Bermuda shorts 18: lockdown diary 1

by Bill Shields

20 April 2020


In April 2017, after 30 years working in NHS finance, former HFMA chairman Bill Shields moved to Bermuda as chief financial officer of the territory’s hospitals board. In this series of blogs, he documents his experiences.

 

Since my last blog which was not that long ago, Avril and I exhibited most of the common and some of the more rare Covid-19 symptoms. She has had the cough and fatigue as well as an upset stomach; I have had fatigue, raised temperature (but, thankfully, not for long) and, strangely, conjunctivitis.

Bermuda Hospitals Board had already initiated a quarantine protocol for anyone returning after 14 March, so I knew I would be working from home for two weeks in any case. Becoming symptomatic after a few days meant I had to self-isolate, be symptom-free for three days and then have a further seven days away from work.

In the end, this meant three weeks off work, following a week-long vacation, so an entire month in total. This is the longest period I have been away from the workplace in my entire career and, apart from teaching me how mind-numbing retirement can be, it presented a few unexpected challenges.

First, how to self-isolate when you and then your partner are symptomatic when you live in a tiny, two-bedroom apartment. This was not easy but, fortunately, we were not sick at the same time!

Second, how to get enough exercise and mental stimulation rather than raiding the fridge or food cupboard out of sheer boredom. Third, finding anything worth watching on Netflix, Amazon or BBC iPlayer when your virtual private network has been knocked out by a thunder storm on the first day of lockdown and refuses to be reset!

And last, trying to keep a large, bouncy labrador fit when you can only walk one kilometre from home and spend no more than an hour doing exercise – believe it, or not, a treadmill is very useful for this!

The last of these challenges arose as our quarantine period coincided with the start of lockdown and restriction in movement on the island (in self-isolation, we obviously couldn’t leave the house). With nearly 60 positive cases and, sadly, five deaths, the Government of Bermuda enacted a state of emergency with a ‘shelter in place’ order.

This means that individuals can only leave the house for essential grocery shopping (and this is managed through your surname determining which days you can visit the supermarket) to go to the pharmacy, or if you work for an essential service such as BHB, the police or power generation company. You can also exercise for one hour within 1km of your address.

These restrictions are enforced by the Royal Bermuda Regiment, which operates checkpoints at various points around the island. This may sound extreme, but it does demonstrate the clear commitment of the government to enforce social distancing and limit the impact of Covid-19.

All of this is necessary as the latest predictions indicate a likely surge in patient admissions in the next six to eight weeks. You will all be aware of the pressure on intensive care beds but, here, we have had a few additional challenges.

President Trump’s enactment of the Defence Protection Act, which dates back to the Korean War, has had a major impact on our largest source of medical equipment and consumables. This has led to delays in procuring much-needed personal protective equipment (PPE), with the threat of shipments being seized by US Customs and the reprioritisation of orders placed for ventilators due to the US’s own need to procure significant numbers.

Equally challenging has been the difficulty of getting PPE out of China. Prior to the pandemic, I must confess I didn’t realise that almost all PPE originates there and, following concerns over quality control with earlier shipments to Europe, is now subject to more stringent, time-consuming checks by the Chinese authorities.

All of this has led to huge amounts of time in negotiation with vendors and intermediaries by my amazing procurement team. The same people are also acting on behalf of government and checking out new suppliers and offers of help, which may be legitimate, but are often rerouting of supplies from China or the US with a considerable mark-up.

I’m sure many of you have, like me, spent more time than you’d like reflecting on personal and professional priorities. Being symptomatic with a disease like this is a real worry. It is, obviously, possible that influenza could kill you, but most people will expect to recover. Covid-19 is not like that and I’m sure many people suffering with it are having some very dark thoughts, as are their families and loved ones.

This is also, a very real concern for frontline clinical staff. This is why we, like colleagues in the NHS, must do everything we possibly can to secure the necessary equipment and protection to ensure they can do their jobs while being as safe as is possible. We must also be cognisant of cost and governance, but these must not dictate how we deal with this issue in the first instance.

I will keep you posted as we all work to deliver healthcare for our populations at a time when this has never been more critical.

Until the next time, keep safe and good day!



  

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