COVID-19 has affected residents of all ages in the Cayman Islands, with confirmed cases so far impacting individuals ages 14-84, a group of local doctors from Cayman’s three major hospitals told the press Thursday morning.
The average age of Cayman’s 66 confirmed coronavirus cases is 43.
Health Services Authority Medical Director Dr. Delroy Jefferson said 52% of the confirmed cases were male .
All three patients who have entered critical care, including two treated with ventilation, have been men. A total of 11 individuals so far have been admitted at some point to hospital, and Jefferson confirmed that men have made up a majority of this group.
He described doctors on island as joining forces in the “war” against COVID-19.
“We’re in a very intense situation right now with this COVID pandemic,” he said. “Fortunately, we’ve had various physicians within the various facilities coming together to plot a way forward.”
Doctors from all three hospitals in Grand Cayman and members of the Cayman Islands Medical and Dental Society have been in close collaboration to prepare the island for the worst-case scenario, in which a surge of cases could overwhelm facilities.
While Cayman remains in phase 1, considered a controlled and manageable stage, the medical community is aware that it must be prepared for all possibilities.
“We’re at the very early phase and we’re hoping that’s the only phase we’ll ever experience,” Jefferson said.
He said the Cayman Islands Hospital’s critical care unit currently has capacity to provide ventilation to seven COVID-19 patients, but that there are enough ventilators on island to expand that number to 36.
Dr. Archita Joshi-Bhatt of Health City Cayman Islands said the East End hospital is prepared to receive patients for a phase 2, if a surge in cases occurs. The hospital has earmarked 11 beds in the intensive care unit and 24 additional ward rooms with centralised oxygen supply for COVID-19 treatment, she said. This includes beds in negative-pressure isolation rooms. Such rooms allow air to flow in but not out, to control the spread of infection.
Combined, Cayman Islands Hospital and Health City are able to receive 27 patients for ventilation and 54 for non-ventilation treatment of COVID-19. CTMH Doctors Hospital would be able to contribute three dedicated beds to the virus.
Anaesthesia machines on island are also being considered as backup ventilators if the need arises. Joshi-Bhatt said the HSA has four anaesthesia machines and Health City has five that could be converted to ventilators.
Jefferson said Cayman is in the advanced stages of setting up an alternate care site, which would be needed if all three hospitals reach capacity for COVID-19 treatment.
If this site were needed, Dr. Stephen Gay of Doctors Hospital said that would mean Cayman had reached a “dire” stage in pandemic control. The need for an alternate site would mean Cayman had reached stage 4, a critical phase in which main healthcare resources have been exhausted.
“We don’t want to get there,” Gay said. “This is why leaders have instituted the isolation and containment measures that are currently in place.”
So far, the main form of COVID-19 care on island has been through supportive therapies, such as oxygen and hydration support, Joshi-Bhatt said. Other medications for septic shock and blood pressure, as well as antibiotics, may be administered as part of the critical care response.
“There is no recommended or approved therapy for COVID-19 at this time,” Joshi-Bhatt said.
She described initial studies and data that have been promising but explained that the knowledge about COVID-19 remains fluid and doctors are learning more about the virus every day. One medication that has been considered on a case-by-case basis is hydroxychloroquine, but the drug is not appropriate for all patients, such as those with cardiac issues, she said.
She added that the symptoms presented for COVID-19 have been variable and not all people present pulmonary problems as their main concern. Patients have also presented with nausea, vomiting, diarrhoea, abdominal pain, rashes, body aches, fever and lack of appetite.