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Crisis’ toll on non-COVID patients

Dr Duane Sands

Dr Duane Sands

By KHRISNA RUSSELL

Tribune Chief Reporter

krussell@tribunemedia.net

FORMER Health Minister Dr Duane Sands believes some people who have sought medical care for non-COVID-19 illnesses in the public healthcare system have probably suffered and died due to the strain the virus has had on resources.

In an interview with The Tribune yesterday, Dr Sands said various issues have made it difficult to treat cases at Princess Margaret Hospital as there continues to be “no room at the inn” there.

It has come down to triaging patients and making decisions that may not always end up with a positive outcome, Dr Sands said.

He was asked if people seeking care were being turned away as the worst health crisis in the country’s history rages on.

Deaths, not just those related to COVID-19, appeared to have increased recently, as seen in The Tribune’s obituaries that have published full 48-page editions along with surplus pages for several weeks now. In the previous months, the obituary section has also been fully subscribed.

 “This ain’t got nothing to do with insurance,” Dr Sands said. “Whether you have insurance or don’t have insurance right now the inn is full. So, this has to do with bed availability, a reduction in services, the availability of nurses and the impact on certain physicians being out sick.

 “So, right now it is very difficult to get certain types of cases done and to admit certain patients unless they are critically ill and even then, you know we have critically ill patients who are trying to get in hospital particularly from the Family Islands and we can’t bring them in.”

 In some instances, he said a patient may be sent home to monitor their condition or simply wait until the hospital is able to accommodate their care.

 “I mean you basically try to do triage to determine what is the most effective use of scarce resources and sometimes you get it right and sometimes you don’t,” Dr Sands said.

 “Dr [Charles] Diggiss, [Doctors Hospital chief executive officer] has been very vocal on this matter as well and he says that they’ve had to make difficult decisions about who goes on a ventilator, who doesn’t go on a ventilator and that doesn’t only apply to COVID patients that applies to all the patients.

“So, let me give you an example. I took care of a gentleman with a very serious injury yesterday. There are no ICU beds in the hospital. Any other time that I would have taken care of him there would be absolutely no doubt that he had to go to the intensive care unit.

 “There were no intensive care unit beds. This patient was critically injured, and we had to manage out of the intensive care unit. Now fortunately he survived, but that speaks to the handicap that has been placed not just on the public healthcare system but on the healthcare system period.”

 He continued: “If you come in with a chest pain now you may end up being sent home even though you are having a heart attack because the system doesn’t have the capacity to function at the level that it ideally functions and so are you having patients suffer or die as a result of the impact of COVID? The answer is probably yes.

 “And you can only do the best that you can do, and this is very, very frustrating for staff. For instance, if you have a standard nurse to patient ratio in a given area and you say that on such and such a ward, we do one to five, one to six, one to three, one to two, nowadays that’s gone. All of those ratios at times will have to be stretched because you only have so many nurses and they can only work so many hours and so if you have somebody who is working 10 straight 16-hour shifts at some point in time she has to go home and rest.

“So, what are you gonna do? You will do the best that you can.”

Comments

bahamianson 3 years, 4 months ago

Do we have a.minister of health? Sands speaks to health issues a lot. I thi k this is an afront to the sitting minister. He should stop and let the minister answer and respond to questions

jackbnimble 3 years, 4 months ago

Who’s fooling who? We all know Sands is the real deal. He walks in his gift and should never have been removed in the first place. But this is what happens when you have a jokey and petty leader heading a country and looking for a second term. Not on my watch!!

rosiepi 3 years, 4 months ago

These issues have been reported now for over a year, I recall last spring Cardio MDs in the Toronto area estimated that over 6 weeks they had lost 3 dozen patients because their procedures were cancelled and/or they could not get the procedures needed. So I'll make a wild guessestimate that the Bahamas is in far worse shape.

ThisIsOurs 3 years, 4 months ago

Sands could break away from the FNM with his campaifn slogan as the country needs a real doctor.

And no, I dont think he should literally do that.

ohdrap4 3 years, 4 months ago

What is the sitting minister sitting on?

Is that the one who declared that we have " a cure in the form of a vaccine".

And cannot differentiate "titular " and "testicular"?

