Health worker shortage grows

The Nassau Guardian April 21, 2020

Rachel Knowles

Locksley Munroe

A senior physician yesterday expressed grave concerns over what he characterized as a healthcare worker shortage after a patient on a ward at Princess Margaret Hospital (PMH) tested positive for COVID-19.

The statement from Dr. Locksley Munroe, consultant general surgeon, came hours before health officials reported four additional confirmed cases of COVID-19 in The Bahamas, driving the total cases to date to 64.

Asked last night whether any of the new cases were additional patients from the Medical Surgical Ward II, Minister of Health Dr. Duane Sands said ‘yes’, but added he was unsure how many of the four are connected to the ward.

Sands did say that none of the cases were healthcare professionals.

Munroe told The Nassau Guardian, “Right now, we have a serious challenge with providing services because we do not have what it takes right now,” he said.

“People are gone; gone because they were exposed.”

He added, “Sunday was really a disaster. This patient turned up and nobody knew.”

Munroe said half his team was taken out of the system after being exposed to the patient.

“Bahamian people need to understand that this is not a joke and that people get exposed unexpectedly,” he said.

“And, now you have a very serious problem because there is no way you have the same number of staff you had. Right now, I have one person on my team — one. This is not a joke. There’s just one other person on my team because my intern is gone and my [senior house officer] SHO is gone because they were on that ward.”

He added, “There are at least six or seven persons who have gone out of the department of surgery, which means that our resources are significantly challenged once again.”

And Munroe said the surgical department is not the only one that might have been exposed.

“It has definitely reduced the number of staff that’s available now,” said Munroe, former Consultant Physicians Staff Association (CPSA) president.

“There are certain principles that underlay medical practice, and the med-surg ward is one of these new principles, which means that any patient could go on the ward, whether it was a medical patient, whether it was a surgical patient or whatever. And, that is what took place in this instance.

“We had medical patients on there, surgical patients on there.

“Therefore, all of the teams were going on that ward and an asymptomatic patient came in, and it turns out that that patient was COVID-19-positive at the end of the day.

“[It], therefore, implies that all the persons who were going on that ward since that patient admission would have been exposed to that patient. So, that is where the problem lies. So, again, what has happened is a lot of people have been taken out because they have to be screened.

“[T]here are a lot of deficits in the system because people have to be screened to ensure that they are not positive for the virus.”

The Public Hospitals Authority (PHA) announced the closure of the ward at PMH on Sunday following the confirmation of the COVID-19 case.

The PHA said all remaining patients on the ward have been tested for COVID-19 and contact tracing of people who were previously discharged from the ward has started via the Ministry of Health’s Disease Surveillance Unit. It also said PHA employee health services have commenced assessment for all employees who had direct contact with the patient.

Munroe yesterday urged the public to take social distancing seriously.

“They should be concerned, and as far as I am concerned, I think that what they need to do is pay attention to the advice that the Ministry [of Health] and [Prime Minister Dr. Hubert Minnis] are giving out, because they could make a significant difference in your actual outcome,” he said.

“Patients out there need to understand that we are in a problem and the problem is that people on the frontline are being exposed.”

He added, “There’s going to come to a point where you just won’t have anybody if we don’t gain control of this. And people have to gain control of themselves.”

Earlier this month, Minister of Health Dr. Duane Sands said that one in five confirmed COVID-19 cases has been healthcare workers. There were roughly 40 cases of COVID-19 at that time.

As of yesterday, there were 64 confirmed cases of COVID-19 in The Bahamas — 55 on New Providence, seven on Grand Bahama, one on Bimini and one on Cat Cay.

Health officials have acknowledged that limited resources have allowed them to test only symptomatic people. However, testing is set to be ramped up with the availability of more test kits.