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Ward infection ‘massive blow’ to health teams

Minister of Health Dr Duane Sands. (File photo)

Minister of Health Dr Duane Sands. (File photo)

By RASHAD ROLLE

Tribune Senior Reporter

rrolle@tribunemedia.net

ABOUT 100 healthcare workers are in self-isolation after they were exposed to a patient with COVID-19 on Princess Margaret Hospital’s surgical ward, prompting Health Minister Dr Duane Sands to say yesterday the country won’t be ready to lift the lockdown and movement restrictions anytime soon.

A surgical ward patient on Sunday became a confirmed COVID-19 case, prompting the closure of PMH’s Medical Surgical Ward II.

At least three patients on that ward have since been confirmed to have the virus.

“This has made a serious dent, a massive blow to the provision of healthcare services,” Dr Sands said before a Cabinet meeting yesterday.

“It speaks to the challenge. We’re not there yet. I know people want to break out of isolation and out of quarantine and come out of lockdown. We are not there yet. We’re not going to be there anytime soon and I need people to understand that as much as you’re tired, as much as you’ve had enough of this, we’re not there yet. These healthcare professionals find themselves on the battlefield and potentially exposed and so now they are out for 14 days.”

Their isolation “has made a serious impact on the delivery of health services,” he said, adding: “This patient was not suspected to have COVID and was there for an entirely different reason. There was, even in retrospect, very little reason to suspect that this patient should have had COVID.”

Dr Sands said the country does not have the luxury of testing every person who attends a hospital, revealing a shortage of swabs will also impact the ability to increase testing in a widespread way.

He said: “If you say every single person who comes to the hospital should be tested, bear in mind we see 50,000 people through Accident and Emergency every year…if you say now that we are going to test all of them, that’s 136 tests per day. (Say a) patient comes in with a gunshot wound, are you going to do a test before you take care of that patient? (That’s) not practical. (Say) somebody comes in with a heart attack, are you going to test before you manage that patient?

“What we need to recognise is that there are limitations to testing, even as we ramp up and there are limitations to ramping up because around the world there is a challenge to getting the basic swabs, the supply chain for that simple device cannot be sourced anywhere in the world. It is not a Q-Tip, it is a special type of swab and so we have the kits, we have the reagents, we have the labs, we have the machines, but nobody has the swabs. We have a few hundred right now and we hope to get another 500 today but before we go ramping up to do 200 tests a day we need to look at what’s going to happen down the road, three days from now, four days from now. It is a balancing act and even as we ramp up we have to ramp up deliberately and carefully.”

Dr Sands bemoaned the impact that large gatherings can have on the fight against COVID-19, pointing to the crowd of hotel union members who assembled on Tonique Williams Darling Highway on Monday as an example of what the country cannot afford.

“Events like (what happened on Monday) where we had thousands or hundreds of people congregating in a space, (are) not a good idea and if we are going to do things like that again let’s plan it a bit better, let’s use technology, maybe we can avoid watching the numbers climb.”

Dr Sands was pressed on the wisdom of reopening some businesses even as health officials plead for people to stay home. On Sunday, Prime Minister Dr Hubert Minnis identified several businesses that will be open on specific days.

“One of the things we want to do is make the assumptions that people will be responsible,” Dr Sands said, “that having gone through this now for a month that we are getting it, and the majority of Bahamians have gotten it…that five percent, that seven percent who are in lines will be a challenge.”

Comments

alfalfa 2 years, 5 months ago

One has to ask. How is any patient admitted to a public ward at the hospital, where multiple patients are confined, not tested for the covid 19 virus, in light of the seriousness of the spread. This has been highlighted in the weekly updates by the minister, and all the talk of procedures, protocols, and best practices seem to not be implemented at the governments largest health facility. It should have long ago been made mandatory that any patient, at any hospital on the country, be tested prior to placement in a hospital ward. What happens when this is not done is painfully evident.

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joeblow 2 years, 5 months ago

Sands said weeks ago that they had test kits but no swabs!! Who in the world would order tests but not an essential component that allows you to use the test. This reeks of incompetence all around. What have they done to try and rectify the problem other than talk?

He also said 10,000 rapid tests were ordered, what happened to those? http://www.tribune242.com/news/2020/m..." rel="nofollow">http://www.tribune242.com/news/2020/m...

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shonkai 2 years, 5 months ago

Once we get the swabs we will have run out of healthcare professional who can perform the tests. Sigh.