And cannot differentiate "comingling" and "commiserating"?

And whose driver and secretary are frontline covid warriors?

John 3 years, 4 months ago

‘ Vaccination remains a key priority for many countries but infectious disease experts say effective Covid-19 treatments will still be necessary Several large-scale clinical trials are still under way around the globe to assess and determine the most promising medications Vasco said that treatments along with supportive care have contributed to Singapore’s low mortality rate. .’ . “Treatment of Covid is critical because the vaccine is not 100 per cent,” said Professor Dale Fisher, an infectious disease expert from the National University of Singapore (NUS) Yong Loo Lin School of Medicine. “Some will always refuse vaccination and, on occasion, a vaccinated person could get sick. That’s expected so we want the best options found and available.” However, he said these outcomes are not part of a clinical trial, where the impact of specific Covid-19 treatments on patients can be compared quantifiably with those who did not receive treatments. Fisher said the biggest driver of poor outcomes globally has been overwhelmed hospitals without enough beds, ventilators and oxygen. “When all these basics remain available, we are even more enabled to save lives with the clinical skills and techniques we have learned and the drugs we now have available,” he said.‘

John 3 years, 4 months ago

‘ The largest of the trials, involving more than 12,000 patients, is being conducted at Oxford University. Since March 2020, the Recovery trial has studied several drugs for their efficacy in treating Covid-19 patients. Some drugs have been shown to be ineffective, such as the anti-malaria drug hydroxychloroquine, which was promoted as a potential treatment by former US president Donald Trump.’ . . ‘However, others such as the cheap steroid dexamethasone and the arthritis drug tocilizumab have been effective in treating patients, and have saved lives as Britain battled major outbreaks.’ .TIME to abandon the ineffective, single prong ‘Vaccinate ALL’ approach to this pandemic and follow the footsteps of countries that are achieving positive results. Singapore has managed to keep both its numbers of nee cases and deaths low. . ‘ .’ . In Singapore, the Health Science Authority last week granted interim authorisation for the antibody drug sotrovimab, which was developed by pharmaceutical company GlaxoSmithKline and immunology company Vir Biotechnology, and was used to treat patients aged 18 and over with mild or moderate Covid-19. These patients do not require supplemental oxygen but are at risk of developing more severe symptoms.’

JokeyJack 3 years, 4 months ago

You are discussing medicine during this medical crises? You looking to get lovk up eh? You know that's not allowed. Take the vaccine and shut up.

John 3 years, 4 months ago

Taking the vaccines and shutting up are in two different parameters. Both mutually exclusive. And because of how the Covid pandemic is presently being managed in this country it may become a choice between taking the vaccine or dying.

tribanon 3 years, 4 months ago

Our grossly under-resourced and very dysfunctional public health system was doomed to failure long before COVID-19 came along. It's a failed system perpetuated by successive FNM and PLP administrations. PMH has been unnecessarily killing the seriously ill for decades now. And both Sands and Minnis as senior medical doctors know this only too well.

Minnis actually served as minister of health in an Ingraham-led FNM administration and did diddly-squat to address our country's woefully inadequate public health system. The more than $150 million that he, as PM, plowed into corrupt deals involving the bankrupt Grand Lucayan property could and should have gone instead to making urgently needed improvements to our public health system.

And to think Sands also supported, as minister of health at the time, government's purchase of the bankrupt Grand Lucayan property from Hutchison Whampoa even though he too knew full well that the funds borrowed for that deal could have been better deployed to addressing our nation's urgent public health issues.

The current Minnis-led FNM administration in only 4 years is already responsible for more than 30% of our country's total national debt. Where has all of that borrowed money gone? We certainly know it didn't go to addressing the urgent needs of our public health system. Where's all of that transparency Minnis promised us time and time again back in April and early May 2017, before he became PM?

TalRussell 3 years, 4 months ago

Unlike Coopers Town's Fisherman Comrade Papa Hubert, — who has built up immunity, that’s somewhere near 98.9 percent — shunning Thee Mr. Minnis, — whilst Dr. Duane, continues to prop up the Red parties failed leader, — Yes?

whogothere 3 years, 3 months ago

Drive up hysteria - and what did you think was going to happen...?

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