Increased COVID-19 deaths linked to comorbidity, not resources – DMPS

The death toll from the novel coronavirus (COVID-19) here in Guyana is highly linked to comorbidity in patients, which is derived from pre-existing medical conditions.
This was the position shared by Director of Medical and Professional Services (DMPS) at the Georgetown Public Hospital, Dr Fawcett Jeffrey, on Tuesday.
The health official explained that a closer look at the recent deaths showed that there were no shortages of medical equipment or protective gears for staffers in the designated Intensive Care Unit (ICU). As the virus progresses, more information has been surfacing about its nature, which has established a link between comorbidity and the death rate.
“When you have COVID-19 and comorbidities, then this can lead to your demise. I don’t think there is a limitation of resources for my doctors who are working in the COVID-19 ICU that has actually caused the demise of the patients. It’s just the natural history of COVID-19 patients that are severely ill and have comorbidities that has caused the number of death,” Dr Jeffrey informed.
A team has been established to review deaths from the virus to produce answers, as well as to improve treatment for new patients. It was found that very young patient that would have succumbed from the virus had some underlying condition.
“So far, in the reviews of the patients that we have had, there is nothing specific that we can say was a deficiency, that led to the demise of the patient. Even though internationally it was said that the elderly are the more affected age group, in Guyana we had quite a younger age group of persons that tended to succumb but all of them had some comorbid condition.”

Contamination
While addressing concerns of cross-contamination, Dr Jeffrey said every effort has been taken to separate patients who are in the transition process. Since the hospital is unaware of the status of the patient at this time, any contamination is accidental. After testing, those that return with positive results are immediately isolated.
The Director outlined, “Most of these patients in the transition unit, we do not know their status so we have to take precautions to avoid communication until we know their status. When we know their status, we immediately move them to a place that is safer. In a transition area in any institution around the world, there is always a risk.”
Nevertheless, he said it is also difficult when patients choose not to comply. For this, staff members have been asked to maintain all protocols.
“At no point has there been a deliberate attempt by anyone to facilitate cross-contamination. The institution has protocols that our staff follow to mitigate that problem…It’s all about staff being careful, making sure they keep their distance.
The senior official expressed that they will be able to move patients at a faster rate, with the backlog reducing to under 100. The Caribbean Public Health Agency (CARPHA) assisted Guyana with testing of a few hundred cases.

Impact
In efforts to curtail the spread of the novel coronavirus (COVID-19) and treat patients, other specialised services at the Georgetown Public Hospital have been affected. The entire East-West wing is now occupied to treat coronavirus patients, and resources from the other departments were transferred to aid this fight.
“It caused us to stop admitting regular patients. We had separate areas of the hospital…We lost a lot of beds; I think it’s about 112 beds. All of those were moved from the [department of surgery] and internal medicine so that we could accommodate patients with COVID-19 – suspected or positive. So that is the real impact of COVID-19 had on the institution that would have affected general surgery, internal medicine and all of the other specialties. Our numbers have come down so much surgically,” the DMPS positioned.
In 2019, GPHC would have facilitated 7619 surgeries but this number has dwindled significantly to just 1344 for the year thus far. (G12)