WITH COVID-19 cases cramming hospitals islandwide, attention is being drawn to the “overwhelmed” state of the island’s already limited intensive care units (ICU), with doctors now more than ever being forced to make life and death decisions.

Jamaica recorded 334 new COVID-19 cases and 13 virus-related deaths on Tuesday, according to the latest statistics from the Ministry of Health and Wellness. This pushed the total number of confirmed cases on the island since the outbreak to 55,790 and the confirmed deaths to 1,254. Some 345 individuals are hospitalised with the virus, 69 of whom are considered moderately ill and 35 critically ill at last count.

According to a May 2020 special report by the Inter-American Development Bank (IDB) assessing the challenges of the Jamaican health-care system to combat the pandemic, there were, at that time, 40 functional ICU public beds in Jamaica, inclusive of those at the University Hospital West Indies, Kingston Public Hospital, Cornwall Regional, and Bustamante Hospital for Children. Meanwhile, in the private hospitals there were 11 ICU beds — five at the Montego Bay Hospital and six at the Cardiac Intensive Care Unit of the Heart Institute of the Caribbean.

In late May, the health ministry reported the addition of 41 ICU beds. The IDB at the time, however, said it is expected that COVID-19 cases would significantly increase in Jamaica and that the number of ICU beds needed would surpass current capacity. It said, while Jamaica should fare better with appropriate and timely measures, authorities should also prepare and consider a worst-case scenario.

According to one medic with whom the Jamaica Observer spoke yesterday, that worst-case scenario is now here.

“They are basically overwhelmed. It’s not like COVID came about and all our ICUs are full, we have always had issues with our ICUs, doctors have always been facing difficulties as to who will get access to ICU. It is not something that COVID has caused, it is something that COVID is highlighting. In the public sector you have a finite number of ICU beds, it has always been a problem,” the individual, who spoke on condition of anonymity, said.

According to the health-care professional, the present surge which has put an added demand on the system is jeopardising the welfare of individuals with other conditions that require intensive care.

“It is not like a doctor can cause a ventilator to materialise out of nowhere. it’s not like you have beds on reserve waiting for the surge. If these emergencies take place we just don’t have the facilities. The reality is that people will die, and that’s what has been happening — people have been dying and there is absolutely nothing anyone is able to do about it,” he stated, while imploring Jamaicans to adhere to the protocols and restrictions and accept the vaccines.

He said the situation is also compounded by resource constraints.

“As it stands, they don’t really have a finite number of people with the expertise to man the ICUs; it’s not that any and every doctor can, you have to be specially trained to work in an ICU beyond just graduating from medical school. You need special training to understand the equipment,” the medical doctor pointed out.

Furthermore, he said patients in ICU require closer care than general admissions.

“They typically require one-to-one patient care, so it’s not like on a general ward where you can have one doctor tending to 10 patients. In an ICU, one-to-one nursing care is often required, and at least one-to-one doctor care in an ideal situation, but we are very much far from ideal right now,” he pointed out.