Medical Corner

image-thumb.pngWe have accepted the suggestion from a BU family member to facilitate discussion on medical matters which is a topic area that should interest us all. Based on exchanges with and between BU family members posted over time, many of you work in the medical field or possess information on various medical issues acquired based on personal circumstance or otherwise. Medical Corner seeks to encourage ANYONE to submit views on medical experiences, new developments in the industry or any related matter which readers feel can serve to educate the BU family.

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  • Kidney disease warning for Bajans

    by TONY BEST

    AS THE UNITED STATES’ best known infectious disease expert, Dr Anthony Fauci, warned Americans they may soon have to “hunker down” in the face of a second wave of COVID-19 in the fall and winter seasons, a top transplant surgeon is urging Bajans to beware the highly infectious virus and its potentially deadly complications.
    Dr Velma Scantlebury, a Barbadian and the world’s first black female transplant surgeon, said people in her birthplace should remember some key things about the coronavirus and its dangers to people everywhere, especially the elderly and those with underlying conditions such as diabetes and hypertension.
    Key organs
    At the top of the list is that COVID-19, the disease which has led to the global pandemic, can affect key organs such as the heart, lung, liver and kidneys. “It can cause lasting kidney damage,” the award-winning surgeon told the DAILY NATION. “And Barbadians, like people everywhere, should get tested and be careful.”
    Next, COVID-19 is not like the flu, explained the surgeon who grew up in Goodland in St Michael and came to the US from Barbados as a teenager.
    It is a novel virus that can cause severe complications which can end in death, added Dr Scantlebury, who attended Columbia University in New York and was selected by a top transplant surgeon in the US to be trained in that field.
    Third, young Bajans, as in the case of youthful Americans, Canadians, Europeans, Asians and others, can “end up with severe consequences” if they become infected with the virus.
    Kidney damage
    “You should get checked (medically) for kidney damage,” said Dr Scantlebury. “If you have underlying kidney disease – high blood pressure or diabetes – and your kidney function is okay – not great but not a problem – it can certainly worsen your underlying kidney issue and it becomes important to follow it up if you have a COVID infection. “You should ensure that you get your kidney function monitored. You should have someone check the protein in your urine and check your creatinine to make sure it is not higher.
    “Patients can resolve most of their injuries but if they have an underlying injury to their kidneys despite having what appears to be a normal creatinine, they can still end up with a worsening kidney function.”
    The Barbadian gave her birthplace good marks for its management of the virus when the outbreak occurred several months ago.
    Barbados was able to keep a lid on the spread of the virus, which has taken almost a million lives globally – more than 198 000 of them in the US – since March. She agreed with the decision to reopen schools, saying it would have been difficult to keep the thousands of students out of the classrooms.
    “Barbados has done a good job controlling the spread of the virus,” said Dr Scantlebury, who has chronicled her rise to the highest rungs of the medical ladder in the US in her well written 240page autobiography, Beyond Every Wall, Becoming the First Black Female Transplant Surgeon.
    “The Government was right to shut down the country when it did. That helped to curb any spread of the virus.
    Barbados managed the situation very well and I am sure it will continue to do so in the months and years ahead,” she said.
    “It is very difficult to keep young children in schools from interacting with each other, but it is important to ensure that they wear their masks and that social distancing and contact tracing are carried out.
    “As a surgeon, I have grown accustomed to wearing masks all day and I am sure people in Barbados would get accustomed to it because it protects you.”
    Guidance
    Like Rihanna, the Grammy- award winning music icon whose roots are in Barbados and who praised her mother for her success in business, especially her concepts of beauty, Dr Scantlebury also paid tribute to her mother, Kathleen Scantlebury, for the guidance and commitment to education which the surgeon traced to Barbados and Christian beliefs. “My mother made sure we were always at school,” she wrote in her autobiography. “Excellence was demanded. As part of a new generation (in Barbados) we had better options for further education.”
    “The opportunities for advancement, for accumulating wealth, for snaring the future she knew we all deserved were all tied to excellence in educational pursuits.”

