Bermuda shorts 24: between a rock and a hard place

by Bill Shields

26 November 2021

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.

Much has happened since my last blog and, as I write, I’m very much looking forward to attending the HFMA annual conference in December. This will be the first in-person event I will have been to since the 2019 conference.

While we have all become accustomed to doing many more of our daily and work activities remotely and on-line, the experience of meeting in person is impossible to replace and this is what I’m most looking forward to.

Here in Bermuda, we have just exited the fourth wave of Covid. This has been the most devastating wave yet for the island – with 70 fatalities, which is over twice the number in the other three phases combined.

There is widespread evidence from around the world of vaccine hesitancy in some communities. This has also been the case in Bermuda. The data clearly demonstrate the efficacy of the Covid vaccines. But misinformation spread on many social media platforms has played a significant part. Some channels have discouraged inoculation by playing up side effects, talking up natural immunity and seeking to discredit vaccine protection through selective use of data. Of equal concern, has been the enthusiasm to try unproven treatments, while shunning the vaccine.

That said, Bermuda continues with an extremely rigorous set of protocols to limit spread of the virus. All visitors and residents, vaccinated or not, must have a pre-arrival PCR test, one on arrival, one on day four and one on day ten. Unvaccinated arrivals must quarantine for 14 days. Masks are still mandatory indoors. And indoor dining at restaurants and attendance at any large events is limited to those who are either vaccinated, or have had a negative PCR test within the last 14 days, this being evidenced by a SafeKey QR code on a mobile device.

Even for someone who has had 23 PCR and two antigen tests, all of which have been negative, since the beginning of the pandemic, I do know a number of vaccinated friends and colleagues who have suffered from breakthrough infections and feel that this is a necessary requirement for the foreseeable future.

A further dilemma posed by the latest Covid surge in Bermuda has been the impact on unvaccinated staff. At its height, BHB had 80 staff who were quarantined due to being infected or being a close contact of someone who was. This placed severe pressure on services provided by the only hospital on the island with 70 Covid positive inpatients, many in intensive care. There are no agency staff to call on and healthcare staff in other sectors, such as care homes, are also unavailable for work.

The knee jerk reaction is to mandate vaccination, if not for all staff, then for frontline healthcare workers. Notwithstanding the legal perspective of such a move, when many clinical staff are guest workers on work permits, it is possible that such a move will lead to resignations and do nothing to resolve the staff shortage.

In contrast, on my last visit to the UK in October, I was struck by how different the situation in England was: not a mask in sight; no social distancing; mass gatherings, such as sporting events, back to their pre-pandemic attendance levels; and pubs, clubs and restaurants back to normal opening hours.

While the UK government has prioritised opening up the economy, and has led the world in vaccination take-up, this still feels like a significant gamble given the possibility of future strains of Covid being more virulent, or even a mutation occurring in the spike protein. And with waning protection after six months, much will depend on the speed and extent of take-up of booster shots.

Again, Bermuda has been extremely fortunate in procuring new stocks of the Pfizer BioNTech vaccine and I, like many of my colleagues, stood in line to receive mine in early November. Fortunately, unlike my first and second doses, this time I had a very mild reaction and didn’t even need to resort to painkillers.

One positive of the lockdown earlier this year during Bermuda’s third wave of Covid, is that, as well as yoga, I discovered the gym, or more specifically the treadmill. Fortunately for me, my new apartment has a gym, which could be used during lockdown – even if it’s so humid, it could double as a sauna!

Since May, I have seen my times steadily reduce, the culmination of which was my first ever competitive 5k race a few days ago in what can only be described as a tropical monsoon! I had hoped to complete the race in somewhere close to 25 minutes, so was very pleased with a time of 24:36, 38th place out of 128 and 2nd for the over-50s. Buoyed by my success and perhaps rashly, I have enrolled for a half marathon in the coming weeks, where I hope to get close to a time of two hours.

Being back in the UK over the last few months after such a prolonged period away, it was really good to meet and become reacquainted with many old friends and colleagues I hadn’t seen for some time. I am really looking forward to catching up with many more in December, finding out what they’ve been up to and sharing mutual experiences and learning from this last 18 months.

Until then, good day!