 The respiratory hospital is a healthcare facility that has 130 beds, 15 of which are for ICU cases. This hospital attends to respiratory cases such as COVID-19, tuberculosis, asthma and other respiratory illnesses. During the fourth wave, we had 826 patients being admitted. 80% of these cases were discharged. During this fifth wave, from the 16th of December until now, we have 383 patients being admitted and we are seeing a similar trend of recovery of more than 80% of our patients being recovering thus far. While in the fourth wave, we had a lot of patients being admitted in the high dependency unit and the intensive care unit of the respiratory hospital, we note that in this particular wave, we do not have many patients who meet the criteria to be admitted in these two departments. A lot of the patients that come in, they do have COVID-19, they have flu-like symptoms etc, but they come because of a different reason. They may have a mild flu-like symptoms and they are COVID-19 positive, but they come in because they are pregnant, they come in because they have a fractured hip or it may be a gunshot wound, it may be an acute abdomen and as a result these individuals are treated at the Victoria Hospital because they do have COVID-19, they are COVID-19 positive as well. We have an active accident and emergency department because of the type of wave we have at this point. A lot of patients do come in because it's very Omicron variant, it's very transmissible, lots of patients come in, but some of them do get admitted and a lot of others actually can go home to complete home isolation. What we had to do at the Victoria Hospital is open a swabbing clinic. Now these clinics are something you would see at the primary healthcare level, the respiratory clinics, but we notice that the majority of persons or lots of persons after going to the respiratory clinics so many persons going to the respiratory clinics, they came to the Victoria Hospital and we try our best to assist persons and we could not say that you cannot come to the hospital for just swabbing because it's a hospital, we decided to open a swabbing clinic where we have a unit with persons where you can come to get registered and get swabbed, sent home and followed up thereafter. So that is something different from what we did in the fourth wave but because of the need in this wave we had to make that change to be able to facilitate the clients that are coming in. What we want to do as well is resume our medical outpatient clinic, that is something we had started in the earlier waves where we wanted to follow up the cases that have been discharged from the respiratory hospital. We all know that COVID-19 is a new illness and as a result we treat people in the hospital but we always wonder how are they doing after discharge? What complications? We wanted to make sure we have sufficient information about this new illness and the medical outpatient clinic allowed us to follow up our patients that were already discharged. With the Delta variant it made it a bit difficult for us to continue this because we had to have all our staff on board taking care of persons that were very unwell. At this point we want to resume our medical outpatient clinic so we can follow up our cases. We're also looking to do a physiotherapy outpatient clinic because a lot of the cases got COVID, got lung COVID and as a result we wanted to make sure that they have respiratory rehabilitation. So that is something we're going to start off or resume to allow our patients to be followed up. So we can have an idea as clinical persons the effects of the complications that happen after one is infected with COVID admitted and then discharged. So one would ask after saying all of these things Dr. Eugene, why so many deaths? Especially during the last wave. I mean during the last wave we had deaths and we had so many persons thinking if you come to Victoria Hospital you're going to die and although we are aware from our data which is what we go on we had more than 80% recovery of our patients who had been admitted but we had deaths and persons were very worried about the deaths and why come to Victoria Hospital when you come to Victoria Hospital, persons feel you were going to die. One of the things we can say for sure from our data that a lot of persons who came especially in the last wave who came to the Victoria Hospital and passed away were not vaccinated. We were aware of that. We looked at the vaccinated status of the patients that passed away and we noticed the large majority of them were unvaccinated. We also realized there was the delay in access or delay of coming to the hospital. It could very well be because what was circulating on social media I mean most persons were getting social media messages where persons were saying they're not enough staff, persons are going to come, you're going to die, do not come here and a lot of different things that really caused more fear and anxiety in the population. So a lot of persons were not coming to the hospital, they were staying at home trying to treat themselves despite the fact that their symptoms were getting really bad but they really wanted to stay at home because they had a lot of fear coming to the hospital. What happened is that some persons died at home, other persons when they really could not anymore they called the ambulance and they died on the way to the hospital. So when the ambulance brought them to the Victoria Hospital, they were actually dead. They were dead before arrival. We actually had people who died on arrival. As soon as they arrived they passed away or they crashed and we had to do CPR. We also had patients who came in so bad when it comes or they were so extreme in the symptoms or so critical that we had to move them straight from A&E and rush them into ICU or high dependency unit. That is because they came at a very late stage in their illness. When we spoke to family members, we found out that a person was sick for two weeks before or a week and a half before but they delayed coming in because of fear and they didn't want to die. So I think persons who came in earlier we realized we had a better clinical outcome from them because they came in earlier on and we could have done more for them versus those who came in very late who died on arrival or died before arrival or went straight into ICU using a lot of our resources and the clinical outcomes did not come out as we wanted it to be. Despite all of this and all of the complaints, we at the Victoria Hospital we sat down together and we said we need to make the experience of our patients and the family members of the patients better. If they are fearing or they have a lot of fear to come to the hospital we need to do the necessary to improve what we do as a hospital to ensure that they have a better experience as a patient and as a family members who are very worried about their loved ones being admitted in the hospital. We had improved callee communication services, especially the Wi-Fi. Family members can now speak to their loved ones straight from the ward. You