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THREE hospitals have reported a downward trend in the number of COVID-19 patients, even as the country anticipates a possible fourth wave of the novel coronavirus.The health-care facilities are Mandeville Regional Hospital in Manchester, National Chest Hospital in St Andrew and Princess Margaret Hospital in St Thomas.In the House of Representatives on Tuesday, Prime Minister Andrew Holness said the Government expects and is preparing for a possible fourth wave of infections, which is likely in January, just after the Christmas season.Noting that the COVID-19 cases are trending downward at the Mandeville Regional Hospital, Chief Executive Officer Alwyn Miller said, "What we find is that every time it trends down, it will remain within a certain band for a week and then probably go down a little more. We are watching it and hope it will go even less."Up to yesterday, Miller said that there were six confirmed and 10 suspected COVID-19 patients, which he said is a significant decline when compared to the ending of last month when there were a little over 20 COVID-19 patients.But, Miller said while there are fewer COVID-19 patients, the hospital is still operating at full capacity."I think the front-line workers have gotten a little break and given that the daily influx that we had in July and August; they are not seeing that as much but certainly we have many other patients who are here. We still have a full hospital. Today [yesterday] we have 232 patients so we still have a full hospital and the staff are fully occupied," he said.At the same time, CEO at National Chest Hospital Dwayne Francis said at the facility, "We are not doing badly at this time.""We are not seeing any significant surge. From what we have seen over the third wave, we are significantly lower than what we are at."Although he was not able to state the specific number of COVID-19 patients at the facility, Francis said when the surge of COVID-19 patients started in August they had 26 positive cases, which increased to more than 100 patients in September going in to October.He said based on his observations, there are now less than 100 COVID-19 patients at the facility."We would like to see a continuous reduction in the numbers and we would like to see persons adhering to the COVID-19 policies and taking the jab where necessary and help to reduce the COVID-19 numbers that we were seeing. Now that we are going into a fourth wave, we would really appreciate our country going back to a sense of normalcy," he told the Observer. A similar concern was shared by Melecia Linton, CEO of the Princess Margaret Hospital."There are more discussions centred around a fourth wave for the ending of the year to early January and, so we are keeping that in mind and trying our very best to prepare for the surge," she said.According to Linton, the hospital has nine confirmed and 17 suspected COVID-19 patients."From the middle of October coming into November, the numbers would have remained stable for the most part this has caused us to be managing patients from only one area. At Princess Margaret we have two COVID-19 wards, but as a result of the decline, we are only managing from one space now," she explained.She also added that the accommodation of less COVID-19 patients has resulted in a reduction in oxygen consumption.Linton urged Jamaicans to continue following the COVID-19 safety protocols and to get vaccinated."The truth is that COVID-19 will remain with us for a while and while we may see fluctuation in the numbers, we need to get back to some normalcy so that there is some certainty in managing our health system," she said.