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  • Ethical side of medicine
    By Gercine Carter
    gercinecarter@nationnews.com
    Throughout a 55-year career, Sir Errol Walrond promoted the practice of high ethical standards in the medical profession, while serving as a clinician, surgeon, educator, and as administrator and policy driver for surgical and medical education throughout the West Indies.
    For over 20 years, his knowledge and wisdom about the many ethical issues that undoubtedly arise in the practice of medicine have been informing his contribution as main discussant at the case conferences he was instrumental in convening for this very purpose.
    Today, at 84, the Professor Emeritus of Surgery and former dean of the Faculty of Medicine at the University of the West Indies (UWI), retains a storehouse of information collected in these monthly conferences in which he continues to participate. He has now chronicled those cases, the ethical issues and the discussion surrounding them in his latest book, A Question Of Ethics: Case Conferences In Everyday Ethical And Legal Issues.
    In a review of the just-released 339-page book, Professor Emeritus of Psychiatry and African- American Studies at Yale University, Dr Ezra Griffith, wrote: “All caregivers must understand the familiarity with the professional ethics that undergird our work [and] is a foundation that supports high quality in our caregiving. It is also the best sign that we believe in the inherent dignity of our patients.”
    Explaining his motivation for writing the book, Sir Errol harked back to 30 years ago when he was dean of the Faculty of Medicine at UWI, Cave Hill, and was moved to organise his first case conference for clinicians.
    Did not like behaviour
    “I kept getting people saying to me, mainly people from outside the profession – friends, sometimes patients – that they did not like the behaviour of the young doctors who were coming out, and that they did not seem to have the ethical principles of the older doctors.
    “I felt it was a general problem with how people were seeing the ethics of the profession . . . . I think that meant generally that people were getting more information about their conditions and they were beginning to question the ethics about how some of their illnesses were being handled,” he told the Sunday Sun in an interview. “I thought that we needed to look at the question more generally. I organised a conference which brought together some of the professionals and it came to us that while they were teaching the technical business of looking after patients, we were not teaching how they deal when they met a problem that was not technical.”
    Those case conferences have continued for the last 20 years, with the latest held as recently as last week. Sir Errol records complex cases presented by many clinicians over the years, discusses the associated ethical issues and gives insight into the challenges for both doctor and patient,
    Continued on next page.
    Sir Errol writes about ethics and legal issues facing medical practitioners as well as suggestions offered for possible courses of action. In the placid setting of a shaded patio overlooking the lush gardens of his St James home, as he thumbed through the pages of the book, Sir Errol said it discussed “some very thorny issues”.
    “There are situations where care is futile and sometimes it is the patient, sometimes it is the family, sometimes it is the doctors who are pushing for every minute of life when they know that they are not going to succeed. Those are complex situations.
    One thing I learnt in listening over the years and seeing the advances in medicine over the years is that sometimes what appears futile now is an advance in care in a few years’ time. So you need to have a mental framework of how you are going to handle it and what will be the limits, and those limits have to be individualised.”
    Rules of conduct
    Referring to the section “Professional Conduct And Risk”, aimed at the doctors and medical students, Sir Errol said: “There are a number of things in there where I would want the public and the profession to understand what are the rules of conduct. For instance, there is a proper way of doing a consultation or getting a second opinion . . . . The fact that doctors and sometimes nurses are sometimes ill themselves and they are still working – who bells that cat? Who is going to say you are too ill to work?
    “That is very important and it includes the areas where the practitioner may get into trouble in terms of medical malpractice and negligence, and they need to understand what are the parameters.”
    He related a story about a doctor in a London hospital where he was working as a medical student.
    “This is a case that I always tell them [participants in case conferences] about, that illustrates when you think you are doing good but you are doing it without consent, how you are liable for battery.”
    Acute appendicitis
    He outlined how a male patient was brought into the hospital for an operation for acute appendicitis and said during the operation the anaesthetist drew the surgeon’s attention to a large lump on the patient’s head which was making it very difficult for the anaesthesia to be administered. Identifying the lump as a lipoma, the doctor removed it after having performed the appendectomy for which the patient had originally been admitted to hospital.
    However, soon after the patient’s discharge, the hospital received a suit from the patient’s lawyer claiming substantial damages for loss of income. Only then did the doctor discover the patient worked in a circus as a two-headed man.
    The collection of cases also highlights issues such as whether an unborn child has rights; weighs decisions related to religious beliefs against life-saving medical decisions; explores the legal role of alternative practitioners in medical practice; the doctor’s role in cases of child abuse; and matters of patient consent and confidentiality. Sir Errol also gives the public access to medical insights which would not ordinarily be available to them.
    This is his second book on ethical issues, following the first, Ethical Practice In Everyday Health Care,
    released in 2005.
    Sir Errol qualified as a doctor in 1960, became a Fellow of the Royal College of Surgeons in Britain in 1964 and was the founding president of the Caribbean College of Surgeons, which seeks to set standards for surgeons in the practice of surgery and surgical education. He retired from UWI as a professor in 2001 and was honoured with the title of Professor Emeritus in 2001. He retired from the practice of medicine completely in 2015.
    “Everything I did, I tried to make it a teaching moment and sometimes that teaching moment was the patients,” he said.