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professionalbahamian 2 years, 5 months ago

5 or 10 minute test results are available. It is practical. Please Google it.

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Well_mudda_take_sic 2 years, 5 months ago

“This patient was not suspected to have COVID and was there for an entirely different reason. There was, even in retrospect, very little reason to suspect that this patient should have had COVID.”

Dr Sands {also} said the country does not have the luxury of testing every person who attends a hospital, revealing a shortage of swabs will also impact the ability to increase testing in a widespread way.

What a bunch of malarkey!

It's now patently obvious we never had any semblance of a healthcare system, period! As many of us either knew or strongly suspected, it was always totally dysfunctional and much too easily overwhelmed long before the Red China Virus came along.

In order to 'flatten the curve' and keep it flattened so that our virtually non-existent healthcare system never becomes overwhelmed by more than a couple of seriously ill cover-19 patients at any point in time, we would have to all stay at home and keep our country totally shutdown for at least the next two decades. Most virologists seem to agree that there will never be a 100% bullet proof vaccine for the various strains of the covid-19 that are sure to develop from its ability to mutate, and at best we would instead end up with something like a regular annual flu shot. And we all know that the annual vaccine for the flu shot is reasonably effective in some years and not at all effective in other years. Just relish the reality of those thoughts for one moment!

With no effective healthcare system, the Minnis-led FNM government is even harder pressed provide ample justification for its lockdown measures based on the threat of the Red China Virus alone. And what will happen in those years when the covid-19 vaccination offers little protection against a new severe strain of it that will likely be brought to our shores by a cruise ship passenger? Not a good thought at all!

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ThisIsOurs 2 years, 5 months ago

"revealing a shortage of swabs will also impact the ability to increase testing in a widespread way."

But the PM made a grand announcement just 3 days ago that they would begin wide spread testing... sigh who knows the struggle but those who in it... anyway I hope they develop a vaccine soon. It doesn't look like well have an effective testing program ever ...for whatever reason even if it's legitimate

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Well_mudda_take_sic 2 years, 5 months ago

There will be no vaccine for at least another year and even then it will not afford bullet proof protection against various mutated strains of covid-19, in much the same way that the annual flu vaccine is pretty much a hit and miss proposition for stopping an outbreak of a severe strain of the flu. Most people tend to forget that covid-19 is a member of the same family of corona viruses that gives us the flu......the main differences being that covid-19 a/k/a the Red China Virus is a much more highly infectious and deadly type of flu.

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242in404 2 years, 5 months ago

The regular flu is not a corona virus. Other corona viruses are SARS, MERS, etc. more serious than the flu and don’t mutate as often.

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Well_mudda_take_sic 2 years, 5 months ago

To @242in404: Assuming you're not a Red China misinformation spreader, I suggest you get your facts straight by reading more reputable sources of info. You can start at this link to the CDC: https://www.cdc.gov/coronavirus/types...">https://www.cdc.gov/coronavirus/types...

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Bobsyeruncle 2 years, 5 months ago

Sorry Mudda, I think you are getting confused. They are caused by different viruses.

The 'regular' flu (and I emphasize the word regular), is NOT a Corona virus. Like Covid-19, the 'regular' flu is an infectious respiratory illness, but is caused by a totally different virus, even though symptoms are very similar. In fact 'regular' flu (Influenza) is caused by any of several different types and strains of influenza virus, with the onset of symptoms occurring generally sooner than with Covid-19. The 'irregular' types of flu (and now I emphasize the word irregular), would also include SARS or MERS etc. and are caused by Coronaviruses.

The following is taken from the CDC website:

*"Common human coronaviruses, including types 229E, NL63, OC43, and HKU1, usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. Most people get infected with one or more of these viruses at some point in their lives. This information applies to common human coronaviruses and should not be confused with coronavirus disease 2019 (formerly referred to as 2019 Novel Coronavirus)." - The bold type is not from me, but from the CDC website

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Bobsyeruncle 2 years, 5 months ago

Also, with respect to the vaccine it's important that you understand the difference between the annual flu vaccine and the potential Covid 19 vaccine.

The seasonal flu vaccine is made up of several flu vaccines, which may be different each year, the composition of which is determined each year based on surveillance data of which types are currently circulating and forecast to circulate (this is done by info from USA, UK, Japan, China & Australia). The vaccine might have a different composition depending on whether you live in the Northern or Southern Hemispheres. It's pretty much guess work, which is why the success rate of the annual flu vaccine isn't that great.

