BHB moves to limited visitors from Sunday 9 May

Friday 7 May 2021: Bermuda Hospitals Board (BHB) today announces that, given the return to a lower prevalence of COVID-19 in Bermuda, it will once more allow limited visitation from Sunday 9 May 2021 for acute care and long term care patients.

Key changes include two visitors allowed at any one time for acute care patients in the ACW, one visitor at any time for acute care patients in the General Wing, and long term care patients can receive one visitor for two hours each day.

Norma Smith, Vice President, Clinical Operations (Acute and Ambulatory), comments: “With the community cases declining, we are very pleased that like the rest of Bermuda we will open up a bit more and once more welcome visitors. We ceased visitation during the worst of the recent surge, but prevalence is low enough for us to once more have visitors, and we are very happy that the mothers in long term care or acute care wards will be able to reconnect in person on Mother’s Day.”

Due to the need to maintain physical distancing within the Emergency Department and Lamb Foggo Urgent Care Centre, however, requirements for people attending the Emergency Department are not changing, and patients should attend alone. Companions will only be allowed when the patient is vulnerable, under 18 (legal minor), or if the patient is combative or near end of life. Should a patient pass away, ED will allow an additional person to support the companion. In such circumstances, ED will only permit up to three companions in the ED family room.

Dr Chikezie Dean Okereke, Chief of Emergency, notes: “We appreciate there are circumstances when a patient needs a companion, but outside of the stated exceptions, we do not have the internal space to have patients and companions, while ensuring physical distancing and safety for all. We certainly empathise when there is a passing so will allow up to three people in the family room so that the companion has support, but we still need to ensure and practice safety first at all times and unfortunately can’t accommodate larger groups of family and friends.”

The following requirements must be followed when visiting any BHB services:

• Visitors must be masked at all times, including in patient rooms
• Visitors must maintain physical distancing at all times, including in patient rooms
• People who have symptoms of COVID-19 or any other infection will not be allowed to visit
• If someone has travelled, they should only visit after they have a negative day 14 test.
• For infection control purposes, visitors will not be allowed to use patient bathrooms and will need to use public restrooms on each floor.
• Overnight stays are not allowed at this time, other than in exceptional circumstances.

All current visiting requirements are listed below:

Acute care patients in the Acute Care Wing units (Ace Barber, Ascendant Partner Re, Catlin Lindo): patients who are not on isolation can have up to two visitors in their room at any one time between noon and 8pm.

Acute care patients in the General Wing (Curtis Ward): as these rooms are smaller and have other patients in, acute care patients in the General Wing (Curtis Ward) can have one visitor in their room at any one time between noon and 8pm.

Isolation patients: For patients on isolation due to a known infection of any kind, or in the first 24 hours of admission while waiting for results of the required COVID-19 test, two designated support people pre-identified by the patient will be able to visit for up to two hours per day.

Intensive Care Unit: Designated support people allowed to visit for two hours between 10am and 2pm, or 4pm and 8pm. Visitors must be on the ICU visitors list.

Maternity:

• One designated support person may stay up to 8 hours after the birth
• If the mother is not discharged within 24 hours, the one designated support person will be allowed to visit up to 4 hours a day between 10am and 6pm
• Doulas will be allowed for the birth with a support person

Acute Inpatient Care for Mid-Atlantic Wellness Institute services (adult, child and adolescent services):

• Pre-identified support people can visit for 30 minutes each day between noon and 6pm
• Support people should check in at the front desk
• One person can visit at any one time and visitation will be in a public space, such as a family conference room

Long Term Care (KEMH and MWI), including Group Homes:

• One designated support person can visit for two hours each day between noon and 6pm. No isolated patients can have visitors.

Emergency Department and Lamb Foggo Urgent Care Centre:

• Patients should come to Emergency on their own, to minimise numbers in the ED waiting room and ensure physical distancing is possible
• Exceptions for one visitor will be made in the following circumstances:
  • Vulnerable individuals and children (1 parent/support person)
  • Combative individuals
  • End of life cases
• Please note if someone dies in the ED or is brought to the hospital after passing away, only one person and one support person for that individual can attend. Up to three people can be in the ED family room. Other family and friends should not attend as there is not adequate space to gather safely, and the ability to offer viewings very limited.

