All private hospitals in Nelson Mandela Bay have suspended non-urgent surgeries and admissions and two are bringing staff from other provinces as facilities are hit by a double crisis – an increasing number of healthcare professionals falling ill and a rising demand for high-care and intensive care beds.
Premier Oscar Mabuyane said on Monday 22 June that 15,751 people in the Eastern Cape had tested positive for the coronavirus. With 8,035 people having recovered that left 7,716 active cases and 285 deaths.
The province’s biggest metro, Nelson Mandela Bay, had 4,706 positive cases, of whom 2,116 had recovered and 86 deaths.
Professor Lungile Pepeta, the dean of the Department of Health Sciences at Nelson Mandela University, said the community in Nelson Mandela Bay needed to join forces and fight the pandemic using all their combined resources.
“We are perishing in our silos,” he said. “Some private hospitals are full and others are filling up. People with medical aids have to look for help at the state hospitals. The state hospitals will be full soon. In 10 days we are going to need maybe 100 ICU beds in the metro – where are we going to find those?”
He proposed the urgent establishment of an operations committee for the metro, joining business, healthcare facilities, civil society, the university and the labour unions.
“We must get the expertise of the private colleagues to set up the right systems for us. This is not a time to be negative, but we all know we don’t have the right systems. We need collaboration and cooperation – and we need unity.
… the main driver of infections in the metro remains poor adherence to precautionary measures like washing hands, wearing a mask in public and maintaining personal distance.
“The only way to get the infections down will be through behavioural change and the education of communities. People will have to accept that our hospitals won’t be able to accommodate everyone. We don’t have enough ICU beds. When there are 10,000 cases, where are we going to find the beds?
“The reality check is you can fly in ventilators, you can get them donated, but the key thing is that you cannot donate human resources for health. My main concern is the doctors and nurses who must manage these patients. You can get the personal protective equipment donated, but where are you going to find the doctors? How are they going to manage the patients who need critical care? That is our biggest blind spot. By now we should have shifts and names in place.
“This is not the time for a silo mentality. People from Nelson Mandela Bay must join forces to fight this war for the Bay,” he said.
“We should establish a committee and meet every day – a united front. We are beyond the stage where they can bury the truth. We don’t have time to waste to blame each other. This is not the time for a blame game.
“We don’t have time for political nonsense. I never know what they talk about half the time, in any event. We must get our own people together and use our own expertise to save ourselves.”
He said he had 40 highly trained nursing students ready to start helping.
“I have called back my final-year nursing students. They are young. They are low risk. They have high energy levels and they want to make a contribution. They want to tell their children they were helping their people during a pandemic. They are keen to become part of history.
“Our Emergency Medical Services students are ready to work on the ambulances. I want to get these youngsters the right PPE [personal protective equipment] and put them to work. But now I have to look for someone to discuss this first. I don’t want to do that. We need to be able to move faster.
“The current doubling rate is 10 days and this will get shorter. Hospitals are already turning people away because there are no beds.”
Eastern Cape Department of Health spokesperson Sizwe Kupelo said the main driver of infections in the metro remains poor adherence to precautionary measures like washing hands, wearing a mask in public and maintaining personal distance.
He said they had managed to reduce the testing backlog in the province and now had a turnaround time of between 48 and 72 hours. Last month it was between 14 and 21 days.
According to the latest statistics issued by the Eastern Cape Department of Health, 224 people who had tested positive for the coronavirus were in hospitals in Nelson Mandela Bay. Of these, 123 were at private hospitals and 101 at state hospitals. Another 148 needed hospitalisation while awaiting their test results. Of these, 41 were in private hospitals and 107 at state hospitals. There are currently 35 patients in the intensive care units across state and private hospitals.
All elective surgeries and non-urgent admissions at Netcare Greenacres Hospital in Port Elizabeth and Netcare Cuyler Hospital in Uitenhage were cancelled until further notice except where this would be detrimental to the patient in an effort to free up beds in the hospitals’ high care and intensive care units.
Andre Bothma, area general manager Eastern Cape of Netcare’s hospital division, said the decision was taken after the Eastern Cape Department of Health announced during a briefing session on Friday 19 June that the number of Covid-19 positive persons in the province had doubled over the past 10 days.
“In anticipation of a surge in Covid-19 persons requiring hospital care, we have taken the decision to suspend admissions for elective surgery at both Netcare Greenacres and Netcare Cuyler Hospitals in order to free up ICU and high care beds which would otherwise have been used for patients after their elective surgery,” Bothma said.
He added, however, that the hospital would continue providing care to patients with life-threatening conditions or injuries.
Riaan Croucamp, the regional manager for Life Healthcare hospitals in Nelson Mandela Bay, said Life St George’s Hospital currently has 33 ICU beds available specifically for Covid-19 patients as well as 44 ventilators and 87 monitors.
He said the two Life Healthcare hospitals in the metro, St George’s Hospital and Mercantile Hospital, can still admit Covid-19 patients.
“We have limited theatre cases to emergency and semi-elective cases only. Available staff is a major constraint on the numbers of patients that can be cared for. However, we are working with agencies and our hospitals in other provinces to assist with staff resources. ICU beds are at a premium throughout the region.”
Croucamp said they were bringing staff in from provinces that have not been hit by a surge in infections, and were in discussion with the Department of Health about collaboration options with provincial facilities.
He said 59 employees at Life St George’s hospital had tested positive for coronavirus infections.
“Of these, 27 have recovered and have returned to work so far.”
According to the latest statistics issued by the Eastern Cape Department of Health, 224 people who had tested positive for the coronavirus were in hospitals in Nelson Mandela Bay. Of these, 123 were at private hospitals and 101 at state hospitals. Another 148 needed hospitalisation while awaiting their test results. Of these, 41 were in private hospitals and 107 at state hospitals. There are currently 35 patients in the intensive care units across state and private hospitals.
The first phase of a field hospital sponsored by the German government will be opened in Nelson Mandela Bay on Tuesday and will provide another 1,485 beds and eventually 3,300 beds.
The head of the health department, Dr Thobile Mbengashe, said the Nelson Mandela Metro had a total of 387 beds available and 34 ICU beds.
Health spokesperson Kupelo said there was currently no official private/public partnership agreement between private hospitals and the Eastern Cape Department of Health, but they were working together.
Doctors who work in the public sector have expressed their fears that due to a dire shortage of nurses, hospitals will not be able to open more intensive care beds.
“We are very concerned that there soon will be no more space to admit the very ill, whether they have Covid-19 or another severe disease,” one doctor said.
“People will be dying without us being able to help them. The number of trauma cases has increased dramatically and this has put further strain on our limited resources.”
Mabuyane said 763 health workers in the province had taken ill with Covid-19.
The first phase of a field hospital sponsored by the German government will be opened in Nelson Mandela Bay on Tuesday and will provide another 1,485 beds and eventually 3,300 beds.
Kupelo said the provincial government will operate and manage the hospital and provide medicine and personnel for this hospital until March 2021.
Mabuyane added that there had been 73 culpable homicide cases, 236 murder cases, 1,066 serious assault cases, 135 attempted murder cases, 109 drunk driving cases, and 291 rape cases opened in the province since the ban on alcohol sales was reversed.
“Alcohol has been found to be the causal factor in the commission of these crimes.” DM/MC
This article appeared in the Daily Maverick on 22 June 2020, written by Estelle Ellis.