There were on­ly three more In­ten­sive Care Unit (ICU) spaces avail­able in the par­al­lel health­care sys­tem in Trinidad and To­ba­go for COVID-19 pa­tients as of Mon­day morn­ing. The rev­e­la­tion comes just two days af­ter the Min­is­ter of Health warned that the coun­try was on the verge of run­ning out of space to pro­vide this lev­el of crit­i­cal treat­ment to pa­tients. He al­so cau­tioned that doc­tors will be forced to de­cide who re­ceives treat­ment.

And that al­ready ap­pears to be in mo­tion as nine pa­tients in need of ICU care in the par­al­lel health­care sys­tem are yet to be trans­ferred be­cause of the lack of space.

Speak­ing at the min­istry’s vir­tu­al press con­fer­ence on Mon­day, Prin­ci­pal Med­ical Of­fi­cer of In­sti­tu­tions Dr Maryam Ab­dool-Richards said 54 of the 57 ICU beds in the par­al­lel health­care sys­tem were oc­cu­pied. This is de­spite the sys­tem hav­ing some 30 per cent more ICU ca­pac­i­ty than it did when this cur­rent wave of in­fec­tions be­gan.

“The In­ten­sive Care Unit in our coun­try has now out­stripped or is equal to the sup­ply of beds,” she said.

This phased in­crease, she said, was part of the min­istry’s prepa­ra­tion for the ar­rival of the more in­fec­tious and dead­lier Delta vari­ant. The most re­cent ex­pan­sion came over the week­end when two ICU beds were added to the Ari­ma Gen­er­al Hos­pi­tal. How­ev­er, by yes­ter­day morn­ing, they were filled.

The sole re­main­ing ICU space in Trinidad as of yes­ter­day morn­ing was at the Au­gus­tus Long Hos­pi­tal. The oth­er two spaces are in To­ba­go.

She re­vealed that there were al­so nine COVID-19 pa­tients re­ceiv­ing ICU care at the Ac­ci­dent and Emer­gency De­part­ments of hos­pi­tals in the tra­di­tion­al health­care sys­tem await­ing trans­fer in­to a COVID-19 fa­cil­i­ty.

“As of 8.30 am this morn­ing, there were 27 se­vere­ly and crit­i­cal­ly ill COVID-19 pa­tients await­ing trans­fer in­to the Par­al­lel Health­care Sys­tem. Of those, nine pa­tients—rep­re­sent­ing 33 per cent—were of ICU or In­ten­sive Care Unit lev­el,” she said.

None of these pa­tients, she said, are ful­ly vac­ci­nat­ed.

In fact, Dr Ab­dool-Richards said 96 per cent of the pa­tients cur­rent­ly fight­ing for life in Trinidad’s ICUs are not ful­ly vac­ci­nat­ed. This means just two pa­tients were ful­ly vac­ci­nat­ed while the oth­er 52 were un­vac­ci­nat­ed. She added that 94.1 per cent of all hos­pi­talised COVID-19 pa­tients be­tween Ju­ly 22 and Oc­to­ber 6 were al­so un­vac­ci­nat­ed.

She said the min­istry is work­ing to in­crease ca­pac­i­ty but ad­mit­ted the con­tin­gency does not al­low for a sig­nif­i­cant bed in­crease due to re­source con­straints such as med­ical staff to tend to the pa­tients.

Guardian Me­dia un­der­stands the con­tin­gency can fa­cil­i­tate the ad­di­tion of around sev­en beds.

“We have been try­ing to in­crease ca­pac­i­ty for ICU beds based on the de­mand, based on pre­pared­ness for the Delta vari­ant but a bed is not just a bed,” she said.

“These beds re­quire staff, equip­ment and many oth­er fac­tors. We have to con­sid­er the am­bu­lance trans­fer sys­tem as well to trans­port these crit­i­cal­ly ill pa­tients.”

It is not the first time the par­al­lel health­care sys­tem has come un­der se­vere pres­sure and strain ow­ing to the num­ber of COVID cas­es in the coun­try.

In May, the par­al­lel health­care sys­tem was out of beds, as all avail­able beds at the then sev­en fa­cil­i­ties were oc­cu­pied with ill pa­tients re­quir­ing hos­pi­tal­i­sa­tion.

Back then the ICU was at full ca­pac­i­ty, with the HDU near­ing ca­pac­i­ty.

But yes­ter­day, Dr Ab­dool-Richards warned the sit­u­a­tion could be avoid­ed as she urged peo­ple to get vac­ci­nat­ed to pre­vent hos­pi­tal­i­sa­tion.

“Vac­ci­na­tion re­duces the risk of you ac­quir­ing the COVID-19 virus, vac­ci­na­tion re­duces the risk of you spread­ing the COVID-19 virus es­pe­cial­ly to vul­ner­a­ble per­sons and vac­ci­na­tion re­duces the risk of you be­ing hos­pi­talised and re­quir­ing In­ten­sive Care Unit treat­ment,” she said.

Dr Hinds warns there could be an­oth­er spike in COVID cas­es

Apart from low vac­ci­na­tion num­bers, a source fa­mil­iar with the sit­u­a­tion ex­plained to Guardian Me­dia that the Delta vari­ant was lead­ing to more se­vere in­fec­tions in some pa­tients mean­ing they would, in turn, re­quire a high­er lev­el of care. The source al­so ex­plained that peo­ple were wait­ing too long be­fore seek­ing med­ical at­ten­tion which meant a high­er lev­el of care need­ed to be ad­min­is­tered.

Com­pound­ing the is­sue of ICU over­crowd­ing is the rev­e­la­tion by the min­istry’s Epi­demi­ol­o­gy Di­vi­sion’s tech­ni­cal di­rec­tor, Dr Av­ery Hinds, that cas­es ap­pear to be in­creas­ing around the coun­try.

“We’re be­gin­ning to see week on week in­creas­es as op­posed to the fluc­tu­a­tion we were see­ing be­fore,” he said.

Dr Hinds said if the coun­try con­tin­ued to record over 200 cas­es per day, Oc­to­ber is set to have the largest num­ber of month­ly con­firmed cas­es than each of the pre­vi­ous three months.

“We’re sound­ing the alarm that there may be in­creas­ing rates of trans­mis­sion we have to keep an eye on. We need to ad­here to those pub­lic health reg­u­la­tions even as we move around more, en­gage more in var­i­ous ac­tiv­i­ties and, def­i­nite­ly, we need to en­sure both the pro­tec­tion of our­selves and those around us by mak­ing use of the avail­able vac­ci­na­tions,” he said.

Dr Hinds said if the pop­u­la­tion does not take heed now, there could be an­oth­er spike in cas­es.

“We are be­gin­ning to no­tice very small changes in trend and those small changes, if we aren’t ap­ply­ing all the oth­er brak­ing fac­tors, can, of course, mul­ti­ply in rate as time goes on- spawn­ing an­oth­er wave,” he said.

“What we are very much hop­ing is that the be­hav­iour of the pop­u­la­tion in terms of vac­cine up­take, in terms of ad­her­ing to all of the reg­u­la­tions, in terms of not breach­ing the guide­lines around par­tic­i­pa­tion in group ac­tiv­i­ties- all of those fac­tors will help to slow the pos­si­bil­i­ty of an in­creased rate of trans­mis­sion,” Dr Hinds added.