For ICU was built as the endmost buttress in this Battle of Covid Cynoscephalae, wherefore defeat translates cinis in cinerem pulvis ad pulvis. Thus, of such cataclysmic forewarning, forward thinking leaders cognisant of defeat finality have unhesitatingly invested in healthcare, to boost the citizenry chances.
But ours is the Covid Clueless, of only reverse gears and goons, who live as we die to crash their way from one pandemic catastrophe to another, with the Covid-19 Intensive Clueless Unit(ICU), registered most recent.
And this we know, evidenced by what we see- Too many are needlessly dying because of low staff morale, certainly not down to suppressed enthusiasm, but more of the burden our healthcare heroes are shouldering to provide us a fighting chance. In analogy, PPP has given them the most porous of baskets, to fetch water. Water of life, our love ones desperately need in what should be the highest level of care.
Levels of care
For these aforestated levels predate Western medicine, of laymen stratification, sick, really sick and sick bad. Admittedly, this isn’t dissimilar to modern medical stratum;
Level 0 – General Medical ward.
Level 1— Acute Medical Unit(AMU).
Level 2—High Dependence Unit.
Level 3—Intensive care: Patients requiring two or more organ support or ventilation alone, with one specialist ICU nurse per patient and a doctor in the unit 24hrs per day.
Thus of amalgamation, laymen and lifesavers, patients at Level 0 are ‘sick,’ thus managed at home or General Medical Ward. Level 1 and some aspects of Level 2 are ‘really sick’, hence managed in the AMU, while Level 3 are ‘sick bad,’ thus managed in ICU.
Then of unwritten rules, the General Medical Wards are supervised by Internists, AMU by Acute Medicine Specialists and ICU, the specialty in question, by Intensivists. Indeed, the Intensivist, not dissimilar to other specialists, would’ve been of extensive postgraduate training, inclusive of medical physiology, ventilator management, central lines, chest drains and A-lines insertions along with endotracheal intubation etc. For these we see on ICU visitation.
ICU machinery
And such visitations are inevitably daunting, of bleeping machines, love ones connected to electronic monitors displaying indecipherable flashing numbers, with tubes in orifices, all on account of these the life sustaining machineries;
CVVH: Similar but not identical to haemo-dialysis in cleansing the blood of waste product via a neck vein.
Cardiovascular support: The heart, a muscular pump may require augmentation of weak contractions and slow rate, with medications.
Ventilator: The dreaded word, the artificial lung, the wall between Covid-19 and death. And the sequential physiology of Covid-19 has spike proteins binding to lung receptors, precipitating cascading inflammation reactions culminating in respiratory failure, initially of simple oxygenation but as inflammation takes hold, the iron lung becomes the last line of defence.
Total Parental Nutrition: Certainly, nutrients are critical in supporting recovery but with ingestion impossible and starvation not an option, sustenance is via specialised liquid nutrition(TPN) administered via a neck vein.
A-line: A catheter inserted in the wrist to aid invasive blood pressure monitoring along as an arterial blood source to monitor blood gases and acids, via a test known as arterial blood gas(ABG).
For these and many more are only possible from our overworked healthcare professionals.
Caring for the health professionals
The fact is, our healthcare professionals go above and beyond to manage this PPP orchestrated Covid-19 crisis. As a result, burn-outs are pervasive with consequent fatigue driven medical errors which could be catastrophic in the context of ICU. For these burn-outs preludes psychological related afflictions, of endpoints spectrum, emotional lability to suicides. But what we can’t see, that PPP ignores, are the exponential increases in stress related psychological conditions eg PTSD. And some remedies are, inclusive of but not limited to, ensuring adequate numbers of trained staff which is only possible with prior workforce job planning. The provision of occupational health professionals, counsellors, psychologists among other mental health support. And with exponentially increasing hospitalisations and deaths, along with hospitals perennially at capacity, lockdowns can serve as a respite.
PPP Intensive Clueless Unit
But this’s our reality, the Infectious Disease Hospital, the brainchild of Mr. Granger’s APNU+AFC, is of forty ITU beds and ventilators. And the direct consequence of PPP 23yrs without workforce planning, has only one Intensivist in the country, with the occasional foreign Intensivist, not of numbers to safely manage the unit. The result is, doctors are forced to undertake practises beyond their competence, likely contributing to the Covid-19 deaths.
Additionally, all patients on ventilators must have regular ABGs monitoring to inform correct settings of the ventilator, but this isn’t being done, for the unit is without a blood gas machine. As a result, doctors are forced to guess life and death ventilator settings which are likely also contributing to the Covid-mortality. But herein is the reason PPP neglected healthcare for those 23 murderous years-Their priority was never to save lives, rather it was to maximise phantom deaths. And here’s the evidence.
There are severe shortages of specialist doctors. Consequence of no workforce planning over 23yrs.
There is a chronic shortage of nurses. Consequence of no workforce planning over 23yrs.
Patient care is abysmal. Surely wasn’t addressed over 23yrs.
No mental health services for the Pandemic healthcare professionals. Consequence of no workforce planning over 23yrs.
We are second to Haiti in all cause mortality in the Caribbean. Surely wasn’t addressed over 23yrs.
We are second to Haiti in lowest life expectancy. Surely wasn’t addressed over 23yrs
The health service is medieval at best, with the absence of basic equipment. Surely wasn’t addressed over 23yrs.
We have the 3rd highest death per capita for Covid-19. Surely not being addressed.
For PPP with a policy of discrimination has forced qualified doctors and nurses out of the locked gates and ultimately out of the country. And for this, our love ones are dying in the Infectious Disease ICU, not only from Covid-19, but as a consequence of a healthcare system neglected and collapsing from 23yrs of dereliction. Thus, as they are given the ventilator breaths of life, ABGs critical for ventilator settings, cannot be done. And of further complications, the unit is without adequate numbers of Intensivist to provide a safe service. Certainly, Yes Yes Yes, this is the result of a healthcare service devastated by the PPP, being lay bare by Covid-19.
Now as the Covid-19 unmanned apocalyptic train accelerates to 900 deaths, they are rewarding nonworking sugar-workers quid pro quo $billions, to misplace their X at the ballot-boxes, rather than investing in the collapsed healthcare system. Indeed, this certainly confirms that their priority isn’t preserving Covid-19 lives rather it’s to politicised living.
But this Covid-19 is just the tip of the iceberg, for data on other medical conditions are securely vaulted. In fact, these data are likely to be beyond Jason scary, thus suggest I will that they be made public on Halloween day to cut cost on Halloween costumes and decorations.