"We will not get to that alarming position"

Wednesday 20 May 2020

Guidelines drawn up to help doctors decide which covid-19 patients should get life-saving care if the hospital is crippled by virus cases are no longer needed, the Health Minister has said.

Deputy Richard Renouf said the fact the island has successfully flattened the curve of infection means that its health service will not get to the “alarming position” where they have to use the Ethical Framework.

Published just last month, the guidance document was developed by Jersey’s most senior clinicians to help doctors with “prioritising patients for care and rationing scarce resources”, should it become impossible to help everyone with covid-19 in need.

The “guiding principle” of the framework, which had full political backing, was that patients with “higher clinical likelihood of benefit” would be given precedence over those less likely to make a full recovery or enjoy a longer life expectancy.

This means that, in a worst case scenario, patients deemed to have a lower chance of survival could have a ventilator withdrawn from them or be moved from the ICU in favour of someone else.

Pictured: Doctors might never need to invoke the ethical framework, Deputy Renouf said.

But Deputy Renouf says the measures imposed by the government now mean it's unlikely there will ever be a need for the guidelines.

“As a result of all our preparations, the risk of someone dying from covid-19 has been greatly reduced,” the Minister said. 

He went on to say that it had never been part of the Government’s strategy to “accept a certain number of deaths”, adding that they had nonetheless had to plan for deaths.

“We have produced an Ethical Framework, which I acknowledge created a variety of different emotions, but we did that at the request of clinicians at a time we faced the possibility of a steep curve in the infection rate.

“It was difficult to make that preparation, but it was right to do so and I think we are in a position where we trust now, we will not get to that alarming position of having to invoke an Ethical Framework.”

Deputy @JessePerchard is now asking the Chief Minister, @John_Le_Fondre to develop and implement a new ‘COVID-19 elimination strategy’, including a detailed plan of action with a focus on eliminating the virus in Jersey. (1/4)

READ THE PROPOSAL HERE: https://t.co/eT7LGPxIJ2

— States Assembly (@StatesAssembly) May 19, 2020

The comments were made as the States Assembly was debating Deputy Jess Perchard’s proposition for the government to pursue an elimination strategy.

The St. Saviour representative’s proposal asks that any elimination strategy must include rapid case detection by widespread testing, continued intensive hygiene promotion, a coordinated communications strategy, “intensive physical distancing that may include various severities of lockdown”, and “border controls with high quality quarantine of those arriving in Jersey." 

She argued that her proposals aimed to "build upon" the good work done to flatten the curve so far, rather than taking the government in a different direction altogether.

Deputy Perchard also explained that she had extensively researched her proposals, speaking to islanders, business leaders and medical professionals about them, and quoted a letter from a GP backing the idea.

The Chief Minister @John_Le_Fondre is now proposing changes to @JessePerchard's COVID-19 elimination strategy proposal. (1/2)

READ THE PROPOSAL HERE: https://t.co/FnBWh7tARM

— States Assembly (@StatesAssembly) May 19, 2020

The Chief Minister, Senator John Le Fondré, has published a series of amendments to the proposals, which Deputy Perchard said changed the nature of her own.

Several Members spoke in support of the amendments, but welcomed the opportunity to debate the government’s strategy.

Some highlighted that a stricter lockdown would be damaging to islanders’ wellbeing as well as the economy. 

The majority of those who spoke yesterday, including Deputy Perchard herself, praised the government for the measures implemented so far, which have led to a vast reduction in the number of new cases.

Members also said there was no reason to depart from the medical advice which has steered the island so far.

The debate will continue today.

Pictured top: A hospital theatre converted into an Intensive Care Unit.