For Covid 19, we already know it's exact DNA profile and composition so it is a very specific target to develop a vaccine for, (think Small Pox), so no guess work is required unlike with the annual flu shot.

Hope this clears up any confusion

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happyfly 2 years, 5 months ago

I thought Covid19 had an RNA nucleus instead of DNA and that RNA mutates much easier than DNA ?

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Bobsyeruncle 2 years, 5 months ago

One more thing. People often use "Cold" and "Flu" interchangeably, when they are in fact different and caused by different viruses. I think the virus that causes the common cold, is in fact a Corona Virus.

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Well_mudda_take_sic 2 years, 5 months ago

Many thanks for the clarifications here and my apologies to @242in404.

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birdiestrachan 2 years, 5 months ago

The question should not be if you have travelled lately.

The question should be have you visited the Government hospitals or clinics lately?

The Doctor talking about how many people visited the clinics and hospital per year. Makes no sense.

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hj 2 years, 5 months ago

For years some people were bragging that the healthcare system was the best in the region ( i wonder with what region they were comparing it,maybe Haiti ). Will the lockdown be extended until the healthcare system gets its act together?

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TalRussell 2 years, 5 months ago

The Hospitals were on my dire virus warning watch list along with government and privately operated Care Homes, Prison, Immigration Detention Center, Sandilands, and In custody Police Lockups?
There's also the UNs dangerous Hati warning no government official mentions even in passing. Are we to believe that the loaded down with men, women, and children sailing sloops have suddenly stopped departing out from Haiti?
The true and accurate number the colony-wide virus-related infected and the dead remains under suspect watch? Nod once for yeah, twice for no?

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ThisIsOurs 2 years, 5 months ago

The story of case #22 a dialysis patient said he got sick after visiting the hospital. This would have been weeks ago. Wasn't Coakley one of the first if not the first who unfortunately succumbed? This would also indicate that the issue at the hospital is a long-standing one. Just like out here in the community, noone really knows who's infected

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TalRussell 2 years, 5 months ago

Sadly, ma comrade ThisIsOurs, the mainstream print, TV, and talk radio stations know lots going on behind closed doors but have a much vested financial interest to protect as not pursue Imperialists' red regime's cabinet ministers and government officials?
Even the presidents/prime ministers/governors mayors US, Canada, France, Spain, and the UK along with their health officials face-off with the media 7 days a week defend their handing coronavirus.

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DDK 2 years, 5 months ago

Just another damned excuse to keep control of The People's lives and dig us into such a deep financial pit we will never be able to climb out ! Do this Minnis and Sands tag team really believe someone will come to our Country's rescue when we are totally destroyed and say "Here are another hundred million dollars for you to squander"?

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Economist 2 years, 5 months ago

Last week Cayman Islands had 45,000 test available AT COST.

They have 65,000 people and 100,000 tests for themselves in addition to ones for sale.

How can the PM expect us, the people, to take all his long winded speeches on the seriousness for the lockdown when he doesn't take COVID 19 seriously himself?

We need some real leadership to deal with this crisis.

We need people who understand how to handle COVID 19 and , like Germany, Isreal, Iceland, understand that testing combined with a lockdown is the only way to defeat it.

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ConchFretter 2 years, 5 months ago

Most countries, and most hospitals within those countries, are not testing EVERY patient that is admitted to a hospital, regardless of symptoms. With testing being at a premium, testing every person that comes into the ER, regardless of their temp, lack of cough, broken bone, etc. would be ideal but is not reality.

So I do not fault PMH... in this instance,,.

Now, if they were not using PPE on every patient that they encountered, as IF every single patient was COVID-19 positive, then that definitely is a delinquency on their part and put many of their healthcare workers at risk.

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TalRussell 2 years, 5 months ago

Ma comrade Conch, few have been calling for outright testing all PopoulacesOrdinary but want a beefing up in the testing health care workers, and all others primarily in private and government Care Living Facilities, and spaces like the Prison, Sandilands, Hurricane Dorian Shelters, Immigration Detention Center, the Royal Constabulary, Immigration, and Customs Departments, housing a large number of people who share living and social common areas. Do you have an issue with such testing?