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  • Another hospital definitely not needed
    THE RECENT MENTION of “bed-blocking” at the Queen Elizabeth Hospital (QEH) by elderly incapacitated patients has led to the media highlighting a view that “Another hospital is way overdue” (DAILY NATION, Tuesday, November 3) Nothing could be further from the truth.
    Barbados has a larger proportion of elderly citizens than most CARICOM countries. There are several reasons for this: 1. the largely physically active lifestyle before Independence promoted longevity, 2. we probably have a healthier gene pool, for historical reasons linked to the slave trade, and 3. continuing emigration of younger people to North America.
    Unfortunately, the epidemiological transition, with a largely inactive lifestyle since Independence, has produced an epidemic of chronic diseases, which greatly increase the morbidity of the elderly – a high prevalence of high blood pressure, heart disease, diabetes and their consequences such as strokes and amputations, and hence significant disability and dependence.
    But this does not mean that hugely expensive tertiary care beds in a second or expanded hospital are needed. Our beds to population ratio is as good as most Western countries. Incapacitated elderly-forcare do not need intensive and costly tertiary care. As the Prime Minister has pointed out, the QEH beds cost five times as much as Geriatric Hospital beds. What is needed is a multifaceted approach, with several key programmes, to prevent the “bed-blocking” the minister commented on, which has in fact been going on for decades and fluctuates with fluctuations in staffing, operation of equipment such as X-ray and lab services, morale and other causes of variable efficiency of overall care.
    The first need to deal with the current problem is adequate residential accommodation – the Geriatric Hospital, infirmary and elderly care-home beds. The latter is a programme of private care that has been operating for some years. Infirmary beds were seriously reduced with the demolition of the Christ Church Infirmary at Oistins and, more recently, closure of that in St Lucy. The Geriatric Hospital has accommodated more than 500 patients for much of the past. Is it being efficiently utilised today, to accommodate those described as “left” at the QEH and said to be “blocking beds”?
    Day-care centres
    The medium-term solution is the provision of day-care centres. I have written and spoken repeatedly – in conferences, columns and in the Senate – for 40 years about the obvious benefits of such facilities. The example of the St Barnabas Church Day Care Centre is a role model that can easily be followed both by many of our churches which have church halls and similar outbuildings, and by government and the private sector.
    Such a centre not only maintains activity into old age for a longer period, delaying dependence, but solves the problem of day care for many elderly subjects and families.
    The long-term solutions, of course, include both the broad public health and educational approaches advocated by the Chronic Non-Communicable Disease Commission led by Sir Trevor Hassell, and the expansion of the support health care services of rehabilitation therapy (occupational therapy and physical therapy), which help to delay invalidity, accelerate recovery from illness and hospitalisation, and help the disabled to function in their own homes.
    We certainly do not need another hospital or a new hospital in order to improve our health services and the care of the elderly. In fact, some 14 years ago the then Minister of Health commissioned an extensive study by the leading hospital consulting team, Capita, Norman and Dawbarn. The better of their two options proposed, that of a complete rehab and improvement job and a state-of-the-art new multi-storey wing to the north, was estimated to cost just under $600 million. They also suggested a new hospital, with fewer beds, at an estimated cost of just under $900 million – 50 per cent more.
    I am relieved that this Government is not being misled into proposing a new hospital, as we do simply do not need one and would not be able to afford it anyway.
    What we do need, as shown in the study of health care human resources commissioned by the Faculty of Medical Sciences in 2007, are increases in several categories of health professionals. Our problems are all soluble by an evidence-based, multifaceted approach and improved efficiency at all levels – not by more bricks and mortar.
    Professor Emeritus Sir Henry Fraser is a professor of medicine and clinical pharmacology.
    What is needed is a multifaceted approach, with several key programmes, to prevent
    the ‘bed-blocking’ the minister commented on, which has in fact been going on for decades . . .

