Long wait for a bed
Patients spending up to three days in A&E as hospitals feel the crush
The 60-bed capacity Noel Holmes Hospital in Hanover is currently at 90 per cent occupancy.

LUCEA, Hanover — With the health ministry reporting that some 260 patients were waiting on beds across 18 public health facilities last Friday, assistant regional director for South East Regional Health Authority (SERHA) Dr Susan Wright has reported that people are now waiting for up to three days for beds on wards.

"With some persons not being able to be admitted, they have to be holding them in the A&E [accident and emergency department] awaiting bed space. One of the greatest things that we have impressed upon the staff is to communicate with our patients so they get that sense of empathy and care," Dr Wright told the Jamaica Observer.

"However, the staff still monitor them and attend to them as if they are on the ward," added Dr Wright as she underscored that the more severe cases would be given priority.

She noted that people abandoned at hospitals are also contributing to the shortage of beds.

FRAY...the vast majority of dengue cases don’t end up in the hospital

According to Dr Wright, this puts a strain on hospital resources as it takes a while for social workers to track down the relatives of the social cases.

In the meantime, hospitals in the western end of the island are reporting that social cases continue to contribute to their lack of bed spaces.

Senior medical officer at Noel Holmes Hospital in Hanover, Dr Patrice Monthrope told the Observer that COVID-19 is no longer a major concern and the hospital is coping with dengue cases.

"We have three adults suspected [with dengue] and two paediatric cases, so that is just five — which is not bad," said Dr Monthrope.

MONTHROPE....we are always challenged by the patient load but we have to do our best to manage

The 60-bed capacity hospital currently has 90 per cent occupancy. However its paediatric ward, which was built to accommodate three children, currently has 15.

"We are always challenged by the patient load but we have to do our best to manage. We are definitely challenged, especially with paediatric patients, and some of those probably would be gastroenteritis," added Dr Monthrope as he pointed to the long-running problem of social patients taking up beds which could be available for people with real medical emergencies.

Dr Monthrope noted that Noel Holmes Hospital is now housing 10 people who have been discharged but remain in the facility.

According to Dr Monthrope, the hospital recently employed a social worker who will assist in uniting discharged patients, who remain in the hospital, with their families.

But even as the hospital struggles with these issues Dr Monthrope said another major challenge is a shortage of staff.

He said the period between August and September was the worst as the hospital faced an increase in the number of patients with outbreaks of dengue and gastroenteritis in the parish.

"We are still critically short-staffed but when the outbreak initially [occurred], we were down to like five doctors in the whole hospital — and that is for all of the areas. So, we were less than 60 per cent of the required number of doctors that we are supposed to get," stated Dr Monthrope.

Since then, the hospital has received two additional doctors but this is still a far cry from the 11 that should be on the books.

In the neighbouring parish of St James, clinical coordinator for Western Regional Health Authority (WRHA) Dr Delroy Fray said an overrun of hospital bed space by patients with viral illnesses is not an issue.

"These viral illnesses are mainly outpatient burden, and they are treated adequately there and very few end up in hospital. I don't know if it will change but that is what we see," Dr Fray told the Observer.

"COVID-19 is not really an impact on the hospital system at this time. And, on any day you might have an average of eight to 10 patients waiting for COVID tests. They presented with COVID symptoms that look like that, and you end up with probably one or two. So, it is really not a problem," stated Dr Fray.

Noting that COVID-19 is endemic to the point where no large spike will be seen, Dr Fray revealed that between October 14 and 16 the hospital had only two cases. Since then, there have been no cases.

The clinical coordinator confirmed that the majority of dengue cases are children, but noted that most are not admitted to hospital.

"The vast majority of dengue cases are treated as outpatients, and if you can have them hydrate and treat them with Panadol, they don't end up in the hospital," stated Dr Fray who emphasised the need for people who experience signs of abdominal pain, vomiting, rash or bleeding to visit a health facility immediately.

"In respect to the other viruses like influenza, usually it is the elderly people who normally get pneumonia from that — and I haven't seen a significant increase in terms of admission at Cornwall Regional Hospital for that," stated the senior medical officer.

Dr Fray said the main burdens on the hospital are motor vehicle accidents, gunshot wounds, and chronic illnesses.

He said the hospital's overcrowding has to do with chronic illnesses such as renal failure, heart failure, and out-of-control diabetes.

The hospital, which is currently undergoing a $14-billion rehabilitation, has a bed capacity of 364 with 32 social cases.

"If we could remove the 32 from Cornwall we would not have so many people waiting in A&E," stated Dr Fray, who added, "We have been trying desperately to get them out."

In the meantime Savanna-la-Mar Public General Hospital, which has a bed capacity of 209, had exceeded its capacity by 82 patients on October 18.

Health and Wellness Minister Dr Christopher Tufton told the Observer recently that a combination of things has been sighted for the challenges being faced at the hospitals.

"There's COVID, there is suspected dengue, there is the flu season which has started, and of course the parish of Westmoreland has an unfortunate reputation of having multiple bike accidents each day," stated Tufton who also pointed to the challenge faced as a result of social cases.

BY ANTHONY LEWIS & CANDICE HAUGHTON Observer writers editorial@jamaicaobserver.com

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