Lamb Foggo UCC to temporarily close this weekend

Saturday 17 April 2021:  Bermuda Hospitals Board today advises that the Lamb Foggo Urgent Care Centre will not be open for the rest of this weekend. The closure is to enable a deep clean following a COVID-19 case in the facility. We are following all usual procedures for unexpected exposures. We apologise for the short notice. Once the cleaning is complete, the UCC will open again at its normal hours. The cleaning is to ensure the safety of the UCC staff and patients. The Emergency Department remains open for all emergency cases. If someone has COVID-19 or suspects they have symptoms, they should call 239-2009 or 239-1301 before arrival.

BHB COVID-19 Response Update – 4 April 2021

Sunday 4 April 2021: Bermuda Hospitals Board today urged families to take their loved ones home for discharge today to ensure there is enough space for people who require hospital care, and urged everyone over 16 to get vaccinated in order to protect against serious illness and death, and keep hospitalisations down.

People are also reminded that if they are COVID-19 positive, been asked to quarantine or believe they may have COVID-19 symptoms, they should not just turn up at the Emergency Department, but call 239-2009 or 239-1301 for advice on accessing the hospital safely. Symptoms of COVID19 include but are not limited to:

□ Cough
□ Shortness of breath or difficulty breathing
□ Fever of 100.4°F or higher or a sense of having a fever
□ Sore throat
□ Chills
□ New loss of taste or smell
□ Muscle or body aches
□ Nausea/vomiting/diarrhea
□ Congestion/runny nose
□ Unusual tiredness
□ Headache

CEO Dr Michael Richmond comments: “We are concerned about the rising numbers of infections in Bermuda, and urge the community to do what they can to protect themselves. Over the holiday weekend we have had a surge of COVID-19 patients needing admission to the hospital and intensive care unit. The latest reported figures highlight how quickly we have risen to 18 patients with COVID-19, four of whom are in the ICU. We are prepared. We have opened up our overflow ICU already, and have opened up additional areas with beds to maximise capacity. We have good supplies of personal protective equipment (PPE), medications and oxygen. We are managing right now, but we need the community to play their part in ensuring hospital services can continue to manage and that care for everyone in Bermuda is not compromised.”

Chief of Nursing Judy Richardson comments: “We know some families struggle helping their loved one get home when they are ready for discharge, but we need them to act now. Hospitalisation numbers due to COVID-19 are rising in the wake of a sustained surge of cases in the community. The pattern seen the world over is when community cases rise and stay high, hospitals can become overwhelmed very quickly. We are preparing internally, but we also need families to ensure their loved ones who are in hospital go home as soon as they are medically fit to do so.”

Chief of Staff Dr Wesley Miller adds: “Vaccination protects against serious illness and death from COVID-19. Data from Government is already showing that over 90% of the people testing positive are not fully vaccinated. None of the people admitted to KEMH are fully vaccinated, highlighting that you are at much higher risk of serious illness if you are not vaccinated. The small 10% of people testing positive who are fully vaccinated are not getting seriously ill and not needing hospital inpatient care. The risks of rising numbers are not just to people sick with COVID, but if too many people get sick and need hospital care, all healthcare services will be impacted and people on island needing surgeries or management of ongoing conditions are going to suffer. It is time to work together to get through this difficult time. There is no excuse for not getting vaccinated, unless advised by your doctor. This is a safe and effective vaccine, properly tested, safely provided, and free for everyone over 16.”

BHB update in response to COVID-19 surge

Tuesday 30 March 2021: BHB today provides a further update as it responds to the large surge in COVID-19 cases. Actions undertaken are to limit potential transmission within the BHB environment and protect vulnerable residents and patients, and also to be prepared should hospitalisations rise.

