‘Their assistance was invaluable’

The Emergency Medicine Division (EMD) of The University Hospital of the West Indies hosted a special ceremony on Thursday, March 23 to celebrate the facility’s emergency room technicians (ERTs) and phlebotomists for outstanding work during the COVID-19 pandemic. Each member of the ERT and phlebotomist cadre was presented with a certificate of appreciation by division head, Dr Eric Williams.

In attendance were the past heads of the EMD, Dr Jean Williams-Johnson and Dr Simone French; senior director of nursing, Helen Thompson; chief risk manager, Yannick Morgan; and the acting CEO of the hospital, Fitzgerald Mitchell. The event was chaired by the current head, Dr. Eric Williams, assisted by Dr Jason Ifill.

The COVID-19 pandemic spanned more than two years commencing March 10, 2020 with the isolation of the first case at The University Hospital of the West Indies (UHWI). From that point onward healthcare workers on the frontline were exposed to an increased risk of contracting the deadly virus. In addition, there were significant work challenges that needed constant navigation on a day-to-day basis.

The EMD) had to face the nation’s need for urgent care. Healthcare workers triaged and isolated patients and provided appropriate treatment to mitigate morbidity and mortality for patients, staff and visitors to the institution.

Dr Williams, who gave an overview of the division’s challenges and the group’s contribution, noted that there was a desperate need for vigilance and assistance with dwindling resources and the need to maintain equity.

“The Ministry of Health and Wellness (MOHW) worked with the UHWI COVID-19 Task Force to maintain surveillance, maintain dwindling supplies of personal protective equipment (PPE) and other resources as the desperate challenges upsurged. Different strategies were employed to flatten the epidemiological curve as the disease unfolded, using evidence-based research, as well as common-sense thinking,” Dr Williams said.

“The pandemic interrupted both clinical services and training at the main teaching hospital on the island. The staffs were fearful. Despite this they showed resilience, flexibility and adaptability,” he added.

NECESSARY ADJUSTMENTS

Dr Williams said the staff in the emergency room was prepared with video training explaining the placements of PPE. Staffs were also fit tested for N95 masks. In addition the department was modified to create as many isolation spaces as possible.

“The hospital’s COVID-19 task force met daily to assess new information as it became available and make the necessary adjustments. The consultants in the EMD knew they had an unprecedented challenge. Even so the reality of large numbers of ill patients who often presented in extremis with moderate to severe respiratory conditions was daunting,” he said.

“Triage procedures were modified. Oftentimes patients were interviewed on their cellphones before they were brought into the unit to assess their severity and to prevent inadvertent contamination,” he added.

Non-contact (infrared) thermometers were used to screen everybody entering the hospital for fever. Initially Polymerase Chain Reaction (PCR) testing was used to confirm the diagnosis. Subsequently the rapid antigen test became available to assist with case identification with a quicker turnaround time and lesser cost than the PCR test. A swabbing booth was an essential resource.

“There were not enough isolation rooms to safely house Covid patients and separate them from those who were not infected. At first tents were used to assist but this was still not enough. Later the private sector donated the field hospital,” Dr Williams said.

All patients admitted to the hospital were swabbed for the SARSCoV2 virus. The staff like the public became ill and the number of doctors available to perform the necessary swabs dwindled. The then head of the department, Dr. Simone French, approached the emergency room technicians (ERTs) to enlist their help with this important task.

“Dr Jason Ifill was tasked with training the ERTs to perform swabbing duties. Soon after the phlebotomists indicated that they too wanted to help and they were trained. Their assistance was invaluable,” Dr Williams said.