Early signs of infection slowdown in some hotspots as ICU bed availability takes strain

As other hotspot provinces are beginning to show signs of a slowdown, Gauteng is not yet out of the woods, the latest data suggests.

In the first three weeks of the year, hospitalisations nationwide appeared to be stabilising, going from 13,332 in the first week to 8,911 in the second week and 8,932 in this, the third week.

Of the 16,909 Covid-19 patients currently hospitalised, 5,424 are on ventilators.

Last year, the government initiated the manufacture of 20,000 ventilators as a massive shortage of the equipment was predicted during the first wave.

The latest figures by the Institute of Communicable Diseases (NICD) showed signs of a healthcare system in distress in Gauteng, Kwa-Zulu Natal and the Eastern Cape, where hospitalisations were catching up to dwindling bed availability, especially in intensive care units (ICU).

In KwaZulu-Natal where 31,285 cases had been hospitalised to date, 4,084 were currently admitted.

The Eastern Cape’s current Covid-19 admissions stood at 1,503, having admitted 26,531 since the beginning of
the pandemic.

In Gauteng, of its 46,575 cumulative hospitalisations, 5,058 were currently admitted. ICU units housed 1,024 of these patients on ventilators.

According to the institute’s public health specialist, Dr Waasila Jassat, the latest report showed that while the second
wave had affected all provinces, weekly cases, admissions and deaths were higher in the second wave than the first.

Some provinces, however, had begun to show a downturn, including Eastern Cape and Western Cape.

She said the relatively lower ventilation numbers could be due to a lack of available information or a lack of availability.

“Ventilation is for patients with severe disease. Ventilators are not always available in all settings and the distribution is different in the public and private sector, and between different hospitals.

“The data on the number of patients ventilated is what was reported on Datcov. There could be underreporting.”

While it was unclear when Covid-19 cases would peak in Gauteng, the infection rate nationally was expected to peak
in November, according to the latest NICD Covid-19 modeling data.

Epidemiologist Dr Jo Barnes suggested this meant that it was still too early to end Level 3 of the national lockdown, though it could be de-escalated to just hotspot provinces in the next few months.

This was because hospitalisation numbers were not necessarily higher than in the first wave, but the virus was spreading faster than before, indicating that the second strain was a more virulent variation.

Whether it was deadlier, she said, had yet to be proven but early indicators such as lower death rates than during the
peak of the first wave suggested this was unlikely.

“There isn’t necessarily a higher percentage of cases being hospitalised, but certainly we will see a higher demand emerging in the coming months.

“It’s very likely that this surge we are seeing is because of the second strain and we are seeing that it is not necessarily killing people faster but it is certainly spreading fast.

“What we are seeing now is the huge increase we saw from November and December and it was not just the second wave, but possibly the first wave of the new variant.”

According to Barnes, the slight slowdown shown in the number of cases in the first few weeks of January were likely a
beacon of false hope as testing tended to slow down over the weekends and at certain times of the month, leading to random upticks and slowdowns.

The Gauteng health department added 2,419 new beds in the public sector since May 2020.

These included 500 critical care beds and 1,900 general beds.

“An additional 775 ICU beds were created with alternative building technologies and were being equipped with personnel and health technologies.

“Of these 775 beds, 375 will be fully equipped and staffed before the end of January 2021”, the department said in its latest report.

The department said 150 of these would be ready at the Bronkhorspruit Hospital before the end of January.

The Nasrec Field Hospital had space for 500 quarantine beds and 500 high care and ICU beds as of last week, but the occupancy was low.

An additional 500 ICU beds with oxygen had been activated.

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