    Nation

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  • Mobilise against diabetes
    The diabetes epidemic is not an overnight problem, but part of a wider failure at the national level to tackle preventable diseases
    BARBADOS IS TAKEN up with the fight against the COVID-19 pandemic and rightly so, given the health and economic threat it poses. There is, however, another major disease which is impacting a significant number of individuals and by extension their relatives and the nation.
    The devastation diabetes is causing should have a similar kind of national coordinated effort to that which is being placed on containing the coronavirus pandemic and which was done in the fight against HIV/AIDS. It requires a united effort across the public and private sectors, ranging from funding studies at the George Alleyne Chronic Disease Research Centre to placing more emphasis on healthy lifestyles in the workplace.
    Diabetes is inflicting significant financial and medical stress on our health system and national budget and threatens the livelihoods of too many people in a nation whose majority black population appears genetically predisposed to the disease.
    More than 425 million people worldwide live with diabetes, according to the International Diabetes Federation study of 2017, with many going undetected. One in every five Barbadians is believed to be affected by the disease, which is a major cause of death.
    The non-communicable disease specialists have for some years been raising the alarm about the spread of diabetes and there has been some positive response to their appeals for Barbadians to change their lifestyles. The importance of early detection of diabetes so it can be managed through diet, exercise and medication cannot be overemphasised.
    There is an evident increase in physical activity and a greater consciousness of trying to eat the right foods.
    Unfortunately, we are a copycat society and have adopted North American fast food culture by eating and drinking too much of the wrong things. This lifestyle is killing too many Barbadians quickly and quietly.
    The Queen Elizabeth Hospital is consistently full of diabetic cases while surgical wards deal with a high percentage of diabetes-related causes.
    Barbados has gained notoriety for the number of amputations carried out because of diabetes-related problems.
    Healthy foods
    The diabetes epidemic is not an overnight problem, but part of a wider failure at the national level to tackle preventable diseases which exposes the vulnerability of many Barbadians, not only to the COVID-19 virus but a wide range of other health issues. There are too many people predisposed to heart and kidney diseases, strokes, circulation problems and even sexual dysfunction.
    The society faces some pervasive inequalities as a result of the severe economic fallout created by COVID-19 which has put 40 000 people out of work.
    Making healthy foods affordable must be a national priority in the effort to control diabetes. The “No-sugar November” initiative trending online is a welcome effort which should be expanded.
    The country needs a clearly enunciated long-term strategy to reduce the prevalence of diabetes.

