GHA grapples with ‘unprecedented demand’ as Covid hospitalisations continue to rise

The Gibraltar Health Authority is prepping a ‘mini-Nightingale’ ward and has stopped all but critical surgeries as it grapples with an influx of Covid cases needing care.

Across Elderly Residential Services there are 114 positive cases, with a further 31 cases in the Covid-19 Ward and 13 patients in the Critical Care Unit at St Bernard’s Hospital.

The weight of 158 cases needing care has strained the health service, which on Tuesday declared demand was now at an “unprecedented level”.

On Monday the GHA Gold Command meeting decided to raise its organisational posture level to ‘Black’, stopping all but critical cancer surgeries, and life and limb saving surgeries and procedures.

“This is a clear declaration that the hospital is working in excess of capacity as the Critical Care Units and Covid wards are close to full,” a press statement from No.6 Convent Place said.

On Tuesday, six more patients were admitted into the Covid-19 Ward, 13 remained in critical care and, in ERS, five new cases were identified.

But despite 94 recoveries across the local community, the virus continued to spread with 84 new cases.

“Transmission of Covid-19 in the community remains uncontrolled, and the demand on St
Bernard’s Hospital facilities is now at an unprecedented level,” the Government said.

“Only procedures and surgeries that are time sensitive and absolutely must be performed, will be performed, as the risk of delaying these procedures fully outweighs the risk of bringing patients into a hospital where Covid infection levels are so high,” the statement added.

The rise in admissions has seen GHA staff reconfigure and clear out wards to provide additional space for Covid patients.

The CCU was split in two with the Day Surgery Unit cleared out to provide a second ‘clean’ CCU for non-Covid patients.

The original CCU was then kept solely to care for Covid patients.

But the persistent admissions are seeing the GHA continue to repurpose departments.

The Senior Management Team, under the guidance of the Director of Nursing Services, has redesigned the former Lewis Stagnetto Rehabilitation department as a step-down facility for Covid patients who are clinically considered to be at lower risk but who may not yet be quite ready to go home.

This means those on the road to recovery and who need less urgent care can be moved to the ‘mini-Nightingale’ at the rehab facility to give space to others who are more acutely suffering from the effects of Covid-19.

Offices have also been cleared to provide space for nurses and doctors to have a short break after working for hours on end in PPE.

While dressed in PPE staff cannot eat, drink, or take a break.

Since the New Year, 1,284 Covid cases have been detected equalling to 38% of all cases since the pandemic began.

But the issue of mounting cases is two-fold for the GHA as it also needs to protect its patients from coming into contact with the virus.

“At all times we must be responsive to the threat on GHA services due to extremely high levels of viral infection in the community, to not only protect those already in hospital, but to safeguard those who must be admitted for a procedure that may very well save their lives,” said acting Medical Director Dr Krishna Rawal.

Striking this balance is key for the GHA, which has also acknowledged the tough decision-making behind their clinical decisions.

“This is such a difficult balance between protecting patients from coming in to hospital and potentially contracting Covid, and providing surgeries and procedures which simply cannot wait,” the Minister for Health Samantha Sacramento said.

“This is a clinical decision and one not made lightly. Escalating the readiness posture is part of the whole picture of how well the GHA responds to the demands placed on services at any given time. This posture level will remain under review.”

“The sooner that the number of positive cases in the community and resulting positive cases requiring hospital admission can come under control, the sooner that the hospital can deescalate this posture to resume more services.”

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