DR Christopher Tufton, following Thursday’s revelation that there are 118 operational ventilators in the health-care system, is challenging critics who are positing that the number of ventilators distributed among health facilities is still inadequate.

Dr Tufton, the minister of health and wellness, reiterated that this number represents the largest number of ventilators that public health has had, while also arguing that there is a clinical justification for where ventilators are located and how they are used within the system.

“I see people making calculations as to 118 divided by 24 ‘means each hospital should have ‘x’ amount; the number of ventilators for a three-million population is inadequate’. There’s a clinical justification for ventilators — how they are located, how they are utilised, what are the support systems that are necessary, why there is a referral system from one hospital to another. And this is a good opportunity to have that kind of understanding so that the public is not misinformed or [anyone is able to] create an impression that could lead to a wrong conclusion,” he said during a press conference on Thursday.

Dr Tufton pointed out that a ventilator on its own is not the solution as the machines have to be supported by an infrastructure, “So, you move a patient from one place to the next depending on the need, to ensure that a full system is supported.”

Expounding on this point, chief medical officer (CMO) in the health ministry, Dr Jacquiline Bisasor-Mckenzie explained that ventilators are used based on a referral process among the country’s 24 hospitals, which are at different levels.

“The lowest-level hospital offers basic care, and persons are transferred to the next levels depending on the kind of support that they need. And that support may not necessarily be in terms of infrastructure or equipment but, critically, it is also important in terms of the kind of staff, and the kind of multidisciplinary care that is needed to support some patients,” she said.

She noted that high-dependency units (HDU) and intensive care units (ICU) are placed in hospitals that have the appropriate infrastructure and equipment and also have the appropriate staff to care for patients requiring intensive care.

Dr Bisasor-McKenzie pointed out, however, that not all patients who require intensive care or high-dependency care need to be on a ventilator because they may be breathing on their own but yet require continued observation in order to monitor their illness.

“You have persons who may be on a ventilator, or need to be on a ventilator, but then they would have to be transported to an area where they can be monitored and observed, as in a high-dependency or an intensive care unit,” she said.

The CMO said the health-care system’s capacity to manage these intensive care spaces is hampered by lack of staff such as critical care doctors, doctors from different disciplines, and critical care nurses, in particular, to carry out the various functions within the unit.

“The critical care nurses are vital, and if it is that we have 60 or 70 ICU or HDU spaces then we need four times that amount of nurses to be able to support the patient on the three shifts and to allow for them to have breaks,” she said, noting that many of these specialists tend to migrate to seek better opportunities.

She noted that in some instances a ventilator may be available but the patient cannot be supported in an intensive care setting because of inadequate staffing.

Meanwhile, in direct response to the Opposition which has been hounding the Government to state how many functioning ventilators are on the island and where they are located, Dr Tufton asserted that all ventilators are accounted for and are being utilised to save lives on a daily basis.

“There should be no fear by the public that somehow they have gone missing, as is being explicitly or insinuated by the Opposition over the last number of days,” he said.

Leading the charge for answers was shadow spokesperson on health Dr Alfred Dawes who used a press conference on Wednesday to again make the call for a ventilator audit.

He had first raised the issue of operational ventilators following the death of a premature newborn baby at May Pen Hospital in Clarendon last Tuesday, because there was no ventilator.

At that time he was querying the working condition and locations of the more than 100 ventilators which were donated to the Government through the efforts of Private Sector Organisation of Jamaica, European Union, and private individuals during the COVID-19 pandemic.

Dr Tufton, in response, said an audit was being done regarding ventilators in the island. The document was made available on Thursday evening.

At Thursday’s press conference Dr Tufton said the audit found that there are 210 ventilators registered in the health system, of which 118 are operational, 40 are being repaired, and 52 are obsolete.

The audit revealed that hospitals within the Western Regional Health Authority have 26 operational ventilators and eight are non-operational. It said that six of the eight not in use are either awaiting parts or are being/to be repaired. Of the remainder, one is boarded (discarded) and the other is irreparable.

For the South East Regional Health Authority, the audit revealed that 49 ventilators are operational while 42 are not in working condition. Of the number which are non-operational, 15 are awaiting parts/repair.

According to the audit, University Hospital of the West Indies (UHWI) also accounts for 25 of the operational ventilators; there are, however, 29 non-operational, with 16 awaiting parts/repair.

Additionally, 10 ventilators are operational in North East Regional Health Authority while five are out of service; two of those are awaiting parts/repair. For the Southern Regional Health Authority 19 ventilators are operational while six are not working and will all be discarded.

The audit also revealed that some hospitals within the health regions have no ventilators.

“That audit has provided us with specific data [on] all the ventilators that are in the public health system. Based on that audit there are no ventilators that are missing, therefore [there] should not be any speculation or indeed insinuation that somehow ventilators are not being utilised,” Dr Tufton said.

“We went beyond just identifying ventilators that are active, those that are being serviced, those to be serviced but also went to the extreme — identifying those that are obsolete and are not being used anymore because in the public system you have to store even the things that you are not using. There’s a process, a long process of getting rid of those products, but in the interest of transparency we went the full gamut because of the speculations surrounding the ventilators,” he added.