can just log on and you can speak to them, you can FaceTime, you can Facebook, whatever you want you can actually speak to them. The physicians can now speak to the necks of kin regularly without any issues and that made it easier so the family members can get an update of how the patient is while they are admitted at the hospital. We've developed and reviewed our visitation policy as well as our drop-off policy. The visitation policy we've looked at it and we've always allowed persons to come in. We had more restrictions but now we're allowing persons to come in when we review. Persons have been there for one week or two weeks. We have women who came in to deliver and gave both. We have allowed a husband, the partner to come in. We allow family members of someone who have been in the hospital for a long period of time to come in to visit their family members. We know there are times they are patients who are at the end stage of their life. They're not doing well. We make our responsibility to allow the family members to come in at an appointed time where we allow them to go through with PPE to allow them to go to see their loved ones. We also noticed that there was so much difficulty in the family members viewing the body, especially if you have a family who is COVID-19 who died because of COVID-19. You realize that you cannot see the body thereafter. So what we did at the hospital is that although we'd have allowed one family member to go in to see the person at the hospital, we work along with the lab, the OKUH lab, as well as the federal palace to allow the body to be brought back to the Victoria Hospital morgue and that the rest of the family can come in at a later date to view the body of the loved one who passed away. In that way, the family have some degree of closure because not everyone could have come into the hospital to view the family member while the person was alive. All our patients that are coming in, we also give them tissue and water and if they do not have toiletries, we provide them with toiletries until the family members can bring their items for them at the gate. All of these things we did to make it more comfortable for our patients. We brought in a new cadre of staff called patient welfare assistants and these particular staff members are like patient advocates. They go to the wards, they help other patients. We have family members who come at the gate to drop off items. The family members may come in as well to pay for a particular test which is done at a different hospital or pay for something else and this patient welfare assistant work along with the family members and the patients to make their stay at the hospital more comfortable and that has worked well for many family members because they feel there is someone on ground who is in touch with the patient and in touch with them to make it easier for them as they wait for the family members at home. At this point, I think I need to thank every single nexofkin and I think the nexofkin and the majority of them have done a phenomenal job. They've been very excellent helping out the majority of the matters that deal with their family and we want to thank you for that but we will need you to assist us a bit more so we can make the stay more comfortable for your loved one. We want you to provide us with a correct number, whatever, wherever you are whether in the south, coming from the hospital in the south whether you're coming from another hospital in the north or a health center or you're coming to bring your patient in please ensure that you give us the correct contact number for you as the nexofkin and that is important. If you have another contact number and you want to leave two for us that would be well appreciated because it's very difficult for us at the hospital when we have difficulties in contacting the nexofkin. Sometimes it is so difficult that the physicians have to take the picture of the patient who's on the bed, who's alive or even a deceased patient send it to me and then we have to send it to our security chief or security supervisors who then will have to leave the police, the fire service or even go to the community and ask someone if they know this particular person because we cannot get the nexofkin simply because a number is your own we have a wrong number or the number is not functional so we ask in the nexofkin to ensure that you give us a functional number and if you have two numbers, we'd appreciate two numbers as well we also want the nexofkin to agree with the family members family members need to get along especially for the person who's been admitted please decide who will be the nexofkin because we do not want to be speaking to one nexofkin and then we have other family members coming in complaining that they do not know anything about the patient but that physician is already communicated with the documented nexofkin so we expect the nexofkin who's documented to be the one to be lazing with the different family members so that they can relay that information we do not want to be giving too much information out to different people about one patient so we encourage the family members to understand to work along with the nexofkin we also allow us asking the nexofkin if they can to bring in an ID of the patient who's admitted they can send it to us via email they can WhatsApp it to us it will be good for us as we try to improve our record keeping of the patient so we ask persons to bring in their ID cards or to send it to us via WhatsApp or email so we can have better charting of our patients our drop off services continue of course and we will let in persons know that we would like persons to drop off the breakfast for 7 o'clock in the morning 7am lunch at 12 and dinner at 5 it makes it easier for us to coordinate with ourselves to ensure that the food goes up on time to the patients on the ward we also ask the nexofkin to please try not to bring bulky stuff do not bring large cases of water bags of food electrical items and all of this so it is a lot we have to find a place to put it we have to take care of it and if for whatever reason your family members go deteriorate and the physicians need to run in and do CPR then it becomes difficult because there's so many items around the place it makes it difficult for them to be able to resuscitate so we are asking them to bring items 2 weeks supply of clothing toiletries face masks you can bring tea you can bring milk you can bring sugar mosquito repellents healthy snacks sanitary napkins you can bring your cell phones bring your charger these are some other things that we can deal with but try not to bring heavy items or electrical items that can affect us at the hospital we want to let people know that the government of St. Lucia has invested significantly in this facility and we the staff at the respiratory hospital will try our best to improve on the care that we give to patients but we will do our best but we want you to assist us by doing your part as well and together we can make the experience for patients and our clinical outcome we better thank you