“Nev­er was so much owed by so many to so few.”

A sen­ti­ment ex­pressed by for­mer British Prime Min­is­ter Win­ston Churchill al­most a cen­tu­ry ago dur­ing the sec­ond world war.

Though to­day’s bat­tle isn’t be­ing waged by pi­lots in the skies over South­ern Eng­land but in­stead by health­care work­ers in hos­pi­tals-, it still rings true.

Across the globe, coun­tries have en­dured their share of the fight and now Trinidad and To­ba­go’s is at a crit­i­cal point.

But with the cur­rent ex­plo­sion of COVID-19 cas­es bom­bard­ing the coun­try, the al­ready ex­haust­ed health­care work­ers have be­gun to buck­le un­der the pres­sure as of­fi­cials warn of an im­mi­nent col­lapse of the par­al­lel health­care sys­tem.

Col­laps­ing sys­tem

The con­tin­u­ous­ly sharp in­crease in COVID-19 cas­es is in­un­dat­ing the coun­try’s main COVID-19 treat­ment sys­tem.

Prin­ci­pal Med­ical Of­fi­cer of In­sti­tu­tions, Dr Maryam Ab­dool-Richards ex­plained dur­ing a re­cent Prime Min­is­ter’s press con­fer­ence, the num­ber of peo­ple be­ing ad­mit­ted in­to the sys­tem far ex­ceed­ed those be­ing dis­charged.

To re­lieve some of the pres­sure, 240 ad­di­tion­al spaces were made avail­able through in­creased step-down fa­cil­i­ty ca­pac­i­ty while field hos­pi­tals were set up at the Cou­va Med­ical and Mul­ti-Train­ing Fa­cil­i­ty and Jean Pierre Com­plex with the as­sis­tance of the Unit­ed States.

The Ari­ma Gen­er­al Hos­pi­tal was al­so brought back in­to the par­al­lel health­care sys­tem due to the surge and the Au­gus­tus Long Hos­pi­tal was switched from hous­ing sus­pect­ed pa­tients to now treat­ing those in­fect­ed.

But as Dr Ab­dool-Richards point­ed out pre­vi­ous­ly, the sys­tem goes far be­yond just beds as it al­so re­quires teams of med­ical per­son­nel to ad­min­is­ter treat­ment.

Bat­tle-weary and over­whelmed health­care work­ers

Un­spun spoke to health­care work­ers in some of the key treat­ment fa­cil­i­ties. They spoke on the con­di­tion of anonymi­ty to pro­tect their jobs as many have been warned against speak­ing to the me­dia. Though their ex­pe­ri­ences were some­what unique to their re­spec­tive fa­cil­i­ties, they all shared the same sen­ti­ment—they were over­worked, un­der­staffed ex­haust­ed, and over­whelmed by the sheer num­ber of pa­tients re­quir­ing treat­ment.

“At this point, even though the surge on­ly re­cent­ly start­ed a lot of the staff are re­al­ly burnt out. Like peo­ple would be cry­ing in­side the hot zones be­cause they are so frus­trat­ed…it is over­whelm­ing and, sor­ry to say, it but most times some of the pa­tients are al­so treat­ing the staff bad as well,” one health­care work­er with­in the Cou­va Med­ical and Mul­ti-Train­ing Fa­cil­i­ty said.

Ac­cord­ing to the pres­i­dent of the Trinidad and To­ba­go Reg­is­tered Nurs­es As­so­ci­a­tion, Idi Stu­art, there is al­so a short­age of nurs­es man­ning these hos­pi­tals.

At Cou­va, he said: “We have one nurse see­ing about 45 pa­tients. That is un­heard of. There is no way one nurse can de­liv­er any form of qual­i­ty care to per­sons with­in that in­sti­tu­tion.”

Fur­ther de­creas­ing man­pow­er, he said, is mem­bers of the nurs­ing fra­ter­ni­ty who are leav­ing the pro­fes­sion ei­ther through re­tire­ment or in search of bet­ter op­por­tu­ni­ties else­where and some who of­ten have to quar­an­tine or iso­late them­selves due to COVID-19 ex­po­sure.

Fur­ther strain­ing health­care work­ers with­in these fa­cil­i­ties is the lim­it­ed re­sources at hand to treat pa­tients.

“We have to pri­ori­tise who goes in­to ICU. So who­ev­er’s most sick or has a high­er prog­no­sis—like who have the most po­ten­tial to save—we do those. So we have to make a lot of dif­fi­cult de­ci­sions. Not be­cause peo­ple can­not be saved but be­cause it has too much peo­ple for us to han­dle,” a med­ical source with­in the Au­gus­tus Long Hos­pi­tal told Un­spun.

The Au­gus­tus Long Hos­pi­tal has been run­ning at full ca­pac­i­ty since its in­cep­tion in­to the treat­ment of in­fect­ed pa­tients some two weeks ago. But while the source ad­mits they need more re­sources, they in­di­cat­ed the pri­ma­ry is­sue is the rate at which pa­tients are com­ing in.

“The main prob­lem is that the num­bers are so high that we can’t keep up with them. That is the main prob­lem. The sec­ondary prob­lem would be that peo­ple who are com­ing in, crit­i­cal pa­tients, do need ven­ti­la­tors…but we wouldn’t be in that sit­u­a­tion in the first place if the num­bers were low­er.”

It’s a sen­ti­ment the T&T Med­ical As­so­ci­a­tion’s pres­i­dent Dr Vishi Be­har­ry al­so shared. He said there is a cer­tain lev­el of re­spon­si­bil­i­ty on the Gov­ern­ment’s part to en­sure these fa­cil­i­ties are prop­er­ly equipped but it’s im­pos­si­ble to hope it could be done to keep up with the ex­plo­sion in cas­es.

“We can­not ex­pect with the rapid num­ber of cas­es that we’ve been see­ing to be able to rapid­ly ex­pand the par­al­lel health­care sys­tem,” he said.

“At the end of the day, while we may want to say the ad­min­is­tra­tion should put more things in place those things don’t hap­pen overnight. A ven­ti­la­tor is not made overnight. Im­por­ta­tion of a ven­ti­la­tor is not done overnight. But cas­es are ris­ing overnight.”

This is why he said it’s im­por­tant cit­i­zens do their part to help curb the spread.

“We have to recog­nise that first of all...the pub­lic health mea­sures that are be­ing in­sti­tut­ed or that have been put in place have been done so for a rea­son—to slow the spread of the virus, to try to min­imise the amount of cas­es,” he said.

The third wave

Fif­teen months in­to the coro­n­avirus spread lo­cal­ly, this coun­try has nev­er wit­nessed an in­crease in cas­es and fa­tal­i­ties as in the cur­rent one which now es­tab­lish­es it­self as a third wave.

With­in weeks the coun­try went from a sev­en day rolling av­er­age of three cas­es re­port­ed per day on March 6 to 341 as of May 13.

In those ten weeks, the coun­try went from 96 ac­tive cas­es to 4,814 with 117 deaths oc­cur­ring.

Be­fore this wave, the most ac­tive cas­es the coun­try ever had to deal with was 2,560 on Sep­tem­ber 17, 2020.

Fol­low­ing the all-time low in March, cas­es be­gan to trend up­wards with the rolling av­er­age hit­ting dou­ble dig­its on March 20. But be­tween April 22 and May 1, the sev­en-day rolling av­er­age rose from 100 to 226 as the coun­try record­ed a stag­ger­ing 1,689 cas­es.

With­in the first 13 days of May, a to­tal of 3,990 cas­es and 85 deaths were record­ed; 21 of which were record­ed with­in 24 hours on Thurs­day.