Health officials have continued to paint a grim picture of Trinidad and Tobago’s parallel healthcare system, as they warned yesterday that there were now more patients than beds in the Intensive Care Units (ICUs).
With only one ICU bed left, the situation has become so severe that it has prompted the Ministry of Health to reopen the field hospital at the Jean Pierre Complex in Port-of-Spain.
Underscoring just how dire the situation had become during the Ministry of Health’s virtual media briefing, Principal Medical Officer of Institutions, Dr Maryam Abdool-Richards, said up to 8.30 am yesterday, there were 24 patients at the Accident and Emergency (A&E) Departments within the traditional healthcare system who were awaiting transfers into the parallel healthcare system.
Of this number, she said seven of them required ICU care but with 51 out of 52 ICU beds occupied, it was not known when that would happen.
Appealing to citizens to get vaccinated, as it would help to reduce the severity of the COVID-19 virus if someone contracted it, Abdool-Richards said the seven patients awaiting transfers had not been not fully vaccinated.
“Our doctors have noticed that persons are presenting to the A&E Department very ill, in a state that they require ventilation and other supporting treatment in the A&E and in some cases, they may be too unstable to move in the short term.”
Health Minister Terrence Deyalsingh said the Jean Pierre Complex field hospital was taken off-line when the COVID-19 numbers began to drop earlier this year, but is now “going back online.”
The field hospital at Couva is occupied.
With no ICU facilities previously available at the field hospitals, Deyalsingh said the ministry may now have to revisit this policy.
Both Deyalsingh and Abdool-Richards reminded the public that while health officials can only do so much to increase the physical capacity by adding more beds, resources are limited.
Abdool-Richards stressed, “Human resources and the availability of equipment and other factors are finite. They will be expended in the near future if we continue along this trend.”
She revealed that 98 per cent of patients currently in the ICUs in the parallel healthcare system are not fully vaccinated.
Up to yesterday, there were a total of 87 ventilators operational within the parallel healthcare system.
Unvaccinated patients require ICU care
Reinforcing just how critical the situation is, Thoracic Medical Director at the Caura Hospital, Dr Michelle Trotman, provided a clinical overview of the patients requiring healthcare services that go beyond the level of ward care.
She said, “That patient primarily, is unvaccinated.
“The patient that we see most often that requires not just ward care but care beyond that, which usually involves ICU or HDC care…what else is significant about that patient is that it tends to be someone over age 60 and somebody who is also facing other life health challenges that we call comorbidities so, therefore, those people with hypertension, those people with diabetes, those people with cancer, those people with asthma…but I want to mention another comorbidity which often does not come to light as much as the others mentioned previously. In medical terms, that’s a patient’s BMI, their Body Mass Index, which is an indication of whether your height and weight are within the realms that would make you at the proper weight, over-weight, or obese.”
She said BMI readings between 20 to 24 meant you are considered acceptable, “so you are a good weight, you’re a good size.”
“After 24, going up to about 30, you are considered over-weight, and after that you are considered obese according to certain criteria.”
In the clinical setting, Trotman said they were finding, “patients that do not seem to have any comorbidities actually have elevations in their BMI and that serves as a comorbidity.”
Saying there were some who were unaware they were suffering from a comorbid disease until they needed medical care, she cautioned younger people.
“Apart from those over 60, we do see younger people, unfortunately, who present themselves for care beyond ward care, so not because you are younger, you are spared.”
Urging people to pay attention to their health and ensure they do not wait too late before seeking treatment if they fall ill, she said stays in the ICU or the High Dependency Unit (HDU) can vary from six to 14 days, and even beyond a month in some cases.
Dr Trotman said some persons may be admitted into the HDU before being escalated to the ICU for treatment, then back down again and so on, without any predictors.
Indicating there were some patients who were not even presenting at the ward level for care, Trotman said, “What we are finding and seeing, unfortunately, is a trend where patients are presenting ill at the HDU and ICU, not necessarily at the ward level, so it is not always that progression we are thinking.”
In renewing the call for citizens to get vaccinated, Trotman assured everyone would receive the same level of healthcare regardless of their vaccination status.
And for those believing that because they are fully vaccinated they no longer need a mask, or could hug their friend, or party more, she warned, “Vaccination does not take away the need for public health measures.”
Deyalsingh: Not too late to get vaccinated
Meanwhile, Health Minister Deyalsingh added his voice to those calling for greater immunisation against COVID-19. He said vaccine hesitancy hotlines had been set up to reach people wanting information, clarification and advice relating to vaccinations.
Revealing that this was a collaborative effort between the Trinidad and Tobago Non-Communicable Disease Alliance (TTNCDA) and Pan American Health Organization (PAHO), he said it will be manned by volunteer doctors from Monday to Friday between 1 pm to 7 pm daily.
He said the deaths T&T had been getting since around July were avoidable because people had access to the vaccines. Deyalsingh noted that was when the mass vaccination programme began and for those who had not heeded the call to get vaccinated, “It is still not too late.”
The Minister added that if more people make that commitment to listen to the science and act to save lives, the ICU and HDU numbers can go downwards in the coming weeks.
He said the aim is to vaccinate another 200,000 to 300,000 people, including children 12 years and over.
The Minister also urged those ill with COVID to desist from managing the virus at home and not to wait until it was so dire that they would need ICU/HDU care.