THE increase in the demand for ward-level beds causes the establishment of a fourth tier of care in the parallel healthcare system (PHS) in Trinidad and Tobago called a stepdown or halfway house.
This was revealed by Principal Medical Officer of Institutions Dr Maryam Abdool-Richards during the Ministry of Health virtual briefing on Monday.
She said there was an increase in the overall capacity of the hospitals in the PHS with the rolling average of cases per day more than 300.
The PMO noted that for every 100 confirmed cases of Covid-19, 15 people were being admitted to hospital.
She said the levels of hospital care in the PHS included:
- Ward level where patients walked around and may require low flow oxygen via a facemask intermittently and were unable to isolate at home with pre-existing conditions;
- The high dependency unit (HDU) which included oxygen therapy and a more concerted effort from nursing personnel; and
- The intensive care unit (ICU) where patients were unconscious, ventilated in critical or severe condition.
Dr Abdool-Richards said the greatest demand currently was for ward level beds and thus the fourth tier of the stepdown or halfway house was created for people recovering from the hospitals but who were not yet fit to go home.
She said the benefits from this system were that it can function independently where patients could be observed by on-call physicians and nurses who are on site and it allowed the freeing up of spaces in other facilities.
Dr Abdool-Richards said, “Increasing beds is not the answer to the Covid-19 pandemic.
“We are testing and exhibiting the resilience of the parallel healthcare system by converting stepdown facilities and quarantine facilities into a more advance level of care to treat those patients who are ill and require continued management and follow up by nurses and doctors. We need to continue to decrease the demand for hospital beds.”
She said additional beds were established i three facilities:
- 50 at the University of the West Indies Debe Campus;
- 20 at the University of T&T Valsayn Campus; and
- 40 at the Point Fortin Hospital.
This has increased the bed capacity in the PHC to 662. She said of these, 572 are ward level beds, 30 are ICU and 60 are HDU.
She said by Monday afternoon, the Caura Hospital was expected to decrease from 86 % occupancy to 66%.
Technical Director of Epidemiology Dr Avery Hinds said 37% of Covid-19 tests done were returning positive.
He said the number of Covid-19 cases reported up to May 9 has almost surpassed the total cases for the entire month of April.