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ConchFretter 2 years, 5 months ago

[Comrade Russell, Health Care workers and vulnerable populations (prisons, nursing homes, etc) definitely need added attention as they are at increased risk. But testing alone is insufficient. Even if you had 10-minute test results, do you test once a week? Twice a week?? Every day??? We are focusing on different sides of the same coin. Those most at risk need extra attention. More testing needs to be done for these groups, and greater restrictions/precautions need to be implemented to decrease the chance of them getting Covid-19. We need both (and more) to improve our chances.

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TalRussell 2 years, 5 months ago

Point readers in direction lead evidence where it says all the before mention facilities residents and staff have and are being coronavirus tested or issued with Personal Protective Equipment PPE, at all...or maybe wait for the colony's army be called in to barricade from PopoulacesOrdinary...oh yeah the Prison and Immigration Detention Center already is?

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Economist 2 years, 5 months ago

They don't have to because they have a very high ratio of testing and have a good grip on the spred of the virus. Look at the ratios.

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paperbahamian 2 years, 5 months ago

It is sad to see so many people full of criticism and spite at a time when the country should be pulling together. These men (Minnis & Sands) are 2 highly qualified doctors, NOT career politicians, and in the present circumstances they are probably the best people to have in charge! They know, better than any politician, how infectious diseases spread and are difficult to contain. They know that less contact between people is the best/only way to slow the speed of contagion. They are not trying to get "Mr Popularity" awards - they are trying to save the lives of their fellow countrymen. Don't blame them for their being no swabs either. Wouldn't common sense (sadly not so common these days) suggest that "Testing Kits" would INCLUDE swabs as part and parcel of the "KIT" ? The fault more likely lies with the provider not the doctors. Bottom line: stop being critical and be more patient and cooperative. The life you save might be your own!

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joeblow 2 years, 5 months ago

… with all due respect it appears you have not been following this as closely as you should have. Both Sands and Minnis have done a bum job managing this crisis.

In early January Sands said we have more dangerous viruses in this country than coronavirus and they were ordering tests (yet we still have a problem with tests). http://www.tribune242.com/news/2020/j..." rel="nofollow">http://www.tribune242.com/news/2020/j...

They set up a "Rapid Response Team" in February but failed to have a plan to ensure positive patients did not move around the community to continue spreading. http://www.tribune242.com/news/2020/f..." rel="nofollow">http://www.tribune242.com/news/2020/f...

Despite us being a tourist destination they refused to consider closing the borders to tourists in early March and continued to allow flights from countries where it was known that the virus was spreading! http://www.tribune242.com/news/2020/m..." rel="nofollow">http://www.tribune242.com/news/2020/m...

I could go on and on, but why? The information has been there all along for others to objectively assess.

https://thenassauguardian.com/2020/04...">https://thenassauguardian.com/2020/04...

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geostorm 2 years, 5 months ago

All you people do is sit around and complain. You all had better be thankful that you ARE in the Bahamas. It could have been far worse. First world countries like Italy and even our dear friends in the USA have suffered tremendous loss due to this deadly virus. They are still trying to get this thing right.

This is a disaster that no one has seen within our lifetime and as far as I am concerned, the government is doing a decent job. It's the Bahamian people who are making it hard on themselves by acting like a pack of fools with no common sense, not adhering to the advice of the medical professionals, making their loved ones sick and bringing unnecessary illness on the rest of the population.

So my advice to all of you feel the need to complain is: shut the heck up and listen to the advice of the medical team led by Dr. Sands. The life you save may end up being your very own!

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happyfly 2 years, 5 months ago

Apart from the fact that the government has left us all with nothing to do but sit around and judge them - I am still waiting for somebody. Government. Career Doctor, Nurse? Somebody tell me what is the point of all of us locking down and containing the spread of this virus beyond flattening the curve which we have already done. Our healthcare system is not overwhelmed. Based on the news today the health care system is generating more sick people than the people out there ignoring social distancing. There is no historical or scientific evidence that says this total population quarantine works. It has never been tried before. Will the virus magically go away if we all stick out heads in the sand and ignore it ?? I don't think so ! So we are all sitting at home watching our life savings get frittered away whilst these guys look at charts and make up new rules every day. Two weeks ago the WHO was adamant that masks didn't work and now it is a God Damn law in the Bahamas that you have to wear one. No sir. No way on earth am I going to sit around and blindly trust that these guys truly know what they are doing.

PS - I am fit and healthy and am fully aware that the chances of me dying from Covid19 are less than 0.1% so I would much rather take my chances back at work than waiting for the economy to completely collapse and loose my job, my home, my future. Screw that !

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