Healthcare staff running out almost as fast as beds

Beds are in short supply, and now hospitals run the risk of running out of nurses and other critical staff, unions have warned.

This comes as Covid-19 infections among healthcare workers increase to the point of asymptomatic officials even being asked to return to work despite their positive status.

Meanwhile, with hospital beds in high-rate provinces such as Gauteng already running out, a healthcare crisis was feared to already be in motion.

The Charlotte Maxeke hospital in Johannesburg saw the unveiling of a shiny new 29-bed critical care unit on Thursday, which will hopefully go some way toward relieving the strain on the province’s systems due to the virus. But while this unit, and the makeshift field hospitals set up across the country may provide the beds needed to accommodate the sick, questions about who will care for them mount.

At Helen Joseph Hospital,  503 out of 2026 workers were tested, with 151 workers testing positive for the virus. This is in addition to 287 patients who were being treated for the disease at the hospital.

The Young Nurses Indaba Trade Union (YNITU) warned that infections and deaths of nurses were being kept secret and were on the rise. According to the union’s deputy president Fikile Dikolomela-Lengene, reports on the ground indicated a death at Yusuf Dadoo Hospital, one at Chris Baragwanath Hospital, and one at Leratong hospital.

“Through all of this nurses are still brave enough to wake up in the morning and keep soldiering on,  still vowing to treat patients. All we are asking is for government to treat them well.” Lack of correct personal protective gear (PPE), lack of access to testing, and general poor working conditions are some of the reasons the union gave for the high infection rate.

Nursing union Denosa has called on government to act swiftly to curb the spread of the virus among healthcare workers, warning that there was no contingency plan to deal with the threat of masses of workers rendered sick and unable to work and even dying.

Denosa Secretary General Cassim Lekhoati said the union was concerned that coupled with diminishing resources, conditions for optimum healthcare for patients was diminishing in tandem with the deteriorating situation of the workers.

“Looking at the capacity issues, we are soon going to have a problem of a high number of admissions in critical areas and nobody to look after them,” said Lekhoati. Hospitals are being forced to send patients home at a higher rate and even more worrying, are the choices staff had to make between saving one patient over another because of a lack of equipment.

“I wouldn’t say we are sending people to go home and die, but what happens in the hospitals for instance, you may find yourself having to prioritise one over another who is less critical, but in other instances it can mean giving a ventilator to one patient and leaving another to possibly die.”

Denosa’s concerns were echoed earlier this week, in a report by Oxfam South Africa, which found that nurses, which make up 77% of South Africa’s healthcare sector, were underpaid for the work and hours put in.

The report found that some nurses can work up to 24 hours without a break, due to a shortage of professional nurses, which existed long before the virus even existed, with only half the number being employed between 2012 and 2016 as compared to the period of 2006 and 2012.

READ MORE: SA’s healthcare system is broken, and neglecting its workers

The healthcare system saw a further strain due to the continuous budget cuts in the national health department.

A clinic in the South of Johannesburg had 27 workers who were confirmed positive for Covid-19, according to a nurse at the facility who could not named. Living out her last few days of self-quarantine, the worker was angry and disappointed in the Department of Health and the National Institute of Communicable Diseases for not implementing policies which protected workers.

While she was quarantined, others at the same facility continued their duties, because according to their employer, being asymptomatic meant that they could continue to report to work.

“We are scared for our lives and are dealing with an employer that does not understand and care for our needs. How can you say that a nurse who is sick must be exposed to patients and the community. You may find that many healthcare workers are carrying this virus to their homes and into the taxis they use every day and they are telling us to continue to work?”

The 34-year-old breadwinner said she was offered a stay at a government quarantine facility, but opted to self-quarantine because of the rumours she has heard about how cold those facilities are.

At the Leratong Hospital in the West Rand, conditions were also cause for concern, with at least 65 positive Covid-19 cases among healthcare professionals being suggested earlier in the week.

In a Whatsapp group message from one unit head at the hospital to her staff, it was stated that four doctors and three nurses in the casualty department had tested positive for the virus by last weekend. The internal medicine department had seven positive doctors and 18 nurses, pediatrics had one doctor and four nurses, three doctors and two nurses in general surgery, one ophthalmologist, two psychiatrists, two psychologists and six nurses in the psychiatric department, and one doctor and two radiologists in the radiology department.

Six National Health Laboratory Services staff members working at the hospital also apparently tested positive.

A source within the surgical department on Thursday claimed that important surgeries are being delayed due to the high number of surgeons at the hospital having tested positive for the disease.

On Thursday Gauteng health MEC Bandile Masuku said he expects Gauteng cases to reach 300 000 by August. Masuku also told journalists that hospitals had already reached capacity and warned that over the next few weeks, overcrowding would become an increasing issue.

This week Gauteng also overtook the Western Cape as the country’s coronavirus epicentre, when the province’s numbers of active cases surpassed those of the DA-run province.

READ MORE: Gauteng buckles under infections

According to the latest statistics, as of 2 July, Gauteng had 49 937 confirmed cases of Covid-19, of which more than 3000 had resulted in hospitalisation.

Of those, 12 957 people had recovered, while the official death toll stayed at 282.

This left Gauteng with 36 698 active cases.

Of the total confirmed cases on 1 July, 22 388 were recorded in Johannesburg, 9 845 in Ekurhuleni and 7 235 cases in Tshwane. Gauteng Health did not release numbers for 2 July at the time of going to print.

Meanwhile, the Nasrec Expo Centre, which is being used as a quarantine and care facility, recently opened its doors on 15 June, according to department spokesperson Philani Mhungu. Initially supposed to house 2 000 beds, the facility is currently housing 88 patients and has 470 beds.

Simnikiweh@citizen.co.za

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