A&E head says resources being stretched due to flu outbreak

UP TO 100 PATIENTS per day have been turning up at the Queen Elizabeth Hospital’s (QEH) Accident & Emergency Department (A&E) over the past two weeks amidst a surge in influenza cases.

Head of the A&E Dr Anne-Marie Cruickshank said this has been happening since Boxing Day and stretching their resources beyond what they can manage.

“Daily, we would see roughly about maybe 80 to 100 patients a day. They don’t all go to full disposition because some may be not heard, some may have been referred to the 24-hour clinic, some may have left against medical advice,” she revealed during an emergency press conference in the QEH’s boardroom yesterday, where officials moved to address the surge which has affected operations in the department. “From Boxing Day to present, we have 40 to 60 patients waiting to be seen at a time, and that’s a lot for us. We may have single numbers, maybe 15 waiting to be seen, but we’re into the 40s and 60s. And last weekend when we had the internal mass casualty, we had 64 waiting to be seen with the ten gunshot wound victims. So that was very intense for us.

Increased numbers

“So we’re seeing increased numbers of patients waiting to be seen, and despite trying to refer them to the 24-hour clinic, the numbers just keep on coming. So we can’t get to zero then because as fast as we see, admit and discharge, ambulances keep bringing, and others are coming by private transport,” Cruickshank explained.

QEH chief executive officer Neil Clark said the exceptionally high demand contributing to longer waiting times for patients was due to a combination of factors, ranging from the global influenza outbreaks to an increase in the number of trauma and injury cases. Alongside this, he added, was a post-holidays rise in complications for patients with chronic conditions such as diabetes, heart disease, asthma

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and hypertension.

“We’re seeing a higher number than normal of people requiring admission, which places pressure on the in-patient beds. These factors together mean that more patients need urgent hospital care at the same time, which can slow how quickly less urgent cases are seen in the A&E Department,” he said.

Clark gave the assurance that they had not lost control of the situation, outlining the QEH’s full operational response and plans to strengthen patient management across the hospital.

“We continue to prioritise the sickest patients through triage, so that those with life-threatening conditions are seen first. We continue with our morning daily briefings, implementing escalation measures dependent on the issues identified on that particular day.

Bed management

“We’re strengthening the daily bed management and discharge planning to free up in-patient beds for the patients coming from A&E, and increasing the availability of bed spaces within the hospital. We’re supporting staff and filling rotas where illness has affected staff availability, and we’re identifying additional medical and nursing staff to support the current backlog of patients within the A&E Department,” Clark told the media.

He pointed out that for 2025, the A&E recorded an 8.5 per cent increase in patients, equivalent to about 160 per month, compared to the previous year.

Cruickshank said the ideal number of patients that could be managed in the A&E was in the range of 25 to 30 per shift.

“Obviously, 65 is more than we can manage, so I would say roughly 25 in a shift. We could see 100 a day and we can divide that up to 20 to 30 in a shift. So having double the number on shift, it’s more than we can manage. So 20s to 30s would be ideal number per shift that we can manage comfortably,” she said.

In response, management has brought in additional staff, including seven residents from the Doctor of Medicine postgraduate programme who will be in rotation. It has also received speciality doctor support and increased staff groupings to help with the surge.

QEH officials have again asked the public to only resort to the A&E for emergencies such as chest pain, severe breathing problems, major injuries, stroke symptoms, serious bleeding or sudden collapse.

“For minor illness and injuries, please use the polyclinics and the urgent care centres, your family doctor, private clinics or pharmacies where appropriate,” Clarke suggested.

“Follow the medical advice for chronic conditions such as diabetes, high blood pressure and asthma to reduce the risk of complications for yourselves. When visiting the hospital, please abide by the QEH general protocols, including hand hygiene and mask-wearing in all clinical areas. If you’re unsure where to go, you can contact the QEH patient advice and liaison service for that guidance.”

In terms of the influenza outbreak, director of clinical and diagnostics services Dr The Most Honourable Corey Forde said 42 cases of Influenza A, B and respiratory sinusitis virus were recorded in December.

He said it was not uncommon for the winter season, which is commonly observed as the flu season.

“I want to really emphasise that this is not a Barbados problem. This is an international problem. Across the globe, there have been these hikes in cases of influenza.

“We were having discussions on this matter from the time we saw the spikes globally. Much as we did for COVID, we kind of got ahead of the game, but you will be faced with these sort of challenges, despite all the measures you put in place,” he said.

He also cautioned that not everyone presenting with symptoms needed to access the A&E and could instead visit the polyclinics for assessment.

Forde said while it is difficult to say when the wave of flu cases will pass, he expects them to lessen as February and March approaches. However, he is urging the public to practise proper hygiene and look after their personal health, as people with chronic non-communicable diseases can experience more aggressive symptoms.

“If you know you have diabetes and hypertension, don’t eat and drink as you want and do everything you want, because if you get this sort of illness, it will make it more difficult for you and certainly for us in terms of management.”

FROM LEFT, acting chief operations officer Louise Bobb, chief executive officer Dr Neil Clark and director of medical services Dr Carlos Chase looking on as director of clinical and diagnostic services Dr The Most Honourable Corey Forde speaks

about the influenza surge during the press conference. (Picture by Haroon Greenidge)