Chief of Staff Dr Wesley Miller comments: “Our initial response has been to reduce footfall and minimise transmission throughout the hospital to protect the most vulnerable people in our care. We are balancing this with the need to maintain medical and psychiatric services. This is why visitation has generally ceased, and outpatients services where possible are moving to remote consultations.

“We are also aware that hospitalisation numbers for people with COVID-19 tend to lag behind the rise in infections by about two weeks, so some of our preparations are ensuring we could manage a surge of people with COVID-19 needing hospital care. We hope that the impressive roll out of vaccines, especially in our older and more vulnerable groups, will protect us from more serious cases, but we still must be ready to care for our community come what may. Thankfully, from our experience last year, we now can triple our critical care capacity and increase acute care beds, and we now have double the oxygen supply we had during the first wave.”

Update on Service Changes:

• Outpatient and urgent/emergency surgeries will continue, but routine elective surgeries (also called same day admissions as these patients need a hospital bed after surgery) will cease, unless they are becoming urgent. This move is to ensure BHB has enough bed space should hospitalisation numbers due to COVID-19 rise.
• Imaging Services Department has rescheduled non-urgent outpatient service to focus on emergencies and inpatient needs.
• The Lamb Foggo Urgent Care Centre x-ray service will cease for two weeks, but the urgent care clinic service with a doctor and nurse will open usual hours (noon to 8pm weekdays and 9am to 9pm weekends).
• Outpatient clinics (for example, appointments with specialist physicians and psychiatrists) will convert to teleconsultations where possible. In-person consultations will be provided if needed.
• Outpatient services that require an in-person appointment may be rescheduled if not urgent. Patients will be contacted directly if they need to be rescheduled, and staff will focus on inpatient and emergency/urgent needs.
• Lab services will continue as usual, by appointment only.
• Dialysis appointments will continue as usual.
• Chemotherapy appointments will continue, although some oncology consultations may be managed remotely.
• There is no visitation for patients in acute care and long term care units across BHB. Moms may have one designated support person in Maternity, but all other visitation is by exception only. Exceptions include end of life and young children.

Accessing Emergency Medical and Psychiatric Care During the COVID-19 Surge:

If you have tested positive for COVID-19, are on quarantine or are experiencing COVID-19 symptoms, you should check the COVID-19 symptom checker at bdahospitaldev.wpengine.com or gov.bm when first assessing your need for care. Call your GP if you need advice on managing symptoms. If hospital care is needed, you should call the Emergency Department (ED) and not turn up before speaking to a member of the ED, who can advise you how to access the hospital safely. Do not go to the Lamb Foggo Urgent Care Centre (UCC). No companions are allowed at either the ED or UCC, unless a parent with a child, or a companion to a vulnerable or combative adult.

Anyone experiencing a mental health crisis, including thoughts about suicide, can call the 24/7 Mid-Atlantic Wellness Institute (MWI) crisis line at 239-1111. Help is there around the clock. While the weekday walk-in service is temporarily suspended, anyone calling the crisis line will be assessed and advised on accessing MWI safely for an in-person consult if necessary.

Reminder on Requirements for Accessing BHB Facilities

Anyone who does have to access BHB facilities are reminded to use the screens for a temperature and mask check on entry and then go to the reception desk. At all times, wear your mask, maintain physical distancing, and wash your hands regularly and well.

BHB ceases visitation in response to COVID-19 surge

Monday 29 March 2021: Due to the large surge of positive COVID-19 cases in the community, BHB will be ceasing all visiting from noon today, Monday 29 March, for acute inpatient units at KEMH and MWI, other than in exceptional circumstances such as end of life or young children. Visiting to long term care units, including group homes, ceased last week.

Maternity will continue to have a support person allowed for moms.

For anyone wanting to reach out to their loved ones in hospital, wifi is free at BHB, so inpatients and residents can use mobile and laptops to stay in touch without incurring costs.

For other areas of the hospital:

·      Outpatient clinics are currently reviewing individual cases and will introduce more telemedicine and focus on urgent cases.  Surgical services are also reviewing lists. Patients will be contacted directly should there be any rescheduling required.

·      Dialysis services will continue as normal. 

