Members of the Trinidad and Tobago Defence Force set up a Field Hospital at the Jean Pierre Complex, Port-of-Spain, to add bed capacity for the increase in COVID-19 cases last Thursday.

“Never was so much owed by so many to so few.”

A sentiment expressed by former British Prime Minister Winston Churchill almost a century ago during the second world war.

Though today’s battle isn’t being waged by pilots in the skies over Southern England but instead by healthcare workers in hospitals-, it still rings true.

Across the globe, countries have endured their share of the fight and now Trinidad and Tobago’s is at a critical point.

But with the current explosion of COVID-19 cases bombarding the country, the already exhausted healthcare workers have begun to buckle under the pressure as officials warn of an imminent collapse of the parallel healthcare system.

Collapsing system

The continuously sharp increase in COVID-19 cases is inundating the country’s main COVID-19 treatment system.

Principal Medical Officer of Institutions, Dr Maryam Abdool-Richards explained during a recent Prime Minister’s press conference, the number of people being admitted into the system far exceeded those being discharged.

To relieve some of the pressure, 240 additional spaces were made available through increased step-down facility capacity while field hospitals were set up at the Couva Medical and Multi-Training Facility and Jean Pierre Complex with the assistance of the United States.

The Arima General Hospital was also brought back into the parallel healthcare system due to the surge and the Augustus Long Hospital was switched from housing suspected patients to now treating those infected.

But as Dr Abdool-Richards pointed out previously, the system goes far beyond just beds as it also requires teams of medical personnel to administer treatment.

Battle-weary and overwhelmed healthcare workers

Unspun spoke to healthcare workers in some of the key treatment facilities. They spoke on the condition of anonymity to protect their jobs as many have been warned against speaking to the media. Though their experiences were somewhat unique to their respective facilities, they all shared the same sentiment—they were overworked, understaffed exhausted, and overwhelmed by the sheer number of patients requiring treatment.

“At this point, even though the surge only recently started a lot of the staff are really burnt out. Like people would be crying inside the hot zones because they are so frustrated…it is overwhelming and, sorry to say, it but most times some of the patients are also treating the staff bad as well,” one healthcare worker within the Couva Medical and Multi-Training Facility said.

According to the president of the Trinidad and Tobago Registered Nurses Association, Idi Stuart, there is also a shortage of nurses manning these hospitals.

At Couva, he said: “We have one nurse seeing about 45 patients. That is unheard of. There is no way one nurse can deliver any form of quality care to persons within that institution.”

Further decreasing manpower, he said, is members of the nursing fraternity who are leaving the profession either through retirement or in search of better opportunities elsewhere and some who often have to quarantine or isolate themselves due to COVID-19 exposure.

Further straining healthcare workers within these facilities is the limited resources at hand to treat patients.

“We have to prioritise who goes into ICU. So whoever’s most sick or has a higher prognosis—like who have the most potential to save—we do those. So we have to make a lot of difficult decisions. Not because people cannot be saved but because it has too much people for us to handle,” a medical source within the Augustus Long Hospital told Unspun.

The Augustus Long Hospital has been running at full capacity since its inception into the treatment of infected patients some two weeks ago. But while the source admits they need more resources, they indicated the primary issue is the rate at which patients are coming in.

“The main problem is that the numbers are so high that we can’t keep up with them. That is the main problem. The secondary problem would be that people who are coming in, critical patients, do need ventilators…but we wouldn’t be in that situation in the first place if the numbers were lower.”

It’s a sentiment the T&T Medical Association’s president Dr Vishi Beharry also shared. He said there is a certain level of responsibility on the Government’s part to ensure these facilities are properly equipped but it’s impossible to hope it could be done to keep up with the explosion in cases.

“We cannot expect with the rapid number of cases that we’ve been seeing to be able to rapidly expand the parallel healthcare system,” he said.

“At the end of the day, while we may want to say the administration should put more things in place those things don’t happen overnight. A ventilator is not made overnight. Importation of a ventilator is not done overnight. But cases are rising overnight.”

This is why he said it’s important citizens do their part to help curb the spread.

“We have to recognise that first of all…the public health measures that are being instituted or that have been put in place have been done so for a reason—to slow the spread of the virus, to try to minimise the amount of cases,” he said.

The third wave

Fifteen months into the coronavirus spread locally, this country has never witnessed an increase in cases and fatalities as in the current one which now establishes itself as a third wave.

Within weeks the country went from a seven day rolling average of three cases reported per day on March 6 to 341 as of May 13.

In those ten weeks, the country went from 96 active cases to 4,814 with 117 deaths occurring.

Before this wave, the most active cases the country ever had to deal with was 2,560 on September 17, 2020.

Following the all-time low in March, cases began to trend upwards with the rolling average hitting double digits on March 20. But between April 22 and May 1, the seven-day rolling average rose from 100 to 226 as the country recorded a staggering 1,689 cases.

Within the first 13 days of May, a total of 3,990 cases and 85 deaths were recorded; 21 of which were recorded within 24 hours on Thursday.