THE South East Regional Health Authority (SERHA) has frozen all leave applications and directed health-care workers on non-essential leave to return to work as its facilities buckle under the weight of the fourth wave of the novel coronavirus pandemic.
The directive issued by SERHA says that the regional director Errol Greene has directed, with immediate effect, that if the need exists, all staff members currently off on non-inescapable/non-essential leave must return; approval of non-inescapable leave must cease until further notice; and only urgent or emergency surgical procedures be addressed until further notice.
SERHA comprises 92 health centres and nine major hospitals to include Bustamante Hospital for Children, Sir John Golding Rehabilitation Centre, Hope Institute, National Chest Hospital, Spanish Town Hospital, Linstead Hospital, Princess Margaret Hospital, St Joseph's Hospital and Kingston Public and Victoria Jubilee hospitals.
Greene, who spoke with the Jamaica Observer on Monday night, explained that all leave has been frozen, not cancelled.
“Given the situation, we have a shortage of staff, and in consultation with the Jamaica Medical Doctors' Association (JMDA), and the Nurses' Association of Jamaica (NAJ), the decision was taken to freeze all leave and, in the exigencies of the service, recall persons who are on leave to carry out the services that are needed at this time,” Green said.
He added that all representatives had been consulted prior to the announcement.
“This information was communicated to all parish managers and hospital CEOs. We did consult with the different representatives and different groups,” he said.
The health ministry put the country on notice last week that it had begun to receive notification from the regional health authorities of absenteeism among medical staff, as well as clerical and administrative employees in the public health system, and was assessing the situation to decide when crisis protocols — such as the cancellation of outpatient clinics, and elective surgeries — would need to be triggered.
Further, it is understood that Bustamante Hospital for Children has been seeing an increasing number of patients, and that most wards at Kingston Public Hospital (KPH) are over capacity. Senior residents have also been put on guard to discharge patients who can safely be released.
On Monday, Spanish Town Hospital CEO Jacqueline Ellis said the 277-bed hospital had reached capacity. She said there were 19 social cases, 31 COVID-positive patients and 61 awaiting test results.
In the meantime, a doctor who spoke to the Observer on condition of anonymity, said the vast majority of anaesthesiologists at University Hospital of the West Indies are either in quarantine or are out sick, effectively cancelling elective surgeries.
Meanwhile, clinical coordinator for the Western Regional Health Authority (WRHA) Dr Delroy Fray said hospitals in that region have, for the moment, been faring better than those in SERHA.
“The Lord has been good to us in the west but we are not complacent. If we follow the trend in Kingston, I think it will get here,” he told the Observer. “Cornwall Regional Hospital is now bearing the bulk of the pressure, with moderate to low numbers at Noel Holmes, Savanna-la-Mar and Falmouth hospitals,” he said.
According to Dr Fray, up to Monday morning 51 nursing staff and 21 doctors were out with COVID-19 at Cornwall Regional, which has a COVID patient load of 59.
The WRHA clinical director said, up to last Friday, the other three hospitals weren't “doing too bad”, but patient numbers are steadily climbing for Savanna-la-Mar, with 27 admissions for COVID-19, and eight doctors and 18 nurses out sick.
Dr Fray said that at Noel Holmes all doctors reported for duty, while one nurse was out, and seven COVID-19 patients were in isolation, whereas, Falmouth hospital had two doctors and 13 nurses out sick, and six patients in isolation.
“So the burden is more at Cornwall and Sav. As the numbers increase, then it will be a problem. If it continues like this in terms of the staff going off we will have a problem,” Dr Fray said.
On the weekend the JMDA called for health facilities to start operating in emergency mode, to preserve the well-being of doctors, while still providing care. The JMDA said a large number of junior doctors are in isolation or quarantine due to exposure to the increasing number of COVID-19 patients seeking medical attention.
President Dr Mindi Fitz-Henley advised that understaffing was affecting doctors' ability to provide adequate patient care.
She said doctors are also suffering from burnout as “it is impractical for us to be expected to run clinics, wards, operating theatres, and all emergency units on a vastly reduced staff cohort”.
Up to Sunday, there were 486 people in hospital with COVID-19. Jamaica has now recorded a total of 113,438 cases of COVID-19 since the first case was reported in March 2020. Of that number, 14,414 are active and 1,220 are new cases.