Welcome to a Cape virus ‘war room’, ready and prepared for battle
More than 200 health professionals have volunteered for training, preparedness drills and emergency rosters
The former smokers’ room at Life Vincent Pallotti Hospital in Cape Town has been transformed into a gleaming Covid-19 emergency centre.
With its own entrance, it’s ready for an influx of patients. A new ICU wing stands next to it, equipped, but empty, for now. Other wards have been emptied and set aside for Covid-19 cases.
Life Vincent Pallotti, in Pinelands, is not unique. Private and state hospitals across the country have been working flat out to prepare for a potential influx of Covid-19 patients, but it is ready. As ready as it is possible to be for an invisible enemy.
More than 200 GPs, anaesthetists and other doctors, who do not have rooms at the hospital, have volunteered for Covid-19 training, daily preparedness drills and emergency rosters.
The hospital has the potential to nearly double its ICU capacity, from 24 adult beds to 43 ICU beds, in a worst-case scenario, which would involve commandeering surgical theatres.
Infectious diseases specialist Dr Helen van der Plas, head of the Covid-19 task team at Vincent Pallotti, said they were engaged with the Western Cape government about a collaboration “when we surge”.
“We might be collaborating on a central bed list,” she said.
The Western Cape health department warned this week of a shortage of ICU nurses and at least 650 ICU beds, if the pandemic escalates rapidly to a peak.
Vincent Pallotti staff have gained confidence in coping with Covid-19, after successfully treating three patients. A 44-year-old man, who had been in ICU, was discharged last week, said ICU head Dr Hoosain Khalfey.
“People fear Covid-19 and initially there was some anxiety, but seeing patients get better and discharged is good for morale. The more (staff) have worked with patients, the more comfortable they have become,” he said.
Becoming comfortable does not mean the hospital team is complacent. On the contrary. Vincent Pallotti has stringent infection control measures in force from the moment you line up, on demarcated spots in the parking lot, to enter the premises.
The hospital started to plan for the pandemic at the end of January, long before the “national state of disaster” was announced, and has a hospital escalation plan, with dedicated Covid-19 teams, for the expected surge in cases.
When the first case was confirmed in SA, medical staff started meeting daily, but now they are back to twice a week, said Van der Plas.
“We have a multidisciplinary team co-ordinating the response. What’s been key is buy-in from hospital management, who have allowed us to take the lead,” she said.
“The hospital manager listens and implements decisions appropriately and timeously. From the staff there has been tremendous willingness to engage.
“I have never seen such goodwill and co-operation among different specialities before. We are having input from (specialist) societies and academics. We are not working in isolation.
“There has been huge goodwill among doctors, from Sea Point to Hout Bay.”
Khalfey said: “Anaesthetists have been training staff in intubation and being as safe as possible. [Dr] Adrian [Burger] has been coming in at seven in the mornings to do simulations on a mannequin.”
About 5% of the 20% of Covid-19 cases admitted will need critical care, which will burden resources, he said.
We have a dedicated ethics committee, including reputable older doctors ... who can help if there are difficulties deciding on who is suitable for treatment or not.Dr Helen van der Plas
In phase 1, the hospital will use the six-bed Covid-19 ICU; in phase 2, the surgical ICU, with at least 20 beds; and by phase 3, critically ill patients will go into theatres.
The hospital has procured additional equipment, including ventilators, cardiac monitors, trauma stretchers, a video laryngoscope and PPE.
Vincent Pallotti also has a huge palliative care team and a psychosocial support team on board.
“We have a dedicated ethics committee, including reputable older doctors not in the hospital and from UCT, who can help if there are difficulties deciding on who is suitable for treatment or not,” said Van der Plas.
Right now, the hospital is far emptier than usual, beds cleared for a potential Covid-19 surge.
Burger said: “It’s like sitting in the trenches in World War 1, constantly in a state of readiness.”