dr Maryam abdool-richards

Dr Maryam Abdool-Richards, Principal Medical Officer-Institutions, Ministry of Health.

While the 11 new deaths recorded yesterday to the Covcid-19 virus is a cause for concern, Principal Medical Officer-Institutions, Dr Maryam Abdool-Richards said what is equally concerning is the fact that more and more severely and critically ill persons are presenting themselves at the Accident and Emergency departments at the nation’s hospitals.

Noting that the overall occupancy at the parallel healthcare system, currently at 36 per cent, continues to be under 40 per cent, a trend for the past 110 days, she added that they have also noted that the proportion of critically and severely ill patients, patients requiring Intensive Care Unit level care, has increased significantly, especially over the past 16 days.

“This morning, there are 358 patients in the hospitals in the parallel healthcare system and step-down facilities. Twenty-nine are in step-down facilities, 329 are in hospitals. The ratio of severely and critically ill patients requiring hospital care to those who are recovering has increased significantly over the last two months, from three times as many severely and critically ill patients to now 11 times severely and critically ill patients,” Abdool-Richards said, while speaking during Wednesday’s virtual Covid-19 press conference.

“As of 8 a.m. this morning, there were 29 patients who are Covid-positive across the four Regional Health Authorities (RHAs) in Trinidad, none in Tobago, who are awaiting admission to the hospitals in the parallel healthcare system. This number has ranged between 17 and approximately 34 over the last 16 days, and it represents a significant increase as previous from July 15 to October 19.”

She said there were six patients awaiting care in the IUC departments and some of those six are too critically ill to be transferred, even though beds are available.

“Of the six ICU level patients, none are fully vaccinated. This is a consistent trend yet again that we have noticed since on or about October 19. So one hundred per cent of persons who require Intensive Care Unit level care, even at the Accident and Emergency due to their clinical status, or in our hospitals in the parallel healthcare system, are not vaccinated. Of the 29 persons who are awaiting admission to the hospitals, and that includes ward level patients, 25 out of the 29 or 86 per cent are not fully vaccinated.

“The percentage of Covid-19 patients who require transfer on a daily basis from the Accident and Emergency Departments to the parallel healthcare system, has been anywhere between 18 per cent and 37 per cent. So, we have noticed anywhere between five to 11 and 15 to 17 patients requiring care in the Intensive Care Unit departments.”

She noted that as at today, every patient who has required Intensive Care Unit level care has been managed according to the Regional Health Authority protocols on Covid-positive patients requiring ICU or HDU care.

“The Accident and Emergency departments’ patients are managed, if too unstable, by the ICU teams attached to the relevant hospital, and they have been receiving the required care including ventilation as needed.”

Parallel healthcare system - hospital status

Abdool-Richards said that while Tobago has had approximately two to three patients in ICU over the past 16 days, they have had to accept an additional three patients.

“So that ICU is filled, five out of five patients. Now there are contingency plans at all hospitals, however, resources are limited. So Tobago is now at one hundred per cent capacity, and that was an overnight change, demonstrating the severity of the situation and the revolving nature. That is how quickly the ICU beds can become filled.

“In Trinidad this morning there are 58 operational ICU beds, and as I would have indicated earlier, we continue to observe and analyse the trends, the clinical and the statistical trends, to reallocate resources to our best ability to increase the number of beds. However, these resources are limited,” Abdool-Richards said.

Stating that 48 out of the 58 ICU beds across the parallel healthcare system are currently occupied by critically ill patients, representing an 83 per cent occupancy, she added that it is actually one of the lowest occupancies that they have noted, having had occupancy levels as high as 95 and 96 per cent.

“It is important to note that like the admissions in the Accident and Emergency, the vast majority of persons in our ICU are not fully vaccinated. This morning, 46 out of 48 persons or 96 per cent have not been fully vaccinated.”

Disturbing trends

“Firstly, persons continue to present to the Accident and Emergency departments in a severe and critical state. Three of the recent deaths, those are persons who would have passed away between Monday and today, were persons who contacted the GMRTT ambulance service. On arrival the ambulance service would have tested their vital signs and spoken to our medical clinical transfer team.

“These persons required hospitalisation and care, however, these three persons denied the transfer. Within one day, they had decompensated or deteriorated at home, and they were transferred immediately to the Accident and Emergency department and two out of the three were admitted into the parallel healthcare system. But unfortunately, these three persons succumbed to the Covid-19. These three persons were not fully vaccinated.”

She stated that the other trend they have noticed with respect to the patients presenting, is that they are not fully vaccinated.

“We continue to see high levels of persons who are not fully vaccinated, being admitted and contacting the GMRTT service. In fact, those that have been fully vaccinated tend to either be discharged home after they have been observed or is at ward level care.

“The Ministry of Health and the RHA continue to do all that we can to save lives. We are reallocating resources. We have increased the number of ambulances and the advanced life support ambulances on shift over the past 16 days. We have added Intensive Care Unit beds. We have increased the capacity to manage ICU patients at the Accident and Emergency departments, and we continue to give every patient their chance to survive because we value every patient as a member of your family, your neighbourhood.

“However, it is now the responsibility of each and every one of you to please take up the Ministry of Health’s offer with respect to vaccination. Don’t delay, vaccinate today,” Abdool-Richards noted.

The country’s Covid-19 death toll stands at 1,720 and there are 605,396 persons who are deemed to be fully vaccinated.

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