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  • BAMP warns against dengue delay
    Bajans ‘waiting too late to get checks’
    by RACHELLE AGARD rachelleagard@nationnews.com
    TOO MANY PEOPLE are waiting too late to go to the doctor to check if they have dengue fever.
    This is according to president of the Barbados Association of Medical Practitioners (BAMP), Dr Lynda Williams, who said while some deem having a fever as symptomatic of COVID-19, that might not be the case.
    “Once we feel someone is coming down with dengue fever, we treat and act and encourage people to present. What has been happening is that I find people have been presenting late and have been symptomatic for days. I don’t know if that is because they are afraid they have something else, but people have been presenting quite late and with advanced stages of dehydration,” she told the DAILY NATION.
    Williams urged anyone feeling lethargic; experiencing pain behind the eyes, headaches, back and joint aches; and/or a rash or generalised itching all over the body, to consult their medical practitioner, particularly if they also had a fever.
    Always vigilant
    “We are always vigilant for dengue. It is an unusual time to be having a dengue outbreak of this magnitude at this time of year, but we are always watchful for the signs of dengue.
    “Of course, people presenting with fever must be interviewed before they even come in the office to find out if there were any respiratory symptoms or other symptoms, so we can differentiate between dengue and possible COVID,” she said.
    Williams, who was recently named as part of Government’s new COVID-19 communications team, said while she could not speak to the number of confirmed dengue cases as that data was collected at the Ministry of Health, there had been more deaths than usual related to the virus.
    Suspect cases
    “When we have suspect cases of dengue, we report them. [The ministry] also does . . . surveillance where they look at certain sites to see how many dengue cases are presenting and see whether there is a rise in cases or not. That’s how we know we are having an increased outbreak,” she said.
    When contacted, Acting Chief Medical Officer Dr Kenneth George said he did not have the statistics to hand, but would be in a better position later this week to provide them.
    Describing dengue as an endemic disease, the BAMP president said it was always around and could flare up at certain times.
    “The thing with dengue is it can develop a very low platelet count and people can develop haemorrhagic fever where they start to bleed suddenly. If you think you have dengue, even if you remain well hydrated, you should still get checked by your doctor to make sure that you’re not having a low platelet count,” Williams said.
    “We encourage everybody who is not feeling well, if you’re having fever, call your doctor’s office. If you’re not having fever, still call and find out and go and be seen and diagnosed. Self-diagnosis and treatment is not always beneficial, so we want to encourage people if they’re not feeling well to be checked,” she said.
    During a media conference at Ilaro Court last December 28, Minister of Health Jeffrey Bostic said the authorities were taking dengue as seriously as COVID-19.
    Mosquito breeding sites
    “We have contracted about 40 additional persons to assist the Environmental Unit to locate mosquito breeding sites. We have spent a considerable amount of money in terms of purchasing both hand-held foggers as well as truck-mounted foggers and we are awaiting the arrival of the foggers.
    “As soon as those machines are here, then we are going to be able to employ four fogging teams – two in the northern half of the country and two in the southern,” he added.
    Over the weekend, Chief Environmental Health Officer Francina Bascombe confirmed that from this week, the Vector Control Unit would restart its fogging programme. (RA)

    Source: Nation

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  • Caribbean males at higher prostate cancer – Caribbean males at higher prostate cancer: https://barbadostoday.bb/2021/01/29/caribbean-males-at-higher-prostate-cancer/

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  • A case of a misdiagnosis by QEH?

