Flu spike: QEH A&E ‘under strain’ as flu drives 100 daily cases

The Queen Elizabeth Hospital’s Accident and Emergency Department is facing sustained pressure as a sharp rise in influenza, trauma and chronic illness cases drives daily attendances past 100, prompting emergency measures to manage patient flow.

Amid one of the most significant global influenza outbreaks since COVID-19, the QEH has recorded a rise in flu-related visits, increased trauma and injury cases, and a growing number of complications from diabetes, heart disease, asthma and hypertension, officials said on Monday.

Speaking at an emergency press conference on Monday at the hospital, QEH Chief Executive Officer Neil Clark said demand on the A&E department had been “exceptionally high”.

“Over the last weeks, the department continues to respond to one of the most significant influenza outbreaks in recent history, globally, since COVID-19,” Clark told journalists. “Over the last year, there have been increases in A&E attendances by 8.5 per cent compared to the previous year, which equates to an extra 160 additional patients each month.” 

The situation had worsened following the holiday period, with more patients requiring admission, he added.

“These factors together mean that more patients need urgent hospital care at the same time, which can slow how quickly less urgent cases are seen in the A&E department,” Clark said.

Hospital officials disclosed that 42 confirmed flu cases were recorded in December, the majority of them Influenza A, alongside circulating cases of respiratory syncytial virus (RSV) and small numbers of COVID-19.

The hospital had activated escalation measures to manage the backlog, including bolstering staffing levels and strengthening bed management and discharge planning, said Clark.

“We’re supporting staff and filling rotas where illness has affected staff availability, and we’re identifying additional medical and nursing staff to support the current backlog of patients within the A&E department. Our clinical and support teams are working around the clock to maintain safety and flow during this exceptionally busy period.”

The CEO also addressed public claims that patients were sitting on the floor and that the department was out of control.

“What may cause some of the confusion is that there are patients on ambulance trolleys, which are lowered closer to the floor for safety reasons. This may create the impression that someone is on the floor, but they are not.”

Additional A&E trolleys are expected to arrive this week, allowing the hospital to phase out the use of ambulance trolleys in the department, he reported.

“We expect the ordered A&E trolleys to arrive this week, and then we would remove the ambulance trolleys so that everyone would appear to be on the same level.”

Clark also outlined strategies used to prioritise emergency cases.

“We continue to prioritise the sickest patients through triage so that those with life-threatening conditions are seen first. We continue with our morning daily briefings, implementing escalation measures based on the issues identified each day.”

Head of the A&E Department, Dr Anne-Marie Cruickshank, confirmed that sustained high patient volumes have prevented staff from clearing the backlog.

She said: “From Boxing Day to present, we are seeing well over 100 patients a day, with 40 to 60 patients waiting to be seen at a time. Ideally, we would have maybe 15 waiting, but last weekend we had 64 patients waiting alongside ten gunshot wound victims, which was very intense.”

The department’s ideal intake is between 20 and 30 patients per shift and said the surge had required additional specialist support, Dr Cruickshank noted.

She explained: “We had to bring back seven resident doctors over consecutive weekends, in addition to increasing nursing and other support staff. All staff groupings were increased to help manage the surge because we work as a team.”

Specialist doctors have now been assigned to work directly within the A&E department to speed up patient processing and decision-making, she added.

Instead of consulting specialists by phone, “they will be in the department with us, so as we see relevant patients, we can speak directly to them and assist with the flow,” she said.

Clark urged the public to reserve the A&E department for genuine emergencies such as chest pain, severe breathing difficulties, major injuries, stroke symptoms, serious bleeding or sudden collapse.

For minor illnesses and injuries, the hospital chief advised Barbadians to seek care at polyclinics, urgent care centres, private doctors or pharmacies, and to properly manage chronic conditions to reduce the risk of complications.