COVID-19 update – January 20, 2021. (PMO)

Barbadians have been assured that proper procedures are in place at the Queen Elizabeth Hospital (QEH) to protect the health and safety of staff and patients amid the COVID-19 pandemic.

This was conveyed today by Director of Medical Services at the QEH, Dr. Clyde Cave, while speaking at a press conference at Ilaro Court. 

He noted that the institution, like the community, faced challenges, perhaps more so, given that it was likely ill patients would present to the hospital.

Adding that just as the public had to presume that everyone may be a carrier of COVID-19, he stressed: “We have to have practices in place to protect the staff and other patients at the hospital while we provide the best medical care for the individual patient.”

Outlining some of the procedures that are in place at the hospital, the Director said: “The first thing we ask is that you call ahead to our help desk 536-4800 that is staffed by professionals, doctors and experienced nurses, who can provide first aid and direct you as to the course. It may be best not to actually come to the hospital at that time. And there may be other things that you’re advised to do.”

He further noted that on arrival at the Accident & Emergency Department, the first stop would be the tent outside where a triage is performed.  

“That is a procedure where we assess the state of the patient’s health, but also their relative risk for COVID.  This is first, in the form of a questionnaire, and we ask the public please to be honest and forthcoming with all the answers to the questionnaire. This is for your own safety, but also for the safety of other patients in Accident & Emergency at the time, and also for our staff.”

According to Dr. Cave, on the basis of that triage, patients are directed either to a respiratory area, where respiratory illnesses and other possible COVID-19 cases are looked after in isolation facilities, or in Accident and Emergency, where there are also precautions in place to prevent COVID-19 transmission, though not as rigorous as in the respiratory area.

The Queen Elizabeth Hospital. (FP)

“Once you’ve been assessed and seen by the doctor, the decision then will be to have a COVID screening test or not,” he said.

While acknowledging that there may be some delay during the time the QEH was awaiting the test result, he said, however, it does not hold up the medical care being provided immediately to the patient.  

Adding that once the test comes back, patients are then directed either to the isolation facilities if they’re positive, or admitted to the general hospital, Dr. Cave stressed: “And, in the general hospital, we also have practices and procedures to minimise any kind of spread because like in the community, we have to be always vigilant.”

Meanwhile, responding to a media query on whether a patient could be deemed to have died from something other than COVID, following a post mortem, the top health official maintained he could notcomment on any individual cases, or give any information that could be extrapolated back to those individuals or their families”.

He stressed: “You know, it is an essential tenet of medical care that we maintain confidentiality. Now, there is perhaps a lay confidence in autopsies as finding a definite cause that may not be borne out by the medical practice of autopsies.  We can’t always decide between two or three different factors.

“We would already know in some cases that there are some co-morbidities like diabetes, renal failure, hypertension, whatever. And we would also have recognised that there was COVID as well. Now, what was the actual main factor?  I’m not sure that autopsies can always sort that out. And, I also have to say that internationally and also here in Barbados, in the era of COVID, autopsies are restricted in practice, because the practice of an autopsy can become an aerosolising procedure, depending on what they do.”

Emphasising that legal guidance had to be taken from the coroner where certain conditions apply, Dr. Cave told media representatives that as a general practice one may end up with a list of contributing factors and not a single one.

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