    Malcolm’s blessing in hour of need
    by JOHN BOYCE
    johnboyce@
    nationnews.com
    AFTER MORE THAN TWO DECADES of “a marriage made in heaven”, 55-yearold pharmacist Malcolm O’Neale is facing the darkest days of his life.
    In 2000, he took the hand of Thirza in marriage and she bore him three children. His wife, who is of Montserratian descent, came to Barbados after the Soufriere volcano erupted in Montserrat in 1995. After qualifying as a pharmacist, she took time out to homeschool their children before entering the Samuel Jackman Prescod Institute of Technology to study draftsmanship in 2019.
    On completion of her studies there she returned to the civil s ervice to continue her work as a pharmacist.
    It was while there that she started to experience severe abdominal pain and “nothing was staying down”.
    Thirza underwent a CT scan and it showed a mass in the area of the colon and lesions on the liver.
    The couple knew that they were dealing with a medical emergency and she was taken to the Queen Elizabeth Hospital where she was admitted.
    ‘Not malignant’
    Thirza was discharged one week later in the first week of April last year with medication and “the assurance that the lesions were not malignant”. However, the pain persisted.
    Malcolm said his wife became a QEH outpatient for several weeks thereafter, but there was no change in her condition.
    The couple then decided to see a private medical specialist who, after several tests, decided to do a colonoscopy.
    “This was now into November and my wife was enduring severe pain all of this time,” Malcolm told the DAILY NATION.
    He added that the costs of the various scans were astronomical and the emotional and financial stresses were taking a toll on them. Though he had health insurance, it was taking too long to get the money and he was out of pocket in a “big way”.
    But worse was to follow. By the end of November the news on her diagnosis was devastating.
    “The doctor told us that based on the results of the biopsy it was cancer.”
    They were then referred to a surgeon who the specialist said would handle the situation from there.
    But the words of the surgeon were even more horrifying.
    “I am sorry, but there is nothing I can do for you because it’s Stage 4 cancer. What you were told is not accurate because not only is it the late stage, but the lesions are not localised on the liver, instead they have spread there,” Malcolm said the surgeon told them.
    He said they were further told that it was inoperable and that because the cancer had spread to the liver, “it would appear to be terminal”.
    Malcolm said his world appeared to be crumbling around him.
    Hurtful
    The surgeon’s findings, along with those of the QEH, were then sent to an oncologist in January this year with a recommendation of chemotherapy. However, because of Thirza’s weakened state it was not practical to administer it.
    “You know what is hurtful? My wife had four blood transfusions, costs for two of which were sponsored by my church, but none of those could bring her to the level where she could start chemo,” he lamented.
    Desperate for a solution, Malcolm tried alternative medicine [natural products] which he believed might prolong her life.
    With mounting financial pressures and the insurance money only covering, in some instances, 80 per cent of the costs and in others, he was told that they were not covered, he was in a “deep financial bind”.
    It was then that a friend introduced him to the “blessing circle”.
    He had several reservations about joining because he had heard of many scams that left scores of people counting their losses.
    But his options were all but dried up and his back was against the wall.
    The administrators of the circle told him that it would give him cash in hand so that when his 47-year-old wife needed it, she would have it.
    Her situation had deteriorated to the point where she could barely use her legs and Malcolm had to be lifting her around. This resulted in him developing venous insufficiency – a condition which occurs when the leg veins don’t allow blood to flow back up to one’s heart.
    Malcolm joined the circle. He waited for eight weeks as the administrators told him he was “blessed out” with the money he so desperately needed.
    “One of the first things I did was to buy her a wheelchair. Without that money I would not have been able to do anything more financially for her.”
    Both his wife and his mother-in-law have also joined the circle to shore up the funds so that she could have the best of care.
    Thirza is now being looked after by a nurse “all because of the blessing circle”.
    But Malcolm said he continues to wrestle with thoughts of despair as he confessed his eternal love for Thirza and their three children.
    Today, he has placed the situation “with my dear wife” in God’s hands and has thanked the blessing circle for coming to his assistance in his hour of need.

    Source: Nation

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  • https://www.barbadosadvocate.com/sites/barbadosadvocate.com/files/styles/large/public/field/image/1Lennox%20Rochester.jpg

    Dementia symptoms increased due to lockdown
    A Sun, 03/14/2021 – 5:40am
    By: Cara L. Jean-Baptiste

    Speaking during a recent virtual lecture hosted by the Federal High School Alumni, Lennox Rochester, Occupational Therapist, highlighted that since the lockdown, a number of people have reported increases in their dementia symptoms due to the reduced stimulation and not being able to go out, and believed that this was something that needed to be addressed.

    He went on to speak on ways in which persons could reduce their risks of getting dementia and noted that while more research was needed to prove that these steps did indeed significantly reduce a person’s risk of getting dementia, they were still beneficial.

    “There is no sure way to prevent dementia, but there are steps that you can take that might help,” he said.

    “Keep your mind active. Doing activities such as reading, solving puzzles, playing word games, memory training, might delay the onset of dementia and decrease its effects. Be physically and socially active; we might have a problem there because due to the pandemic, we are being urged to be less socially active.”

