LEFT: The Eric Williams Medical Sciences Complex, Mt Hope.
RIGHT: The Priority Care Facility which houses the ICU and Isolation Ward at the Eric Williams Medical Sciences Complex, Mt Hope, was peaceful.
BELOW: Ward Three at the Port-of-Spain General Hospital is now used as an isolation ward to treat H1N1 patients. Photos: Jennifer Watson

Despite warnings from the US Center for Disease Control and Prevention (CDC) of a shortfall in the supply of swine flu vaccines as the numbers of cases, hospitalisation and deaths grow to unprecedented levels, chief medical officer of the Ministry of Health Dr Anton Cumberbatch is assuring that T&T will receive its 260,000 vaccines. Cumberbatch said even though production of the H1N1 vaccines is slower than expected, T&T would not be affected. In June, Health Minister Jerry Narace said foreign pharmaceutical companies had offered to supply vaccines to the country by October. That did not materialise. Following the deaths of Vishraj Maharaj and another man on Tuesday at the San Fernando General Hospital, Narace confirmed that the 260,000 vaccines were scheduled to arrive in T&T by mid-November. The vaccine helps control the spread of the virus. On Friday, the New York Times and CNN reported a shortfall in supply. CDC believes that up to 12 million fewer doses of H1N1 vaccine than expected will be available by month-end.

No power to quarantine people
“We normally get our vaccines through the revolving fund with the Pan American Health Organisation and when they buy vaccines, they buy on behalf of all the countries that fall under PAHO, which includes many countries in South and Central America.” Cumberbatch said PAHO buys from more than one manufacturer. “This is standard. This is not only for H1N1 vaccines, but in the way vaccines are produced and delivered on demand.” Cumberbatch said in order to ramp up H1N1 vaccine production, manufacturers will have to curtail producing other vaccines. “The demand for the vaccine globally is so strong so they will be increasing production.” Cumberbatch also appealed to those exhibiting flu-like symptoms to stay at home and avoid travelling on PTSC-articulated buses and air-conditioned maxi taxis. “I don’t think we have the power to quarantine people because you have flu-like symptoms.”
Cumberbatch said the ministry will make another appeal to maxi-taxi drivers to keep their windows open to allow fresh air to circulate in vehicles.

More fatalities to come
But while Cumberbatch was optimistic, one senior medical doctor at the Eric Williams Medical Complex (EWMSC) predicted more deaths. “More fatalities will come and more people will end up in ICU. The deaths are tragic but it is expected.” From the beginning of last week the hospital had been faced with an influx of people coming in for swine flu testing. The resurgence of people’s concern was caused by the deaths of four people—three men and a woman—within the past six days. “We saw a mad rush of people, who perhaps a week ago, would just stick it out at home.” He also denied that there was a new strain of H1N1. New research coming out of London, the doctor said, showed that the flu settles itself in the lungs and throat making breathing difficult. “The virus prevents air from coming into your lungs.” Those tested positive are admitted to the Isolation Ward at the Mount Hope hospital where Tamiflu is administered.

Three warded in ICU
From April to now, the doctor confirmed, over 400 people were tested at the EWMSC for the virus. Of the 400, a total of 157 confirmed positive in T&T. “Between 60 to 70 of the 157 came from this hospital,” he disclosed. Three adult patients, the doctor said, were admitted to the Intensive Care Unit within the last three weeks complaining of distressed breathing. The patients, who were put on respirators, were warded for nine to ten days.
ICU can accommodate up to seven patients at a time. “Two of the five patients can be warded in private, separate rooms for treatment.” Once fully recovered, the patients are admitted to the Isolation Ward for observation, then discharged.

“Statistically there is nothing strange that we have swine flu patients in ICU. The majority will get away, but the minority will have serious complications.” He also disclosed that attempts were being made for all doctors operating at public health institutions to consult and exchange ideas. “This was one way of going forward.” The doctor said obese people were vulnerable to swine flu and that pregnant women and young children should also be wary. Comparing T&T’s H1N1 mortality rate with Canada, Argentina and Venezuela, he said this country’s was relatively small.
“Canada had 68 patients in ICU. 17 per cent of those people did not make it.”

Clogging the system
Stating that people with seasonal flu were coming to the hospital and clogging up the system, the doctor urged people who have flu-like symptoms to first monitor their health. “If after three days of medication, you have persistent high fever, body pains and difficulty breathing, then go to the hospital.” The doctor pointed out that T&T has an enormous advantage over some countries, “in that we have no financial barriers to enter the hospital system. People want to be tested because their neighbour was coughing yesterday.” In some parts of Mexico, the doctor said, patients had to fork out hundreds of dollars to be tested. Yesterday, a relative calm prevailed at the Priority Care Facility, Accident and Emergency department at the EWMSC. A nurse at the front desk stated that only patients with high fever were tested for the condition. Four guards wearing protective gear stood at the entrance to the Isolation Room, barring members of the public from entry. At the Port-of-Spain General Hospital, patients with swine flu are placed on Ward Three, an isolation ward. Up to late yesterday, one female patient was said to be receiving treatment for the virus.