In any emergency or medical challenge, delaying treatment can mean the difference between life and death or full recovery and disability.
It’s a reality medical professionals know all too well and, with the current COVID-19 crisis, Health City Cayman Islands’ Dr. Binoy Chattuparambil says, now more than ever, patients need to take swift action and not fear going to the hospital for treatment.
“Thinking that if you go to the hospital you will get the infection, then that fear will kill many more patients. This is what’s happening across the world now,” Health City’s clinical director said in an interview with the Cayman Compass via Zoom.
It’s a point shared by the chairman of the CTMH Doctors Hospital board, Dr. Yaron Rado.
“It is a very important for patients to not be afraid to seek medical help,” Rado said.
“We notice internationally a rise in patients having heart attacks and dying of them, I want to remind you that time is of the essence and Dr. [Krzysztof] Kukula, the interventional cardiologist at Doctors Hospital, pointed out that COVID-19 can actually mimic a heart condition,” he said.
Cayman’s first COVID-19 patient was diagnosed at Health City last month. He was a passenger who came off the Costa Luminosa cruise ship with a cardiac emergency.
While being treated, he developed coronavirus symptoms and, following confirmation of his COVID-19 status and the testing of staff who had treated him, the hospital closed its doors to the public for two weeks.
Chattuparambil said the hospital triggered its infection-control protocols and isolated 41 staff members. It also contacted all patients who had been at Health City during the time the COVID-19 patient was there.
“We have planned for the two weeks. We suspended the operations here, but at the same time, we were planning for how we opened the hospital without risk for any new patients coming,” he said.
The COVID-19 patient later passed away. Four Health City staffers tested positive for the virus and have since recovered.
Both of Cayman’s private hospitals are working with government and the Health Services Authority in their COVID-19 response and have established protocols to help patients who require assistance.
HSA’s Director of Primary Health Care Dr. Samuel Williams-Rodriguez stressed that there are clear protocols in place to protect all patients and no-one should avoid seeking care.
“Although HSA is not performing elective procedures, patients may still require emergency care or management of chronic diseases as the need for this level of care does not disappear during a pandemic,” he said.
“If someone has a medical need which requires emergency or urgent attention, it is important to seek the necessary medical care to ensure it does not develop into something more serious,” Williams-Rodriguez told the Compass in an emailed response.
Time of the essence in medical treatment
Chattuparambil spoke of one Health City patient who sustained paralysis because he did not seek quick medical assistance quickly after suffering a stroke, due to being scared of contracting COVID-19 at the hospital.
The doctor said that time is of the essence when it comes to strokes and heart attacks, and the sooner medical treatment is sought, the better the chances of recovery. “If you come to the hospital in less than four hours, usually within 48 hours they will recover because we have an interventional neurologist here,” he said.
However, the patient, whom he described as a young man, waited too long to get treatment.
“Because of the scare or the fear of going to the hospital now in this era of COVID, he did not seek help at the right time, and he came so late … when he was totally paralysed. So now, that important window is gone for him or for the right treatment. Now, one side is completely paralysed,” he said.
The chances of full recovery for the patient are unclear, he said.
“It is very difficult to predict. Now, you may get some kind of a recovery, but, in the other scenario, if you had come at the right time, like … four to six hours, he would have been walking now without the any residual defects in the body,” he said.
Chattuparambil stressed that the prevailing mindset of “you cannot or should not go to the hospital or you might get the infection” has to change.
“The heart attacks will be there; strokes will be there. [They’re] not going to go away. Thinking that going to the hospital is not safe now… you are risking your life,” he added.
Health City splits operations, HSA tests all new patients
“Coming to Health City now is as safe as a coming before,” Chattuparambil said as he described how the East End hospital has divided its operations in two for preparation to treat COVID-19 patients, as well as continuing to treat medical emergencies.
“Health City is actually two hospitals in one hospital because physically we [are] separated,” he said, adding that the entire staff at the institution has been segregated into two groups.
Chattuparambil said every hospital is looking at the best ways of separating COVID-19 patients, and the staff that treat them, from the general hospital population and personnnel.
He said, at Health City, patients suspected of having COVID-19 enter through a dedicated entry point and are admitted to a separate ward for treatment from a specific set of healthcare workers.
Doctors Hospital has introduced a care centre where patients can call and set up a telemedicine appointment, Rado said.
“We have introduced a flu clinic in a tent outside, to not bring COVID-19 patients into contact with non-COVID-19 patients. In case of emergencies, patients with unknown status will be moved to a negative pressure room to protect the rest of the ward,” he said, adding that, as of Thursday, Doctors Hospital remained COVID-19-free.
Williams-Rodriguez said as part of the National COVID-19 Response Plan, the HSA has implemented specific zones for patients – COVID positive, negative or a suspected case.
“All inpatients are also being tested as part of the island’s new testing protocol,” he said, adding, “the separation of persons who are COVID-19 positive from persons who are negative or pending results allows a much stricter control of the environment and significantly reduces the risk of contamination”.
The HSA, he said, regularly handles patients with infectious diseases, therefore robust infection-control protocols are in place to handle COVID-19 patients and others with more frequently seen infectious diseases.
“In this case, we are dedicated to providing the best care possible for these patients while continuing to protect the health of our employees caring for them,” he said.
People with COVID-19 can have a wide range of reported symptoms, ranging from mild to severe. These symptoms may appear 2-14 days after exposure to the virus and include:
Shortness of breath or difficulty breathing
Repeated shaking with chills
Loss of taste or smell
– Source: US Centers for Disease Control and Prevention