When Michael Richmond looks back, he can vividly recall the early phase of Covid-19 and going on to a ward where patients had died.

“I think it would be the Easter weekend of 2020. It sticks out in my mind, going on to one ward with the chief of nursing.

“I think there had been three or four deaths during the night from Covid. Experience in hospitals, people die, but it was suddenly the gravity of the situation, about how quickly was this going to accelerate.

“In the early days, there was no immunity, there was no vaccination,” said Dr Richmond.

At the start of the pandemic, he added, there was also limited protective equipment and although the King Edward VII Memorial Hospital never ran out, it came close to it at one or two points.

“There was truly a fear and anxiety of staff that not only were they in the front line maybe to get an infection but how did that impact their own microsystem, in their own family, in their own children, in their own immediate contacts. Were they going to be a vector for their family to get infected?” said Dr Richmond.

“There was a lot of anxiety and fear. I think during the worst of times, people rose up to show the best of themselves. So it was stressful. It was stressful for the frontline staff, no question, but it was actually quite inspiring.”

Asked why, he said: “To see people who committed themselves. I think I now look back on that as a feature of the staff at BHB time and time again. When a challenge has been thrown at them, they have consistently delivered.”

On whether there had been any lingering effects from Covid, Dr Richmond added: “Did we have a long tail of physical illness post Covid? No, I don't think there was a long tail of physical illness, but what I do think, there was a sense of fatigue.

“I think there was a sense of exhaustion, if that’s not just repeating the same word. But I think there was a sense that their threshold for coping was now being challenged.

“So that reserve that people have when they're asked to do a bit extra, I think that got close to running dry.”

Dr Richmond was the Bermuda Hospitals Board’s chief of staff when Covid struck. He later became chief executive and president, a position he is leaving to take up a new post in Britain next year.

He said that one of the most challenging aspects of the pandemic was Bermuda’s position “at the end of the supply chain”.

“In very short order, our supply routes got cut off, particularly from the United States and for understandable reasons.

“This was something that was a quantum greater than we could have ever foreseen or afforded, really, but we made very, very quick plans to access more beds and they came in a timely manner.

“We also made some early orders and purchases for ventilators for intensive care.”

There was also incredible foresight in making an early decision to get back-up oxygen supplies.

He said the acute-care wing was “phenomenally well-serviced” by its ability to alter airflow, enabling the air to be confined to one room. “It's a unique design and that was a major benefit,” said Dr Richmond.

“The staff were phenomenal in their commitment and their forbearance through weeks and months and even years because it kept coming and going.”

Asked of the hospital would be able to cope if there was an outbreak now, Dr Richmond added: “Do we have the knowledge, the, let’s call it, the drug supply, the skill set? Yes, we've got that, but again, there is a limitation in capacity.

“So that always becomes the challenge. If there's an overwhelming outbreak of X, Y, or Z, any single hospital is going to be challenged. Again, we have a limited number of emergency staff, we have a limited number of intensive care staff, so anything which quadruples their work volume is always going to be a challenge.”

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