By Sue-Ann Wayow
EVEN though it is an expensive drug, more Toclizumab should be purchased for advanced care of Covid-19 patients, medical records need to be stored electronically and leaders in the public healthcare system need to communicate better with their frontline staff.
These are just some of the 16 recommendations being made by the five-member committee mandated by Prime Minister Dr Keith Rowley to investigate the public healthcare system and its handling of the Covid-19 pandemic.
The completed report was laid in Parliament on Friday by Minister of the Office of the Prime Minister Stuart Young.
Young said that the 105- page report dated February 14 was received by the Prime Minister this week.
He said other recommendations include strategic planning for persons with non-communicable diseases.
Reading from the report, Young said, “It is likely that citizens with NCDs would again be at increased risk for poor outcomes if and when there is another event such as the Covid-19 pandemic. The clinical staff who have been hired temporarily and whose contracts would be discontinued at the end of the pandemic should be redeployed to respond to the NCD morbidity debt that has accumulated during this pandemic.”
He added, “We (the Committee) were impressed with the application of the nurses, doctors, paramedical and support staff who managed Covid-19 patients. However, at some RHAs, some of the staff in the frontline felt abandoned by the leadership. We recommend the RHAs implement a specific feedback system to monitor the needs of the staff on the frontline.”
Another recommendation is that C40 should be continuously open, seven days per week and that Tocilizumab be given at an advanced stage of Covid-19.
“Most staff were very impressed by its effects and perhaps C40 needs to increase purchasing of this drug. Though it is an expensive drug there is a cost-benefit to be realized from its use. We recommend that the policy regarding Toclizumab use be reviewed,” Young read.
The five-member committee was headed by Professor Terence Seemungal and also consisted of Professor Emerita Phyllis Pitt-Miller, Dr Anton Cumberbatch, Dr Vidya Dean and Professor Donald Simeon.
The formation of the committee was announced by Dr Rowley on January 15 to thoroughly investigate the public healthcare system and its handling of the Covid-19 pandemic. The committee was given one week to present their findings and had subsequently asked for additional time which was granted.
Other recommendations
The committee’s other recommendations include a review of oxygen requirements of all large institutions, emphasis on mental health of medical staff including job security for young doctors and nurses and recommended a contractual period for at least one year. Recreational facilities on-site for staff was also recommended.
The committee was also concerned about the quality and timeliness of meals being provided to patients and recommended that meal also be provided to staff who work in isolated areas.
Improvement in communication for patients and family members were also listed and empathy must be shown even in the past faced environment.
Participants of an online survey listed accommodation as a main concern and that temporary accommodation needed to be improved.
Data also need to be provided as to where deaths occurred in the hospital, whether at a tent, step-down facility or in the actual hospital building.
The committee is also recommending a National Policy regarding ICU admissions and care of the elderly as more emphasis seemed to be placed on paediatric care.
The committee stated, “ It was noted that 15.2% of paediatric admissions were to ICU compared with 1.2% of persons over 80 years of age. This was remarkable given the high death rates amongst the elderly. It was also noted that there were special paediatric ICU beds whereas there was no such facility for the elderly. In addition, the demand for paediatric ICU beds was in absolute terms much smaller than that for adult ICU beds. We did not find any mention of a national policy regarding admissions to ICU for persons of different ages, and recommend that such a policy needs to be articulated.”
Given the time frame for the report, the committee stated that ‘Views of relatives of Covid-19 patients’ was an area that needed further investigation.
“We could not assess their views due to the time constraints of this rapid assessment. We noted that relatives had no or limited access to patients during admission. We recommend a formal survey of the views of relatives of patients who were cared for in the parallel health care system,” the committee stated.
And a written self-assessment by the ministry should be conducted.
The report stated, “Further external assessments of the health care system should be preceded by a written self-assessment.”
The committee thanked the many who assisted in the report including Health Minister Terrence Deyalsingh and Tobago House Assembly (THA) Health Secretary, Dr Faith B. Yisrael for accommodating them.
