As a surge in Covid-19 cases hits Gauteng, South Africa’s biggest private hospital groups say they have not reached capacity in the province, despite being under immense pressure.
They add, though, that the situation remains “fluid”, and the critical care capacity of hospitals, in particular, is under stress.
This week, News24 reported that Gauteng’s state hospitals were also stretched in terms of capacity, with reports emerging throughout the week of patients being turned away from hospitals.
Gauteng health department spokesperson Philani Mhlungu said the system was under pressure, and that patients who needed to be admitted to facilities that were full would be referred to hospitals where there was available bed space.
In its weekly update on Thursday, the Gauteng provincial coronavirus command council said there were 8 301 beds available specifically for Covid-19 patients in private and public hospitals.
According to the provincial command council:
– Additional beds are being created in public hospitals in the province.
– A total of 1 575 beds, which will include 900 intensive care unit beds, are expected to be ready by the end of July.
– As of 1 July, a total of 3 091 people who tested positive were admitted to hospitals in Gauteng.
– 151 patients were being ventilated as of 1 July, and 493 were on oxygen in either ICU or high care units.
– A total of 2 447 patients were in general wards, of which 1 197 were on oxygen.
– As of 1 July, a total of 4 455 patients have been admitted to hospital for Covid-19, while 1 133 patients have since been discharged.
Jacques du Plessis, managing director of Netcare’s hospital division, said the group’s hospitals were experiencing an increase in demand related to Covid-19 patients, and that there was still space for Covid-19 and other patients in the critical and general wards.
“The situation remains extremely fluid and we are therefore continuously assessing the demand for hospitalisation of Covid-19 patients, PUIs (patients under investigation) and other patients in order to manage resources effectively in relation to changing demand.
“Should a situation present where one of our hospitals do not have capacity at a given time, patients will be transported to and accommodated in another of our hospitals which does have capacity,” he said.
Mediclinic’s chief clinical officer Dr Stefan Smuts said Gauteng’s hospitals are not full at the moment.
“However, it is important to note that Covid-19 tends to place increased demand on critical care resources particularly,” he said.
Smuts said: “Hospital bed capacity remains fluid and is liable to change. This dynamic situation is continuously monitored across all bed types and across all hospitals to ensure the optimal use of available resources and continuity of patient care.”
Life Healthcare said the hospital bed capacity was being monitored daily by a Covid-19 doctor committee, which worked in tandem with management.
“Life Healthcare hospitals in some regions are seeing increased numbers, but generally remain ready and able to admit patients under investigation (PUIs) and Covid-19 positive patients requiring hospitalisation. The bed capacity situation is fluid and is being reassessed frequently.
“Our hospital management teams remain in constant contact with one another, their doctors, and other healthcare professionals to ensure that additional beds are made available in the event that this is required,” said the group’s general manager, Dr Charl van Loggerenberg.
But, if the situation worsens, and Gauteng’s hospitals are unable to cope with the surge in cases, there are concerns that Johannesburg’s quarantine facility at Nasrec is not properly equipped to deal with very ill patients.
Gauteng Health MEC Bandile Masuku said on Friday the facility was only intended to treat stable patients, and it therefore does not have oxygen treatment supplies.
But this could change, he said.
“We are not ruling out the fact that we might have to escalate the service at some point,” said Masuku at a tour of the facility on Friday.
Last weekend, News24 reported that a healthcare worker was turned away from four different state hospitals, who were unable to take her in for nearly 10 hours. The 54-year-old woman was eventually hospitalised, and died on Thursday.
Her colleague, Dr Jenny Coetzee, said the health system is not coping under the strain of Covid-19 and the public is not fully aware of the seriousness of the situation.
Coetzee is Head of Prevention in Key Populations at the Perinatal HIV Research Unit at Wits University, and founder and CEO of African Potential Foundation.
“The concern for me is that the system is buckling,” Coetzee said.
And it’s not the fault of healthcare workers or paramedics, who are “hugely disempowered” and are taking great strain, emotionally, Coetzee added.
“There is a massive rush on hospitals and I think it’s happening faster than what the hospitals are ready for. And they are buckling under the strain.”
She said a massive, concerted national effort around non-pharmaceutical interventions was needed.
If the country waits around for pharmaceutical interventions, like a vaccine, it risks making the same mistakes that were made around HIV, which included focusing too little on prevention and too much on treatment.
“Our system will collapse completely. The infections that we are seeing now are the end of Level 4, at just the start of opening up Level 3 – so we are not even seeing the full impact of Level 3 yet. And your average person isn’t understanding the timeline – that there’s a lag before we see the implications of what we are doing.”
This week, News24 was told that several private hospital hospitals in Johannesburg were placed on divert status on Sunday evening, owing to a lack of capacity.
The major hospital groups – Life Healthcare, Mediclinic and Netcare – said the information was from a fake WhatsApp message doing the rounds on social media and that it was not true.
Netcare’s Du Plessis told News24 that the hospitals mentioned were open and taking admissions.
“What may happen on occasion is that, due to various reasons, for example, such as an unexpected staff shortfall, a hospital may be temporarily placed ‘on divert’ for emergencies, in which case, emergency medical services providers are notified and other hospitals in the area provide cover where needed.
“However, it should be noted that this practice has been in existence for many years. We furthermore confirm that emergency medical care will be provided to any person who presents at an emergency department with a life-threatening injury or condition,” he said.
Smuts, from Mediclinic, said any reference to Mediclinic’s hospitals in the message were false.
Life Healthcare’s Van Loggerenberg said it was not true that the group’s facilities were full. He said it was standard practice to put certain areas of care under “temporary capacity divert”.
“For example, should an EMS vehicle need to bring a patient with a brain injury to a hospital and the neurosurgeon on call is not available for immediate care, then all ‘neurosurgery’ medical emergency cases would be put on Temporary Capacity Divert and taken to the next nearest facility until such time that the surgeon has capacity.
“This does not necessarily mean that there are no beds available at the hospital, but rather that the high priority and best care needed is not immediately available.
“It is also important to note that Temporary Capacity Diverts are constantly in flux and can change at any point within a 24-hour period,” he said.