·      Imaging Services is temporarily reducing its non-urgent outpatient service, prioritising emergency, urgent and inpatient needs.

·      Emergency Department patients are reminded that companions are not allowed, unless a parent with a child, or carer/companion/relative with a vulnerable or combative adult. 

·      Anyone worried they may have COVID-19 symptoms can refer to the Symptom Checklist (click here), and should call their doctor or the Emergency Department before seeking care in person.

Anyone who does have to access our hospitals are reminded to use the screens for a temperature and mask check, and wear your mask at all times, maintain physical distancing and wash your hands regularly and well. 

BHB restricts visitation in response to COVID-19 surge

Wednesday 24 March 2021: Bermuda Hospitals Board (BHB) today announces a return to increased restrictions for visitors of inpatients and long term care residents at KEMH and MWI in response to the surge in the prevalence of a highly infectious strain of COVID-19. Changes will come into effect on Thursday 25 March at noon.

Long term care residents and isolation patients on any ward will no longer receive visitors. Acute and critical care patients can have one designated person who can visit them during their stay. The designated person can visit once a day, for up to two hours between 12 noon and 6pm.

Gosling (children’s ward) will allow limited visits by parents only, and Maternity visiting will stay the same as before, with one designated support person able to attend the birth and visit once a day if the mother stays longer than 24 hours.

While there are no significant changes in the Emergency Department and Lamb Foggo Urgent Care Centre (UCC), people are reminded that people who need emergency care should come into the Emergency Department or UCC on their own. Due to the need for appropriate physical distancing, the waiting room cannot safely accommodate companions, relatives or carers as well as patients. As such, companions, relatives or carers can only be permitted in certain situations, such as one parent with their child (under 18), or a carer or relative with a vulnerable or combative patient. As an indoor space, the risks of transmission rises with the number of people in the waiting room and the time they are waiting.

Free wifi is available at BHB so patients and residents can stay in touch by phone or video. Anyone visiting or attending BHB facilities must first go through a temperature and mask check. They must use the available hand sanitisers, and wear a mask and maintain physical distancing at all times.

CEO & President Michael Richmond, MD, comments: “We are very concerned at the increasing number of infections by a variant of COVID-19 that is more infectious. This poses a grave threat to our vulnerable patients and residents, and our response is a first step based on current data. If prevalence continues to rise, we may be forced to stop all visiting and look at other restrictions. We will be monitoring the test results from Government closely each day, as well as our own numbers. We had nine people visit Emergency between last Friday and Monday who were COVID-19 positive. This is the direct consequence of the number of infections rising in the community. We hope, however, that people in Bermuda will continue to pull together, follow the public health guidance, and get vaccinated as this is our path back to some level of normalcy. We each have the power to stand against COVID-19, save lives and get the country through, and if the prevalence reduces again we will once more relax visitation.”

Visitation guidelines from Thursday 25 March by area:

• Acute care inpatient units and Intensive Care Unit (KEMH)
(Ace Barber, Ascendant Partner Re, Catlin Lindo, Curtis, Agape and ICU)
One designated support person identified by each patient may visit once a day for up to two hours between 12 noon and 6pm.

• Gosling Ward
Only parents can visit.

• Isolation patients on any ward (MWI and KEMH)
(Isolation patients either have a confirmed infectious disease, such as COVID-19, or are waiting for the results. All patients admitted are tested for COVID-19 and are on isolation until they receive a negative result)
No visitors, other than in truly exceptional circumstances (such as end of life). Individuals must be approved by the unit manager before visiting.

• Long term care residents (MWI and KEMH)
(KEMH: Cooper, Gordon and Perry Units; MWI: Devon Lodge, Reid Ward and all group homes)
No visitation allowed, other than in exceptional circumstances (such as end of life).

• Agape House
No visitors for long stay patients at Agape House. Patients in their last phase of dying will be allowed two visitors in the room at a time who will be required to wear full personal protective equipment.

• Maternity
One designated support person can attend the birth and up to eight hours afterwards. If mom stays on the ward longer than 24 hours, the support person can visit for up to four hours once a day.