SA scrambles for vital supplies to fight Covid-19 surge

SA is in a life-or-death race to secure essential medical equipment before a surge in Covid-19 patients is expected to hit hospitals in about 10 days' time.

State suppliers are scrambling to secure ventilators, masks, gloves, respirators and sanitisers from local and international manufacturers. But with delays of more than three weeks due to global demand, there are fears deliveries might be too late to save some of the pandemic's victims.

While the health department says it has sufficient supplies "depending on the number of people who succumb to Covid-19", spokesperson Popo Maja said plans were in place to fly to countries that could supply medication and medical equipment.

"We will go. By whatever means we will fetch the supplies that are needed," he said.

Maja said the department was talking to China, South Korea, Cuba and Singapore. "They have committed to assisting us."

Professor Alex van den Heever, a health economist at the Wits School of Governance, said state hospitals had 1,178 intensive care unit (ICUs) beds across the country. Private hospitals had an additional 2,140. ICU beds are equipped with ventilators.

"It is touch and go with bed numbers. This is compounded by the fact that you cannot have Covid-19-infected people in ICU wards with other patients.

"If we can secure ventilators, which will be necessary for the approaching patient infection surge, we can create more ICU beds, but the problem is time. We don't have it.

"Our high-risk period is due to start within 10 days."

Van den Heever said SA should exploit its relationships with countries that were beating the Covid-19 infection curve to obtain equipment and do so at an acceptable price.

"It's not impossible for ventilators, which are highly sophisticated pieces of machinery, to cost R800,000."

While ICU patients usually require ventilation for up to five days, medical experts say Covid-19 patients can require ventilation for up to 21 days.

At a media conference late on Friday, trade & industry minister Ebrahim Patel said anyone wanting to export critical medical supplies needed in SA would now require a licence to do so, "to ensure significant stocks available for SA and neighbouring countries".

"A prototype ventilator can be built here," he said. "Technology previously used to build cars can be repurposed to get a basic ventilator in production as soon as possible."

Patel said the government was fast-tracking the hunt for ventilators and other equipment and would expedite clearance procedures at ports of entry.

"Before the state of national disaster was declared, hospitals could use ventilators only for their own patients," Patel said.

"Now they are allowed to share all these kinds of facilities and share patients, nurses, skilled technicians and medical personnel that operate the equipment.

"We are producing more of what we need and importing as much as we can find elsewhere in the world."

Among the corporations pitching in is Sasol, which is now making sanitiser.

Company spokesperson Alex Anderson said: "As a producer and bulk supplier of a variety of speciality chemicals, Sasol has developed a new, unique blend of alcohol-based chemicals to be used in manufacturing hand sanitisers to help address the increase in demand."

Sasol CEO Fleetwood Grobler said global demand for ethanol and isopropyl alcohol had soared due to the pandemic, but "Sasol has prioritised local supply, and prices for South African sales have remained stable".

A list of Treasury-approved Covid-19 contractors shows the waiting period for equipment and supplies, including for ventilators and respirators, is longer than three weeks.

On Friday the Chinese military donated 2,000 specialised goggles and 3,000 face masks to the South African National Defence Force.

With SA recording its first Covid-19 death on Friday, general manufacturers have ramped up their efforts to help, repurposing machines to produce medical equipment.

Chris Archer, CEO of the South African Private Practitioners Forum, confirmed there were serious supply shortages, especially of ventilators.

"This is a global problem. The state of New York requires 40,000 ventilators, but the US government could only provide 6,000.

"Under normal circumstances an ICU patient's ventilation lasts up to five days, but with Covid-19 this can be 21 days. With the current shortages this means there will be difficulty in helping everyone who has severe Covid-19 symptoms."

He said the forum was assessing what equipment was available and what the country's needs would be.

"SA is behind. Like many globally, our doctors will soon be faced with very difficult decisions. They will have to decide who to put onto ventilation and whether they take people who are not responding off ventilation and let them die."

The Treasury's approved Covid-19 contractors said they were pulling out all the stops to secure supplies.

Hilton Klein, CEO of Numolux Group, which imports respirators and ventilators, said: "We have only been able to secure 25 from China. We are planning to sign off next week on the purchase of 500 ventilators and source other suppliers."

He declined to put a price on the ventilators, but said the cost had skyrocketed.

"This is vital equipment and demand is pushing up prices. It's a dire situation," Klein said.

Nasiegh Khan, a director of New Age Medident, which supplies respirators, gloves and masks, said he had run out of supplies.

Compounding this was that a container with millions of gloves and masks he had ordered from Italy was seized by that country's government.

"They want all material and products for their people first. Even if released, it will take 30 to 40 days to reach SA."

Atiya Hendricks, sales administrator at Henry Schein Dental Warehouse, one of SA's biggest suppliers of masks, sanitisers and gloves for dentists, said the company could not cope with demand.

"In one day we received a request for over 10,000 masks, over 10,000 gloves and 15,000l of sanitiser," Hendricks said.

Eric Ichikowitz, senior vice-president of Paramount Group, said the defence and aerospace company had made six aircraft, including helicopters, available to the government to transport medical personnel and supplies.

"Our engineers and technical specialists are planning to reconfigure manufacturing machinery to produce medical equipment including ventilators and respirators," he said.

South African Airways spokesperson Tlali Tlali said although the airline had suspended commercial flights to slow the spread of the virus to SA, it was processing various requests for the transport of essential goods.

"SAA has capacity, with crew and aircraft with requisite range . for repatriation purposes and for transfers of essential goods.

"We provide ad hoc services at the moment under exceptional circumstances . with stringent measures that have been put in place."

Angelique Coetzee, chair of the South African Medical Association, said the group had called on members to help government efforts to combat the pandemic.

"This is about getting as many doctors as possible on the ground quickly. We are formulating plans with government on how to get our members out into the poorest areas where water, sanitation and hygiene are of serious concern."