it is, we must understand it and correct it. Asthma is too common an ailment in this country to have persons dying.”
On the situation involving Spencer, who died on March 3, hours after her ordeal to get medical attention, the health minister said he has asked for a report from SERHA.
The SERHA chairman said an investigation was under way and KPH Senior Medical Officer Dr Natalie Whylie is due to submit a report later this week.
Spencer, a trained nurse, resorted to her relatives and partners sometime after 2 a.m. on March 2, pleading for help to reach nurses and doctors at the KPH to restart an oxygen therapy machine she said stopped working after a power cut.
“Need help. Get help. My body is weak. My battery is dead,” was one of the desperate appeals Spencer, who was confirmed with COVID-19, made in text messages to her sister, Tosheba Richards.
Help eventually came, but she died hours later.
The two latest cases that have caught public attention have raised questions about the compassionate care being given to the persons who turn up at under-pressure health institutions.
An empathising Professor Wendel Abel, who heads the group Partnership for the Promotion of Patients’ Rights, said there was “tremendous pressure” on the system.
“Under normal circumstances, the system is under pressure, but even more so during the COVID-19 pandemic … . There’s limited access to healthcare and the health staff, they’re under pressure, they’re fatigued,” he argued.
He said the cases show why it was important to reduce transmission risks by following protocols such as wearing masks and avoiding public gatherings so that the “system doesn’t have to stress”.
“These are not ordinary times for the health services. These are extraordinary times. Rights come with responsibilities,” added Abel, a professor of mental health policy and head of the Professor of Mental Health Policy and Head of the Department of Community Health and Psychiatry at The University of the West Indies, Mona.
In 2018, Tufton launched a compassionate care programme for the sector to emphasise the customer service component of public health and delivering care with compassion.
Among the components of the programme are the training of staff in customer service and enhancing basic infrastructure such as the accident and emergency areas to ensure that patients wait in areas of comfort with pictorial messages of advice and encouragement.