    Rochester noted that it was important to make sure you were getting enough vitamins and taking care of and managing any cardiovascular diseases.

    Additionally, he noted that it was important to get quality sleep as the body tended to repair itself during that time.

    He went on to stress that dementia was a normal part of ageing and could occur in normal people, whether or not they had a family history of the disease.

    “Research shows us that the lack of exercise increases the risk of dementia, and while no special diet is shown to reduce dementia, research indicates a great incidence of dementia in persons who eat unhealthy diets compared to those who eat healthy,” he added.

    Source: BarbadosAdvocate

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  • Spike in NCDs
    QEH battling bed space with wave of patients, says Cave
    by COLVILLE MOUNSEY colvillemounsey@nationnews.com
    HAVING SUCCESSFULLY CONTROLLED the spread of COVID-19 at the Queen Elizabeth Hospital (QEH), the facility now has a new challenge on its hands.
    It is now battling a sharp rise in people requiring hospitalisation as a result of non-communicable diseases (NCD).
    This concern was raised by Director of Medical Services at the QEH, Dr Clyde Cave, who said yesterday, on World Health Day, that the situation was at such worrying proportions that bed space had become a serious struggle and had resulted in setbacks in plans to tackle the mounting backlog of elective and non-emergency procedures.
    “It is now a slow process for us to get everything going in terms of the backlog. The main factor that we are facing right now is the availability of patient beds in the hospital. This is an occurrence similar to what we saw last year right after that lockdown. A lot of vulnerable patients stayed away from their usual source of medical care and, as a result, they started to get sicker,” Cave said, while not disclosing whether the QEH had reached its maximum capacity of 519 in-patient beds.
    “We are now seeing that wave of patients again.
    So, at the moment, it is not the COVID-19 disease that we are being overwhelmed with but rather it is normal health cases that have been made worse by the lack or perceived lack of access to the usual preventative medical care,” he added.
    This development is one which Cave chalks up to a consequence of last February’s one-month lockdown.
    He explained that during the lockdown, with much of the national health focus on vaccinations and testing for COVID-19, there was a perceived lack of access to the normal channels of preventative care and, consequently, there has been a spike in complications from NCDs. He revealed that the majority of patients have presented with complications from hypertension and diabetes.
    ‘Main culprits’
    “Hypertension and diabetes are predominantly the main culprits, but other things have also popped up. It may have been a case where they may have just not taken their medication for a while, so we are starting to see breakdowns. This goes for persons who have not taken their cardiac medication or who should have been monitored for a change of their blood pressure medication and now things have gotten out of control,” said Cave.
    He added: “We are also seeing more cases of diabetics who had a scratch on their foot that was not monitored and have now developed an ulcer. These types of things we would have normally taken for granted before because everybody had easy access to early care. But once that was postponed, the cases are getting more serious.”
    However, the senior paediatrician is confident that the upsurge in NCD complications will be brought under control soon. Saying it was a good sign that the country was managing the COVID-19 situation well, Cave added that this would allow for a quicker refocus of the hospital’s efforts. He said the hospital being free of the virus in recent weeks was a good sign the facility could ramp up the return of more of its services.
    “The QEH is a microcosm of the country and the COVID-19 cases that appeared among the staff was a reflection of what was in the community. These were not infections that were picked up from patients. So the kudos must go to the public and the public health strategist and everybody that implemented the community measures because in controlling the community, we have also protected the hospital,” he said.

    Source: Nation

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  • Comorbidities and COVID: A much higher risk of death

