Haiti’s surging COVID infections demand international aid

Gasping for air, patients in Haiti infected with the coronavirus are dying in ambulances after being unable to find a hospital to admit them. One of the few hospitals that does accept COVID-19 patients recently announced that it will stop taking them until further notice.

“We are still saturated,” said Dr. Marc Edson Augustin, the medical director of St. Luke Hospital in Port-au-Prince. “As soon as a bed gets available whether by a patient being discharged home or a death, it gets occupied. The strain is real.”

The sharp rise in COVID-19 cases and deaths in poverty-stricken Haiti is not only placing a strain on an already weak health system, it has led to a demand for ramped-up international support, the head of the World Health Organization’s Americas office said Wednesday.

“There is… a mounting need for resources from the international community to urgently expand care for severe COVID-19 cases in Haiti,” Dr. Carissa Etienne, director of the Pan American Health Organization, said. “This includes the outfitting of new spaces to manage patients as well as the procuring of supplies, needed equipment and oxygen.”

After more than a year of reporting few cases, Haiti is experiencing a deadly wave of infections after detecting two highly contagious variants of the virus — one first found in the United Kingdom and the other in Brazil. With still no access to COVID-19 vaccines, Haitians are panicking as hospitalizations have spiked, the price of oxygen has skyrocketed and the virus has killed several notable personalities in recent days — among them a former senator, a former president of the elections commission, a former coordinator of the national disaster and emergency preparedness office, and the current head of the pension agency.

If there is any doubt that the virus is reaching the slums where people are reluctant to seek medical care and live in overcrowded conditions, Dr. Richard Frechette, a Catholic priest and physician who runs a hospital foundation in the capital, made a chilling observation in a recent plea for help:

“We have received many nuns, a sure sign the COVID is in the popular areas,” said Frechette, whose St. Luke Hospital publicly announced over the weekend that it was filled to capacity and couldn’t take any more patients for the time being.

Frechette, who founded the St. Luke Foundation, was among those who sounded the alarm last month when COVID-19 cases began rising in his hospital. They have calculated that, compared to June of last year when Haiti is believed to have experienced its first peak, the number of COVID-19 cases last month increased by 50%, with many more deaths .

“If the contagion does not slow down, the Haitian healthcare system, especially for COVID care centers will certainly crash,” Augustin, the medical director, said. “Help is needed for COVID Centers.”

With support from entities in Haiti, St. Luke has increased the number of beds for infected patients from 25 to 115. As of May 31, it was managing its oxygen bill through private donations that included deliveries of oxygen concentrators from Haiti’s Ministry of Public Health, UNICEF and GHESKIO.

But the concentrators, which pull air through a filter and only provide a few liters a minute, are not as effective for patients who are severely ill, which is the majority of those seeking care, Frechette said. The hospital’s oxygen bill just for May was over $62,000. With 90 percent of its patients in need of oxygen tanks, it’s looking at a need of $718,000 for three-and-a half months for oxygen.

“Ninety sick people a day needing four tanks each, that’s 360 tanks at $19 a tank for 105 days,” Frechette said. “That’s how we are doing our budget.”

Chantal Hudicourt Ewald, a lawyer and supporter of the St. Luke Foundation, said she is worried Haiti may reach a point where it can’t care for its COVID-19 patients.

“You can have the good will but if you don’t have the money, that’s a concern,” said Ewald, who appealed Wednesday to Haitian physicians in the U.S. and elsewhere for help.

“Each donation is of great importance to help continue providing free oxygen, [which is] essential to save lives,” Ewald said in an email to a Haitian group.

Bruno Maes, the head of UNICEF in Haiti, said that at the request of Haiti’s health ministry the U.N. agency purchased 1,600 oxygen tanks Wednesday, and 300 were made available immediately for the government-run Delmas 2 COVID-19 hospital, St. Luke Hospital and the University Hospital of Mirebalais, which has 100 COVID beds among its three sites. They also purchased 200 empty oxygen cylinders and fuel for the health ministry as well as a generator for a government industrial park to help with electricity for oxygen production.

Maes said UNICEF is working closely with the ministry of health to ensure the local supply of oxygen is available and expanded. “We just bought two generators, one for the Delmas 2 hospital to ensure that the ministry can produce large number of locally produced oxygen tanks,” he said. “Trucks will be bought in the upcoming days. We are fully mobilized, we understand that it’s an emergency to ensure that hospitals have the right capacity and don’t face any gap.”

The first batch of COVID-19 vaccines, 130,000 doses of AstraZeneca from the U.N.-backed COVAX Facility, are expected to arrive in Haiti on June 14, Maes said. He added that preparations are underway for the shipment’s arrival and distribution.

Haiti’s health ministry, which has been reluctant to say where treatment centers are located from fear of attacks, has said there are between 200 and 240 beds in the country, which has a population of 11.5 million. Doctors Without Borders/ Médecins Sans Frontières, which closed its COVID-19 treatment center last year after only three months of operation because of low use, said it has not decided whether to reopen.

“We are closely monitoring the rising number of cases of COVID-19 in Haiti. So far we have responded by making donations of oxygen and personal protective equipment for COVID-19 care in Port-au-Prince,” said Tim Shenk, a spokesman.

Etienne, the head of PAHO, said infections are rising all through the Americas. But Haiti’s situation stands out.

Even with its limited data — officially, the country is reporting 14,931 confirmed cases since last year and 321 deaths — there is reason for worry with Haiti, she said.

“The situation we’re seeing in Haiti is a cautionary tale in just how quickly things can change with this virus,” she said. “Wishful thinking will not resolve this crisis. We need action.”

Etienne called leaders across the region to step up. She said that public health experts across the region have seen misinformation about COVID-19 sow doubt on proven health measures, often in the context of political disputes.

“This pandemic has taught us time and again that leadership determines the effectiveness of a country’s response,” said Etienne. “By stoking controversy where there is none, our leaders are sending mixed messages to the public and standing in the way of effective measures to control the virus. We must unite around stopping this virus — this should be the priority.”

On Tuesday, Haitian President Jovenel Moïse, who continued to insist that Haiti had managed the virus well until now despite failing to enforce its own rules on mask wearing and social distancing, announced that a public health emergency order would be extended for 15 more days. The measure includes a 10 p.m. to 5 a.m. curfew and demands for the wearing of masks. The government, which has not shuttered schools, has issued a ban on graduation ceremonies and end-of-school-year celebrations..

“The situation is serious,” Moïse said during an address to the nation Tuesday. “Today more than ever we must act with prudence and common sense.”

He also called on his finance ministry to pay nurses and other medical staff, who had not been paid since last year. Others have also complained about the government owing them money for face masks produced by factories at the beginning of the pandemic.

Etienne said that the two virus variants of concern and the failure of the population to adhere to public health measures “combined are likely fueling transmission.”

With a population of 11.5 million people, Haiti has just between 200 and 240 beds, its health minister confirmed at a recent press conference. In addition to the need for more international support, she said PAHO was calling “on partners and organizations working in Haiti to urgently reinforce the response to COVID-19.”

“The country will need additional health capacity, as well as support to embrace preventive measures required to curb transmission. Both will be decisive in the coming weeks,” she said. ”There is no time to waste.”