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.