WILLEMSTAD - The hospital of Curaçao in Willemstad is banning visitors and patients for non-acute operations because of COVID-19. But healthcare was already under pressure.
It is quiet during visiting hours in the new hospital in Curaçao. The doors opened in November last year and everything in the hospital is still brand new. Now COVID-19 ensures that visitors are not allowed. Non-acute operations have been canceled. Visits to the sick are no longer allowed since last week Monday. With some exceptions, such as during childbirth or if there is a risk of a patient dying.
The number of infections on the island is not too bad in absolute and relative terms - on Saturday, 62 positive tests were added. “But the trend is rising,” says Ingemar Merkies, CMC's medical director. The hospital last week made an urgent appeal to health authorities to introduce stricter measures to contain the pandemic. “The capacity of the only hospital should serve as a guideline. We are part of the whole, of society.”
Curfew from 11 pm to 9 pm
After the call, the government acted almost immediately, bringing the curfew from 11 pm to 9 pm. Restaurants and catering close at 8 p.m. and masks are mandatory in shops and public transport. The Dutch tourist, who is allowed to fly to the islands by Prime Minister Mark Rutte, should not massively lie on the beach. Up to four sun worshipers together and the rest at a distance.
A quarter of the 263 beds in Merkies hospital are unoccupied. In the hospital in the historic district of Otrobanda, 74 healthcare professionals have been infected since the COVID-19 outbreak in March. Merkies: “Most of them in the Acute Admission Unit and the Emergency Department, where the COVID patients are initially received and treated. Incidentally, infections have been detected in all departments. We think that has to do with behavior and the influx in the hospital. ”
No confidence in the doctor
According to Merkies, care has not only become vulnerable because of COVID. “Health care in Curaçao could have better been organized for years. Two out of three patients who come into the emergency room are self-referrals. They have not seen a doctor.” Patients often skip the GP because they have no confidence in him or her. They prefer to drive to the hospital.
While the outpatient clinic looks dead, it is very busy in the emergency room. The CMC lacks a GP station that can do triage in the evening, at night and during the weekend. “That is now happening in the emergency room, resulting in overload. We are creating a huge influx of patients at the entrance of the hospital. Patients who should have just been with the GP and in most cases should have been treated there as well.”
"Quality of care in primary care can vary greatly"
The lack of a GP station is not an isolated one, says Dr. Charisse Calor of the Sorsaka GP practice. GPs have been calling for reinforcements for years. Calor is committed to investing in general practitioner care, but sees little progress. “A GP station and good primary care depend on digitization, efficient care for the chronically ill and the quality of the GP training; and of course: cooperation. There is something to be said about all aspects.” For example, someone who studies in Costa Rica for five years may establish himself in Curaçao without specialization as a general practitioner. “There is no general practitioner training,” says Calor, which means that the quality of care in primary care can vary greatly.
In addition, Curaçao has an aging family doctor database. One-third of the approximately one hundred GPs on the island are older than 65. “It is more difficult for them to keep up,” says GP Wallid Elhage, chairman of the Curaçao GP Association CHV. The reason for continuing to work into old age is a poor pension provision.
Elhage sees that all issues because of COVID are now suddenly at the top of the agenda. There is a growing realization that medical professional care cannot continue in the new normal if no investment is made in strengthening general practice care.