Docs blank operations on COVID-19 patients

The impasse between surgeons and public health administrators over the fitness of make-shift operating rooms intended for Coronavirus patients escalated today as the surgeons declared their refusal to perform surgeries at the Enmore isolation facility or any other locations that do not meet their standards.

But Dr Corey Forde, Head of Infection Control and Dr Clyde Cave, the head of Medical Services at the Queen Elizabeth Hospital took to national radio adamant that QEH is not to be used to perform procedures on COVID-19 patients. They acknowledged that the high cost and lengthy time needed to prepare alternative theatres has made it difficult to meet the surgeons’ standards and urged the specialist doctors to act in the national interest and adapt.

Making his second appearance in two days on Voice of Barbados’ Down to Brass Tacks call-in programme, General Surgeon Dr Maurice Waldron again stressed that while he understands the danger of bringing COVID-positive patients to the QEH, the hospital is the only one on the island with theatres up to acceptable standards. Speaking on behalf of approximately ten other general surgeons, he again demanded that at least one of the theatres be retrofitted to accommodate COVID patients.

The surgeons’ spokesman said: “There is no way that the QEH should not be ready for surgical patients unless we have an acceptable option outside.

“I understand that we are stretching things to keep [COVID-19] out, but what was done out there is unsafe and I am unwilling to look any patient in the eye and take them in there because the risk to them and even the nurses and junior staff is unacceptable.”

He added that a further check at the Enmore facility had strengthened his resolve.

But Dr Cave is adamant that bringing COVID-positive patients in the QEH would be to the detriment of “the greater good”, and the costs to do so would run into the hundreds of thousands and even millions of dollars.

He told listeners: “I don’t know the cost to retrofit every place. The ones we were looking at cost many thousands of dollars. The custom-built portable units range between $1.4 million and $10 million. Even if it was not about the money, the delivery time would be several months away. So we are identifying places outside of the QEH so that if a case comes up we would be able to provide them with an acceptable standard of care,”

The QEH medical services chief added that private facilities in Belleville have also been identified and engaged on a stand-by basis, but again, he stressed the Government does not have the resources to retrofit them at this point.

Dr Cave argued that difficult decisions had to be made in the interest of the majority of patients at the QEH whose safety would be compromised.

Dr Waldron stressed that support services needed to be in place even at the make-shift facilities and stressed that if one thing goes wrong in surgery, everything could ‘go downhill’ and could cost patients their lives.

Infection control chief Dr Forde argued that throughout the extraordinary circumstances caused by the pandemic, numerous changes needed to be made to the modus operandi of healthcare offices.

He said: “As an infectious disease specialist, it was a bit tricky going to Paragon to see patients in that zone. It was not the normal scenario and it was not constructed for isolation. But I understood as a physician and as someone who lives in this country and has the interest of every Barbadian at heart… I understood my role as an infectious disease physician, infection prevention official as a citizen and my role as the patient who was sitting in there.

“This is an unprecedented scenario and in unprecedented situations, sometimes decisions have to be made that are unpopular but are in the interest of the majority.”
kareemsmith@barbadostoday.bb