Ministry expands covid19 step-down care to make more room in hospitals

Even though there has been a slight decrease in the number of people hospitalised with covid19, the Ministry of Health is increasing the number of beds in step-down facilities to make more room in hospital wards.

Health Minister Terrence Deyalsingh gave the update during Monday’s virtual covid19 briefing.

He explained, “We initially had 188 beds (in step-down facilities) and we have started to increase it by 154. We are going to take our step-down facilities up to 342 beds…almost doubling the number.

“What that means is that we can step down patients more quickly from ward levels at our hospitals and make more room for ward-level care.”

As of Monday, Deyalsingh said hospitals in the parallel healthcare system were 69 per cent occupied (509 people), which was down from a high of 572 people in November.

Occupancy in Trinidad is at 75 per cent and occupancy in Tobago is at 38 per cent.

Deyalsingh did not clarify whether the decrease in hospital occupancy was because fewer people were being hospitalised in general or because of the increase in covid19 deaths in recent weeks, which would have affected the number of people in hospitals.

But he did highlight the country’s current death toll.

“Unfortunately, people are still dying in what I consider to be very large and unacceptably high numbers.

But, he said, “We are also noticing a slight plateauing in our ICU occupancy. As of this (Monday) morning in Trinidad, the ICU occupancy is 79 per cent and in Tobago it’s 71 per cent.

“We could have a serious impact on those numbers if people follow the three W’s, get vaccinated and try to gather in well ventilated areas.”

He reiterated that Health Ministry data shows most people hospitalised for covid19 are unvaccinated. People who are not fully vaccinated accounted for 89.9 per cent (6,408 of 7,134) of patients entering the parallel healthcare system between July 22 and November 17.

To accommodate the expansion of step-down facilities, Deyalsingh also said his ministry has tapped into its strategic stock to give out a total of 115 extra oxygen concentrators to the regional health authorities.

“But doing this (expanding) is not just putting people in a step-down facility. What these step-down facilities provide is a level of oxygen support. You just can’t have (an additional) bed alone, you must have all the supporting pharmaceuticals and non-pharmaceuticals, especially in terms of oxygen.

“These people (leaving hospital) will need to have oxygen therapy for another two, three, four, five days until they are fit enough to go home."

The distribution of extra oxygen concentrators is: the Eastern Regional Health Authority 20; North West Regional Health Authority 15; North Central Regional Health Authority 15; South-West Regional Health Authority 35; and Tobago Regional Health Authority 30.

“We have deployed these additional oxygen concentrators to meet the increasing need for that type of oxygen therapy at our now-expanded step-down facilities.

“People can (now) transition from a ward-care level and make room there for people that need ward-level care…so that we can have the expanded level of care for patients with the appropriate clinical signs and symptoms.”