The Malta Independent 4 June 2020, Thursday

Measures to fight Coronavirus to be stepped up; medical workforce to be strengthened

Kevin Schembri Orland Thursday, 26 March 2020, 09:47 Last update: about 3 months ago

The health authorities are taking extra measures to ensure that an adequate number of beds are being provided to deal with the Coronavirus outbreak, together with having the necessary medical staff to man them.

Concerns were recently raised that, while the health authorities keep speaking about the provision of beds for potential COVID-19 patients, that medical and nursing staff might be in short supply,

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Speaking with The Malta Independent, Clarence Pace - the Director General of Health Services within the Ministry for Health, who is also a Consultant Head and Neck Surgeon, spoke to the Malta Independent about this situation.

Over the past two months a number of measures have been taken to ensure that the number of beds and appropriate healthcare professionals are available to cope with the demand when the need arises, he said.

Pace explained that by having stopped most elective (non-urgent) operations and reduced the number of Out Patient clinics at Mater Dei Hospital, it has freed up many healthcare professionals including doctors, nurses and anaesthetists amongst other professionals who will look after COVID -19 patients.

He explained that the health authorities are also in the process of making the necessary arrangements to outsource a number of nurses who will of course receive the appropriate training required to deal with COVID – 19 patients prior to providing their services.

“Following a number of discussions with the medical council and nursing council, nursing and medical students who are expected to qualify within a few months have been asked by the health authorities to engage in offering their expertise (some of the nurses due to commence this coming Friday) without of course compromising the quality of service offered by these professionals,” he said.

“We are also making arrangements with private hospitals to recruit staff in order to give us a helping hand,” Pace explained.

He explained that the authorities are segregating the services for Coronavirus patients from other services, "whilst taking steps to increase our capacity in terms of both infrastructure and human resources.

Pace said that the health authorities have segregated operating theatres within MDH which will be used to treat any positive COVID-19 patients requiring surgery, from the other operating theatres. Likewise a separate emergency department for COVID-19 positive patients has been set up in the West wing of MDH.

Speaking about bed capacity, Mr Pace said that a number of measures have been taken with the aim of freeing up a number of beds in the eventuality that the beds are required. He explained that by eliminating most elective operations and relocating the psychiatric unit to Mt Carmel Hospital has freed up around 95 beds within Mater Dei Hospital.

The fact that the long term patients who were within MDH for social reasons  (patients were admitted for a medical or surgical problem however for some reason or other remained at MDH rather than having been discharged) were moved out to elderly homes, also freed up more beds at Mater Dei Hospital which could potentially be used for Coronavirus patients, he added.

In addition, non-clinical areas, such as lecture rooms within the medical school together with the medical school library, are being converted into wards, Mr Pace explained, thus further increasing capacity.

He said that beds outside Mater Dei Hospital are also available. St Thomas Hospital, for example, has 25 beds reserved for COVID-19 cases.

“Another major move was vacating Boffa Hospital. All patients were moved into elderly homes while the Dermatology Department was moved to a premises in Gzira, close to Stella Maris College. While the Dermatology Unit’s new location has certain limitations, it is still offering the essential services.”

Considering the above, the total number of extra beds (excluding ITU beds) that are available to isolate and treat COVID-19 positive patients amounts to 600 in Malta and an extra 95 at Gozo General Hospital. This total number of beds does not include the extra beds that will become available once the pre-fabricated hospital will be constructed as recently announced by the Deputy Prime Minister and Minister for Health Chris Fearne.

As for ITU beds, Pace said that Mater Dei Hospital has 20 ITU beds prepped for COVID-19 patients with an extra 14 beds that could be used if the need did arise. 

He explained that the difference between a normal bed for a COVID-19 patients and an ITU bed for Coronavirus patients is that the latter would be for those patients who would require extra monitoring and support with the use of a ventilators. “In addition to the above, another 15 CICU beds (usually utilised for cardiac patients) and another 45 beds for which ventilators have been purchased could potentially be used as ITU beds. Hence the total of ITU beds available amounts to a hundred (plus an additional five at Gozo General Hospital) which is actually is one of the highest ratio of ITU beds per capita in Europe.”

“Currently our aim is to ensure that the cases keep trickling in rather than present with a sudden surge so as to ensure that the capacity of our healthcare services can cope with the demand” Mr Pace said.

“Everyone must follow the guidelines and advice issued by the health authorities. It’s important that the public remains vigilant as far as hand washing is concerned and everyone should follow the instructions issued by the public health authorities down to the last detail.”

“Observe social distancing. Remain contained with the family members of your household only. Only the people living in the same household should stay together,” he reiterated.

“Avoid going out unless it is really essential, such as to a pharmacy or supermarket and if you do go outdoors make sure to exercise precautionary means to clean your hands at all times.”

“It’s imperative to avoid contact with the elderly as these are the cohort of the population that are the most vulnerable as are patients with a weaker immune systems such as cancer patients”

He said that the Public Health Department is working closely with essential services, such as pharmacies and supermarkets, discussing possible alternative methods for people to purchase items such as to encourage the use of online payments and deliveries.  He also stressed the importance of maintaining the safe distance from others whilst waiting in queues despite being outdoors.

 

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