    https://aje.io/aqfqa

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  • Only four QEH ambulances up
    Mechanical issues and accidents have reduced the Queen Elizabeth Hospital’s (QEH) ambulance service’s fleet from ten to four vehicles.
    However, consultant and head of the Emergency Ambulance Service (EAS), Dr David Byer said that with two new vehicles expected to arrive later this year, they will be in a better position to respond to the 15 000 calls received annually.
    He was responding to a query from this newspaper after ambulances were seen parked at Nassco’s River Road, St Michael workshop. He explained that their mechanical maintenance programme was carried out by the QEH’s mechanics and Nassco.
    “Our Emergency Ambulance Service has a total of ten registered ambulances in its fleet. Of these vehicles, two are not functional due to exhaustive mechanical issues, two more have been written off following motor vehicle accidents, and another two are currently undergoing short-term mechanical repairs and are expected to return to service within one to three weeks. As such, there are currently only four vehicles in active service.
    “Unfortunately, this means that there are occasions when we do not always
    have an adequate complement of ambulances to deal with the public demand. In such instances, these services are outsourced to private providers who assist us with covering the shortfall,” Byer said.
    Despite this, he said they had the manpower which allowed for four to six crews to be on duty at any time, and that each ambulance was “more than wellequipped” to deal with both traumatic and nontraumatic incidents.
    Byer said the EAS received about 1 250 calls a month, equating to around 15 000 a year. Sixty-nine per cent are emergencies or urgent calls. Of the remainder, 30 per cent are considered less urgent calls and one per cent non-urgent.
    “Over the past several years the call volume has remained about the same. However, with the advent of COVID-19 last year, the EAS quickly had to institute additional precautionary measures based on the COVID-19 guidelines to ensure the safety of both staff and our patients.”
    He added that although emergency medical technicians were not dispatched during the active phase of Hurricane Elsa last week, they still took calls and provided medical advice.
    “Once the all-clear was given, all calls received
    were responded to in order of the most urgent to the least serious. As usual, post a national shutdown, the teams were significantly busier but preparation is always key in these instances. As such, we were well-positioned to manage the onslaught of calls and requests for assistance,” said Bryan.
    (TG)

    Source: Nation

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  • Move on pesticide can disposal

    The Ministry of Agriculture is rolling out a pesticide container management scheme to create more awareness about the importance of proper pesticide container disposal.
    Speaking on Wednesday during the launch of the programme held at River Plantation in St Philip, Minister of Agriculture Indar Weir said too many farmers were incorrectly disposing of the containers, which not only harmed the environment but posed a serious threat to people.
    “. . . This is a serious cause for concern,” he said. “For not only is the practice a danger to our environment, but it poses a direct risk to persons who may use the container, unaware of its original contents.
    “Farmers, you have the responsibility to eliminate any health hazard on your farm, by ensuring that areas under cultivation or where animals are being kept are always well maintained.”
    Weir added that the ministry was also planning to start a purchase control programme on the chemicals, as the general public having readily access to them was another area of concern.
    “Our intention is to also do a management programme on the sale of pesticides, given the fact that anybody can walk in a hardware store, feed shop or a farm shop and purchase pesticides. Because of the dangers, especially in glyphosate for example, where it was reported in the news in the United States that a company had to pay out large sums of money in a lawsuit because they were sued by a user [who said] he had suffered from cancer as a result of using that product.
    “So we are definitely going to be restricting the sale of pesticides to the general public and then there would be a protocol in place for farmers to have access to them.”
    Although he did not say when the programme would take effect, Weir said that people would soon have to seek some form of authorisation from his ministry or from the Environmental Protection Department.
    Parliamentary representative for St Philip North, Dr Sonia Browne, said it was important that this scheme be implemented as the public needed to be educated about the risk of sickness and even infertility that some pesticides could cause.
    Regional pesticides management project coordinator at the Food and Agriculture Organisation Guy Mathurin said pesticide containers were often reused for other purposes and in some cases all the residue of the original contents was not completely removed.
    He advised farmers and other users to adopt a triple rinse method to properly clean the containers. ( SB)

    Source: Nation

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  • Prepared by Dr. GP[/caption]

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  • Prepare the Body to Fight, Fight, Fight!

    Posted on by DavidOne comment Omega-3 Fatty Acids

    The SARs-CoV-2 virus has moved from epidemic (outbreak in Wuhan, China) to pandemic (spread across several countries) to possible endemic (in simple explanation, the virus will constantly exist like the common flu). Some on BU have been advocating priority must be given by public health officials in through reminders to the public – see Dr. Doughlin’s excellent video –

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