'We fear Covid-19 is overshadowing other health problems': group of doctors write to president

A group of 38 medical practitioners has penned a letter to President Cyril Ramaphosa saying they are concerned the Covid-19 pandemic response is overshadowing non-Covid-19 health care problems.

The five-page letter warned that the government’s approach of having hospitals cut back on services and surgeries, discharge some patients earlier than usual and even temporarily close entire hospitals, was detrimental.

“There is a fine line to be navigated between preventing and causing harm and we fear that we are inadvertently causing much harm to our non-Covid health care seekers. The long-term sequelae of such actions are profound and far-reaching, especially in our resource-restricted system,” read the letter.

The doctors said for the first time in their medical careers many patients are avoiding voluntary access to health care because they are more scared of contracting the virus than facing the repercussions of neglecting their other health care conditions.

“Some pregnant mothers are avoiding antenatal care bookings, many children are going without immunisations and a large number of patients with chronic comorbidities are not presenting for necessary follow-up.

“In SA, approximately 446,544 people die each year due to non-Covid-19 causes. That equates to 1,223 deaths every day. TB, for instance, kills on average 120 South Africans a day, influenza and pneumonia 116, hypertensive diseases 144, diabetes mellitus 78 and cerebrovascular disease 92,” the doctors say.

In addition, they argue that the case fatality ratio of Covid-19 may be even lower than reported as many infected patients — both asymptomatic and symptomatic — are never tested.

“As SA doctors we are familiar with the huge morbidity and mortality due to a lack of cancer treatment, long waiting lists for urgent surgery, lack of life-saving treatment modalities for various health care conditions and even shortages of essential medicines. We are familiar with working in a financially constrained health care system and fear the situation may worsen dramatically post Covid-19 due to the inevitable economic crisis in our country.

“We will be left with a larger disease burden and a smaller health care budget to provide care with — ultimately resulting in a massive increase of morbidity and mortality for both Covid-19 and non-Covid-19 health care users,” the doctors say.

This, they predict will lead to many other health care crises that SA may never recover from.  

The group is “urgently” requesting government Covid-19 decisionmakers, and those implementing these decisions, to thoroughly consider the knock-on effect that every decision has on non-Covid-19 health care.

They also advocate that an independent group of epidemiologists, public health and infectious disease specialists, doctors, economists, statisticians, data specialists and other key role players representing non-Covid-19 health care be established.

They suggest that this non-Covid-19 health care advisory committee work parallel with the Covid-19 ministerial advisory committee to achieve the best health care outcome for the country.