The EDITOR, Madam:

Firstly, I would like to thank Dr. Michael Abrahams for his article titled: “What Really Happened at Andrews Memorial Hospital“, published Tuesday, 28 April 2020. I now understand not only what took place with regard to Ms. Fearon, but also Andrews Memorial Hospital (AMH) notifying the public, on 20 March 2020, that they would not be admitting patients with typical COVID-19 symptoms. Nevertheless, it is obvious this is not so for others, who still think it is “nonsense”.

For me, one phase made all the difference: AMH “does not have an isolation area for patients with the infection”. The implication of this would not be understood by a layperson. I write as one formerly employed to the government under its last Hospital Restoration Project, as local counterpart to specialist, UK-based hospital consultants contracted to the same project. It would therefore be appreciated if you would allow me to hopefully clear up this matter.

Like most well-thinking Jamaicans, I was incensed at AMH’s notification. We are also incensed that some foreign hospitals require healthcare professionals to work without Personal Protective Equipment. However, we fail to realize that Isolation Rooms protect the same healthcare professionals, other patients, and visitors. Knowing they did not have this, AMH acted responsibly in advising the public before-hand they could not admit suspected COVID-19 patients.

Understanding this, it should therefore be understood that they also acted responsibly in trying to refer Ms. Fearon to a better equipped hospital, because all hospitals are not the same. As pointed out in Mr. Anderson’s article titled, “Load of Nonsense, Abrahams“: there are different grades of hospital. So, the healthcare facility itself will limit what the healthcare professionals are able to undertake. It is not a matter of unwillingness.

We now know that Ms. Fearon tested negative. But not knowing this, AMH risked infecting staff, other patients, and visitors by attempting a Caesarean Section. Because, Isolation Rooms are not just any room you can so designate. They are specifically designed for the purpose. An Isolation Room is actually two rooms: the first is called an Ante Room, which is similar to a common vestibule, and has to be passed through enroute to the Patient’s Room.

At very least, the Ante Room has a clinical basin, which is a special lavatory basin designed to minimize infections. It also has provision for staff to change so that the clothing worn to see the isolated patient is not the same worn to see other patients, fellow staff members, or visitors. Of course, hand washing would be facilitated at the clinical basin between changes. The absence of an Ante Room would therefore risk infection of others.

It now common knowledge that Isolation Rooms have air pressures less than their adjacent Corridors, so that air flow is into, and not out of, the space. However, it is a bit more involved than that. Independent Ventilation and Air-Conditioning systems are used that have special filters, or do not re-circulate air at all. And they do have to be balanced so that the air-pressure in the Patient Room is lower than the Ante Room, and that of the Ante Room less than the Corridor.

Finally, University Hospital of the West Indies had a similar experience recently when, unknown to them, a patient was air-lifted from the Turks and Caicos Islands who later tested positive for COVID-19. In this case, they knew that a patient, possibly with COVID-19, was to be transferred and rejected the request. In fact, they were willing to assist AMH in taking its risk: jepordizing the safety of their own staff in the process. Who was being irresponsible here?


Best regards,


…………………………………………………………………………….
Paul Hay MBA, BA(Arch.)
Founder/ Managing Partner



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