Hospital staff under sustained stress from a fourth wave of coronavirus infections will persevere but cannot be allowed to “max out”, the Bermuda Hospitals Board president warned yesterday.

Michael Richmond said that extra staff from overseas would ease the burden but the public had to do its part to help as well.

He explained that it was difficult to say when the King Edward VII Memorial Hospital would be overwhelmed "because we and our staff will keep going and doing our best come what may“.

Dr Richmond, also the BHB CEO, added: “It may be that certain areas such as critical care become more at risk before others, so it depends on numbers and acuity of patients and availability of staff.”

He said: “Hard numbers can exist in terms of beds, space and ventilators – and we would feel confident about our ability to manage at the moment if this was our only concern, but it is not.

“Our staff are already feeling the brunt of the current surge.

“This is relentless, emotionally draining and professionally demanding work and, even with redeployed staff adding to their ranks, many staff are already taking on additional shifts to make sure patients get the care they need.”

The latest figures, released by the Government on Monday, showed there were 54 people in hospital with Covid-19 and 12 were in intensive care.

David Burt, the Premier, said on Sunday that his office was organising a campaign to hire relief healthcare staff from overseas to “ease the demands on our nursing staff in particular”.

Dr Richmond welcomed the prospect of reinforcements in the fight against the pandemic – but that was only part of the battle.

He said: “If we do manage to secure more staff from overseas, this will help ease the pressure – but we still must do all we can to reduce transmission.

“The best and most effective option to save services, save staff and save the lives of our loved ones is for us each to get vaccinated and follow all the public health precautions.

“We can’t wait for the hospital staff to max out before we act as by then it will be too late.”

He said that staff workload was a “primary concern” for the BHB.

Dr Richmond added: “We are finding that the people in critical care with Covid-19 are very sick and remain very sick for days and sometimes weeks.

“We have the ability to increase our capacity based on space, beds and ventilators, but it is not so easy to scale up highly specialised and trained critical care nursing staff and the surge has happened very quickly.”

Dr Richmond said: “In the two weeks leading up to Friday, September 17, we went from seven to 51 Covid-19 admissions to KEMH – a 628 per cent increase – and from one Covid-19 patient in ICU to 13 – a 1200 per cent increase – and hospital admissions continue to go up.

“This is why we are working closely with Government and the Governor to look at options for bringing in mostly nursing staff to help us scale up and to help reduce the pressure felt by our existing critical, emergency and acute care nursing staff right now.”

He said that everything possible had been done to shore up manpower.

Dr Richmond added: “We are only able to manage the current numbers due to the cross training of some our surgical nurses, the redeployment of nurses with appropriate qualification from other services and staff who are already working extra shifts.

“In previous surges, even in the Alpha variant spring surge where hospitalised numbers reached a peak in the mid-40s, this was enough to manage.

“The Delta variant is much more infectious than the Alpha variant, the escalation is higher and we are seeing more very sick people, most of whom are unvaccinated.

“The pressure has been sustained now for two weeks.”

Dr Richmond emphasised that maternity services were running as normal and strict precautions were enforced to ensure mothers and newborns were safe.

He said: “Despite the challenging environment, pregnant women should be reassured that they will be very well cared for and supported.

“We are extremely grateful to all our staff and their continuous effort to care for all who need it, both those with Covid and those with non-Covid medical needs.”

He was speaking after he announced last Friday that the BHB had moved to Disaster Alert Level 4 – the highest.

Dr Richmond confirmed yesterday it was the first time the highest category of the alert system, introduced last year, had been reached.

He said: “This is certainly the most pressure we have been under since the start of the pandemic, with the highest number of hospitalised patients and the highest number of critical care patients at any one time.”

A Ministry of Health spokeswoman said last night that nurses involved in case management or work at the airport were not usually employed in the hospital’s emergency or acute care units.

She explained: “Public health nurses and retired nurses fulfil core public health functions at the borders and in Covid-19 case management.

“Based on a continuous needs assessment, these nurses are allocated to the appropriate setting according to their skill set and experience.

“These nurses who have been assisting are not ICU / emergency room / acute care nurses from the hospital.”

• UPDATE: This article has been updated to include comments from a Ministry of Health spokeswoman.