Public ‘in the dark’ over how bad SA’s Covid-19 hospital horror ...

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Public ‘in the dark’ over how bad SA’s Covid-19 hospital horror really is

Medical watchdog warns there aren’t enough ICU beds for current patients, let alone the impending escalation

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A critical care health worker at the entrance to the Charlotte Maxeke Hospital cardiac intensive care unit, which has been transformed into a Covid-19 facility.
Stark reminder A critical care health worker at the entrance to the Charlotte Maxeke Hospital cardiac intensive care unit, which has been transformed into a Covid-19 facility.
Image: Sebabatso Masomo

As more South Africans succumb to Covid-19, their chances of being admitted to hospital are becoming slimmer. Gaining knowledge of what is going on inside these hospitals is even less likely.

As wards fill up, some hospitals have had to turn Covid-19 patients away, according to SA Medical Association (Sama) chairperson Dr Angelique Coetzee, who warned that the public was in the dark about the state of health facilities.

The problem, she said, was that there were few Covid-19 beds available, and because there was no proper daily update on bed occupancy in public and private hospitals, there was little information about how dire the situation was.

According to Sama, Ekurhuleni and Johannesburg hospitals had the lowest number of Covid-19 beds available. This is a problem when considering Gauteng recorded the second-highest infection rate (45,944) after the Western Cape (64,377) on Thursday.

“The reason people don’t know how bad hospitals are is because Covid patients cannot be visited in hospitals by family or friends. These people were the whistleblowers – they would tell us if there was an issue with the hospitals.

“Now we have to rely on doctors and hospital staff for that information and they are telling us there are not enough beds for the sick.

“There are hospitals in Johannesburg where [Covid-19] patients are lining up in the corridors getting treatment. Many of them are very ill.

“Private hospitals in the city are nearly full up and once they [have reached capacity] patients will be sent to public hospitals, which are already full. We always thought when public hospitals were full the spillover could go to the private hospitals, but it’s going the other way around.”

Private hospitals in the city are nearly full up.

Sibongiseni Delihlazo, spokesperson for the Democratic Nursing Organisation of SA (Denosa), said the organisation was concerned about the availability of beds for Covid-19 patients.

“Our members are reporting a huge influx of Covid-19 patients into facilities, including facilities whose staff have not been taken through any drills or workshops on how to care for a Covid-19 case.”

Delihlazo was also concerned over a shortage of nursing staff and warned that new field hospitals would fail if there was nobody to staff them.

One of the complaints to Sama, seen by Times Select, was from a doctor at the Sebokeng hospital.

“I am concerned about the current state of our hospitals ... not specifically Sebokeng.

“My friends and colleagues working in internal medicine are completely overwhelmed and understaffed ... We have no information about what the current disaster plan is and I’m sure we are currently in a disaster.”

Meanwhile, on Thursday morning, Charlotte Maxeke Hospital in Johannesburg received 29 new ICU beds at the cost of R5m to handle the spike in coronavirus cases. The hospital’s 17 Covid-19 wards had reached a combined 80% capacity and the new beds, donated by First Rand Group’s SPIRE Covid-19 support fund, more than double the existing ICU capacity.

One of 29 new Covid-19 ICU beds at Charlotte Maxeke Hospital.
One of 29 new Covid-19 ICU beds at Charlotte Maxeke Hospital.
Image: Sebabatso Masomo

Prof Mervyn Mer, a principal specialist in critical care and pulmonology at the hospital, said there had been an escalation in new Covid-19 cases just last week. The hospital already had 250 Covid-19 patients in its care.

Speaking on condition of anonymity, two doctors at the hospital said 11 doctors had tested positive for the virus this week. One of the doctors, who works in critical care, said they had more than 60 medical professionals test positive since the start of the virus in SA.

We have two patients who came in here without the virus and they are now positive for Covid - they got it here.

A second doctor said he had become uncomfortable with the number people coming into the hospital daily.

“Come and see the queue into the hospital every morning. These people get screened when they come in, but meanwhile they stand on top of each other in the queue, no social distancing.

“We have two patients who came in here without the virus and they are now positive for Covid – they got it here.”

Sama’s solution was a dedicated Covid hospital, proposed by the Universal Healthcare Foundation, to pick up the spill-over from Gauteng hospitals.

The association had already earmarked the Gallagher Convention Centre in Midrand as the best choice for this hospital.

Sama sent a proposal to the Gauteng and national health departments to establish the Covid-19 Cecilia Makiwane-Gallagher Critical Care Hospital, and is awaiting a response to begin work on it.

The problem, Coetzee said, was that it would take four weeks to build and with the rate of infection the hospitals didn’t have the time.

According to the proposal information, sourced by the Universal Group Actuary and the Actuarial Society of SA, SA needs more than 7,000 additional critical beds, with a combination of oxygen, non-invasive ventilators and invasive ventilators.

And should SA follow European and US (New York) trends, we could have 10 patients fighting for every critical care bed in future.

Said Coetzee: “We’ve had three and a half months to get this right, and we were busy celebrating low case numbers compared to the Western Cape while forgetting basic microbiology again: that Gauteng’s ‘flu season’ is two weeks or more later than the Western Cape’s.

“Gauteng still does not have a provincial dashboard of available ICU beds to have a picture of where capacity lies. I know it was discussed this past weekend and is to be implemented going forward, but if we claim we were planning and preparing, why didn’t we just set this up?”

• The national health department had not responded to questions at the time of publication.