May 03, 2021
Just several weeks in, the country's third wave is making a deadly mark.
Twelve deaths were declared for March when cases began to spike, and when variant mutations were first detected in samples tested locally.
Another four deaths were reclassified from non-COVID deaths to COVID-related deaths as per the ministry’s May 1 report, but no information was provided in that report on when and where those deaths occurred, and on the age and sex of the deceased.
According to internal medicine specialist and senior registrar at Grand Bahama’s Rand Memorial Hospital Dr. Odia Stubbs, the third wave is bringing with it more COVID deaths on the island than in the previous outbreaks.
In an interview with Perspective last week, Stubbs said, “We have more deaths in this third wave here in Grand Bahama. The patients would come in not so bad, but they would deteriorate very quickly compared to the other waves.
“We have had a lot of deaths in the past couple of weeks compared to before, and we have had many Intensive Care Unit (ICU) admissions, patients we have had to intubate, and those who were airlifted.
“They will come in with oxygen saturations of 91 or 92, and then it will go down to 88 and you will be thinking one day that they are fine, and in the next two days, we have to step them up to the critical area.”
Over the past several weeks, Perspective has learned of several COVID-19 positive patients on Grand Bahama – some who have since passed away – who were admitted to the island’s ICU, but the daily dashboard issued by the Ministry of Health has not listed any ICU admissions for the island.
Thus far, the ministry has reported two confirmed Grand Bahama COVID deaths for the month of April.
Yesterday, it confirmed a total of six Grand Bahama COVID deaths previously under investigation; one in April, four in March and one in February.
Dr. Stubbs disclosed that in addition to a higher incidence of deaths being observed, the internal medicine team is also observing a higher incidence of acute kidney damage in the third wave.
She noted, “We saw a few people who ended up on dialysis. They had acute kidney injury because of rhabdomyolysis, and they ended up needing hemodialysis, which is different from the first wave.
“We had one person earlier on who that happened to, but this time it is more frequent.”
A life threatening condition, rhabdomyolysis is the breakdown of skeletal muscle leading to the release of the muscle’s contents into the bloodstream, which can create complications including kidney failure.
Rhabdomyolysis has a number of causes including infection, and though there is limited literature at this time on rhabdomyolysis induced by COVID-19, there have been reports of the condition in COVID patients in other countries.
Stubbs said none of the patients had a prior history of chronic kidney failure, and those who had diabetes or hypertension often first learned of their comorbidities when they sought medical attention for symptoms, most notably fatigue.
The specialist, who sees all admitted COVID-19 patients in public health on Grand Bahama, pointed out that while older residents are more likely to seek medical care for worrisome symptoms, younger residents are troublingly opting to manage their symptoms at home.
She added that those who do seek medical attention for worrisome symptoms are sometimes in a worse medical state than they recognize.
Stubbs explained, “People may come in moderately symptomatic, and we look for an oxygen saturation between 95 to 100. When patients come with saturations like 93 or 92, we are not comfortable with that.
“They might be mildly to moderately ill, but they are more severe than they think they are based on our examination.”
Those examinations, she indicated, would include chest x-rays that show lung damage, and acute respiratory distress syndrome continues to be the most prevalent of serious COVID-19 complications.
Stubbs shared, “To be honest with you, in this community in Grand Bahama, the patients do not like to come to the Rand. There was a [COVID-positive] gentleman who was very ill, young in his 40s, who refused to come in.
“If you start to get short of breath with moderate activity, get to the hospital. We will preach this over and over, but the younger people will not come. A lot of the young people feel they can do this on their own. The older people will come in because they feel sick and they are scared.
“When the younger people do come in, sometimes it is a little too late.”
Younger patients being admitted to hospital
Click here to read more at The Nassau Guardian