St Augustine's battles to save patients and its reputation

Doctors, nurses, patients and their families are demanding to know why staff fighting the coronavirus pandemic were left unprotected at a top Durban hospital where five people died and 66 others tested positive for Covid-19.

After health minister Zweli Mkhize ordered an investigation on Friday into the apparently unchecked outbreak of the virus at Netcare's St Augustine's Hospital, nurses and doctors who spoke to the Sunday Times, as well as their unions, accused the hospital of mismanagement and flouting standard infection-control procedures.

Although Netcare strongly denies this, health workers at the hospital alleged that it failed to provide them with proper protective gear, refused to allow them to wear masks in case they frightened their patients, and did not tell them which ward the Covid-19 patients were being treated in "until it was too late".

On Friday, hours after President Cyril Ramaphosa extended the nationwide lockdown for a further two weeks, Mkhize held an online meeting with chief executives of most of the country's private hospitals and announced an investigation into the St Augustine's outbreak in which 48 nurses were infected. He also announced the establishment of a task team comprising unions, private and public hospitals and the department of health in light of "concerning developments" and complaints from private and public health-care workers.

Already, one nurse employed at Durban's flagship government hospital, Inkosi Albert Luthuli Central Hospital, and who works at St Augustine's for extra money, has tested positive for Covid-19. The provincial health department is now awaiting the results of 40 other nurses at Inkosi Albert Luthuli with whom she had been in contact.

Mkhize and his department are bracing themselves for the figures to rise further as they await a list of agency nurses who came into contact with infected staff so that they, their colleagues and their families can also be traced and tested.

Health workers and their unions at St Augustine's also charged that management failed to tell them that they were treating patients with Covid-19 or to ensure that doctors and other medical staff who had travelled to the UK and US self-isolate for 14 days before returning to work.

A St Augustine's nurse who tested positive for the virus told the Sunday Times that it was a "tense and overwhelming" period for her and her colleagues.

"The hospital management are telling everyone they had the best protocols and put in place all the measures, but it was us at the frontline who dealt with the patients, who ended up being exposed," the nurse said.

"We weren't told about the patients who were positive until it was too late. Management, who haven't even bothered to pay us a visit to see how we are doing, will literally get away with this. It makes me sick to think that they are protecting themselves when people's lives were lost and there is a deadly virus out there."

Another hospital nurse said she had asked to wear a mask after the lockdown was announced more than two weeks ago but was told she was not allowed to do so.

"They said they didn't want to alarm patients. We weren't even told which ward the Covid-19 patients were being kept in. A week later we were given one mask and a brown paper bag and were told that at the end of our shifts we would need to place our masks into the brown bag, which would then be sent for a deep-cleaning processes," she said.

Another nurse told the Sunday Times that they were being victimised in their communities by neighbours who want them to move out, as well as on public transport where they are given a "hard time".

Netcare vehemently denies the allegations, saying it was the first private health-care provider to implement preventative measures including screening patients and visitors, sealing off multiple entrances, limiting visiting hours and closing hospital pharmacies and coffee shops.

Netcare group medical director Dr Anchen Laubscher said a full epidemiological report now being compiled with Professor Salim Abdool Karim, a renowned scientist and chair of the ministerial advisory committee on Covid-19, and a team of epidemiologists from the University of KwaZulu-Natal, will shed light on what happened.

Laubscher denied that nurses were kept in the dark when a Covid-19 patient was admitted, saying they "immediately communicated this" to the health department and National Institute of Communicable Diseases (NICD), and that 30 nurses were subsequently tested.

St Augustine's was closed on Tuesday with 58 patients remaining - split between the red zone for those who have tested positive and the orange zone for patients under investigation who are still awaiting their test results. The hospital's nurses return to work there every day.

"We put on our garb and do what we pledged to do. We are nurses. We are frontline workers and we will do whatever it takes to help patients," another nurse said.

Another health worker said: "The stigma is really bad. We are being blamed by the public for transmitting the virus when there is no proof. The negativity towards St Augustine's employees has really brought down morale in the hospital. It's nerve-racking to go home and see all the negative things said about us on social media."

Kevin Halama, spokesperson for the Health & Other Services Personnel Trade Union of SA (Hospersa), which represents 359 St Augustine's employees of whom 248 are nurses, said the hospital's masks policy was a real concern to staff.

"Their policy entails that staff members will receive one mask every five days while administrative staff will receive one mask every seven days," he said.

Ayanda Zulu, provincial secretary of the National Education, Health and Allied Workers' Union (Nehawu), which represents 210 hospital employees, said they were extremely concerned that more of their members could be infected.

"The employer has been absolutely negligent and does not want to take responsibility. If the employer continues, we will be left with no choice but to take legal action."

Meanwhile, a Durban man, Bennie van Loggerenberg, told the Sunday Times of his brother Richard's rage after St Augustine's sent an SMS to his mother's phone on Tuesday asking if she had experienced any Covid-19 symptoms. His 81-year-old mother, Drienie Dorrington, died there from Covid-19 last week - the third patient to die of the virus at the hospital.

Richard, who had his mom's cellphone, responded: "This is the number of Mrs Dorrington. Passed away on 2/4/2020 from COVID-19 and she was 81-years-old. My mother."

On Tuesday, the hospital sent hundreds of automated messages to patients discharged in March or April asking whether they had experienced any Covid-19 symptoms, including loss of smell or taste, shortness of breath, a cough, sore throat or fever. Patients were asked to reply yes or no.

"My brother was fuming when he received this message. His wife was crying. It was painful," Van Loggerenberg said.

"It is a tragedy that so many medical staff and other individuals have been infected at St Augustine's. I support the statement made by the unions with regards to negligence. We hope and pray that those who are now exposed to the virus will recover shortly. Hopefully the steps that management of the hospital has taken will result in a positive outcome."

Gareth Lemley, whose fiancè was admitted to the hospital on March 24 for surgery, said they were "sick with worry" that they could be carrying the virus.

He said he called the hospital several times after reading about patients dying and testing positive for Covid-19 but they didn't take him seriously. He claims that one staff member told him it was a "hoax".

"We heard nothing. I called several times and explained and was told to stay at home. Eventually, someone called us back on Monday and asked us about our symptoms. We don't have any but we could be in incubation," he said.

"They were very quick to hit us with a R47,000 hospital bill [for the surgery] but surely they could take R700 out of that and ask us to go for testing? Instead we are sitting here worried out of our minds."