“People have to stop moving around, start wearing masks and avoid contact with each other.”
While doctors struggle to find beds for the desperately ill, Dr Mary Kawonga, chairperson of the Gauteng premier’s advisory committee on Covid-19, says human behaviour is fuelling the intensity of the third wave of infections in the province.
“There is a high level of transmission in the community. What is concerning to us is that people are moving around a lot. They are moving more than they did during the second wave. There is a lot of contact happening between people,” said Kawonga.
Some doctors in public hospitals are painting a bleak picture as infections soar, saying there are not enough beds, masks, medication and oxygen tanks at facilities.
Gauteng premier David Makhura welcomed 60 military health personnel who were deployed on Monday to help healthcare professionals in the province.
“The numbers are extremely high. There is no bed capacity,” said a doctor who works at Chris Baragwanath Hospital. He said he was on call and had to go attend to patients.
A doctor who works at Kopanong and Sebokeng hospitals said the situation was worse at Kopanong Hospital.
“There is an unavailability of masks and pharmaceuticals. We are seeing an influx of patients coming through,” said the doctor, who asked to remain anonymous for fear of victimisation.
She said there was not sufficient control of tested Covid-19 negative and positive cases as they were all in the same ward.
“Testing can take longer than expected and, because of the wait, it becomes a problem to accommodate all the patients.
“There is a patient who was misdiagnosed and put in the Covid-19 ward because he was coughing a lot, but it turned out he had cancer which had spread all over his body,” the doctor said.
She said while Kopanong Hospital was dealing with the influx of Covid-19 patients, there was no fogging system in place.
“When hospitals apply for oxygen it takes time. The companies are running out of oxygen supplies. You get a lot of patients without oxygen,” she said.
General practitioner Dr Sheri Fanaroff said part of the problem with bed capacity in Gauteng was that a facility like Nasrec, which would have taken the load off big hospitals, was non-existent.
“They had a facility for oxygen and about 1,000 beds that would have helped patients who can’t get into big hospitals. Charlotte Maxeke Hospital being closed is a massive strain on all the other hospitals. We don’t understand why it is still closed. We really need them to open it. Private hospitals are trying and have made a lot of adjustments over the weekend,” Fanaroff said.
Health MEC Nomathemba Mokgethi announced in February the closure of the Nasrec field hospital due to an expansion of the public healthcare system that had seen additional functional beds being added, and due to “evidence-based” scientific advice from the provincial modelling team.
“We have always been guided by science through the modelling team and by projections from the World Health Organisation in our comprehensive health response to the pandemic. The closure of Nasrec field hospital will not have a major impact in the treatment of Covid-19 patients,” Mokgethi said at the time.
She said her department had capacity to “operationalise” 4,265 functional beds through its hospital infrastructure.
“Bed overload within hospital clusters will be managed through internal transfers between hospitals to relieve areas of shortage within clusters,” she said.
However, in a post on Facebook Fanaroff said it had been “increasingly” difficult for Covid-19 patients to find a hospital bed, private or public, in the province.
“Ambulances wait with sick patients in parking lots outside the hospitals, trying to get a space for the patient in casualty. People struggling to breathe queue outside casualty hoping to get in for oxygen. These are people who have already been treated at home by their doctors, but have progressed past the point where home treatment can help them.”
She suggested that government open up vaccination to people over 50 who had comorbidities.
“I think the government should open vaccines to anyone over 50, particularly those with comorbidities. There are patients who are high risk who beg to be vaccinated.”
Dr Fatimah Lambat, who works at Ahmed Kathrada private hospital, said the third wave was putting a strain on healthcare workers as they now had to work longer hours.
“The third wave is worse than the first and second. Each doctor gets up to 15 to 20 patients a day. There are no hospital beds. Some patients sit in casualties for three days. We do not have capacity.”
She said they first try to treat patients at home until they secure a hospital bed.
“There are no beds. The situation is bad. I don’t think it is under control.”
Despite the high number of cases, Lambat said they were seeing a good recovery rate among patients.
Many people get the virus and don't know because they are asymptomatic. There are others who don't trust the government.
— Dr Mary Kawonga, chairperson of the Gauteng premier’s advisory committee on Covid-19
“The number one thing is early recognition of the inflammatory phase and early treatment during that time.”
She said Covid-19 symptoms were slightly different in the third wave.
“Patients are presenting with nasal and sinus congestion. You do get the coughing and fever but it looks like they are presenting a bit later.”
“People have to stop moving around, start wearing masks and avoid contact with each other, and avoid going to entertainment establishments,” said Kawonga.
“Restaurants are an issue because when you start eating you take off your mask and at that point there is a level of transmission.”
She said there was a misconception among people who had not had symptoms of Covid-19 and believed they were immune to it.
“Many people get the virus but don’t know because they are asymptomatic. There are others who don’t trust the government. They think government is lying and wants to control them.
“In other African countries, people believe if you are black you are not likely to get Covid-19 and if you are not rich you won’t get it.”
She said it was important for people to see the link between their behaviour and someone dying in hospital.
“It is because of their behaviour that we have 8,000 cases a day,” said Kawonga.
She said the advisory committee was monitoring the situation closely.
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