With the third wave in full swing, doctors fear being overwhelmed
Complaints of lack of resources as third wave engulfs Gauteng
Gauteng doctors, swamped by skyrocketing Covid-19 infections, are bracing for the worst as SA's third wave sees them battling staff, bed and even personal protective equipment (PPE) shortages.
The province's health system has come under increasing pressure after the closure of Johannesburg's Charlotte Maxeke Johannesburg Academic Hospital in April, which took 1,000 general beds and 100 intensive care unit (ICU) beds out of action.
"It's a nightmare. We're being overwhelmed by sheer patient numbers, coupled with an increasing lack of beds and staff. Nowhere in Gauteng are there available Covid-19 beds," said Johannesburg private emergency room doctor Adam Barnes.
As Gauteng is engulfed by the third wave, the province on Wednesday recorded 7,859 new infections - its highest yet.
Dr Suhayl Essa, an emergency medicine officer from Charlotte Maxeke, said the situation was dire. Now working between Edenvale, Helen Joseph and Chris Hani Baragwanath hospitals and Hillbrow Community Health Centre, he said the third wave had brought a spike in patients needing hospitalisation.
"While far less need ICU treatment or ventilation compared to the first and second waves, combine the numbers needing hospitalisation with the closure of Charlotte Maxeke and increasingly fewer beds and we face a major crisis. Charlotte's closure did not just mean bed losses. We have also lost the use of oxygen ports."
He said hospital resources, including PPE, were already running short.
Essa said that on Wednesday, while working at Edenvale hospital, staff could not properly isolate four Covid-19-positive patients in the emergency room. "All we could do was draw medical curtains around them. There was also no adequate PPE for staff at the hospital. All I had was an N95 mask and nothing else." He said they usually wore a visor over their masks, and a PPE coverall.
"In my mind I thought I could say I am not prepared to work as I do not feel safe with the Covid-19 patients and other patients lying on the floor, but as a doctor I took an oath to help so I stayed," he said.
"Government should have done a far better job prepping hospitals under lockdown level 5. It is frustrating facing sick and dying people [and] telling them that there is no help, while there are those sitting at home comfortably having potentially stolen money [from PPE contracts]."
Barnes said this year was a nightmare compared to last year. "Emergency rooms are swamped. While we have enough oxygen, we are running out of oxygen ports and concentrators. We fear by next week, when the third wave's peak is expected to hit, there will be a total patient onslaught.
"In the second wave, when our hospitals filled up, we could find bed space at other facilities, but not now and not for the last two weeks. We are having to treat ICU patients in emergency rooms.
"When we get patients we immediately tell their families we cannot guarantee a bed and will do the best we can for the patient."
Critical care paediatrician Dr Robin Saggers, who works at Charlotte Maxeke and Baragwanath hospitals, said: "While children are not badly affected by Covid-19 they still need to be separated from other patients. Everywhere we have run out of space in terms of isolating all patients in case they have Covid-19."
Saggers, who assists Covid patients in Baragwanath's ICU, said the third wave, combined with rising staff infections, had created a terrifying crisis.
"Even though staff are vaccinated, they still become sick and must isolate. Fewer staff mean fewer people to make beds available.
"With the lack of beds, staff, oxygen ports, Charlotte [Maxeke] closed and Rahima Moosa and Helen Joseph hospitals facing a severe water crisis, we are in dire straits."
Gauteng health department spokesperson Kwara Kekana said there were 3,840 dedicated Covid-19 beds, with plans for 747 more to be made available. She said the province had everything in place should the third wave be worse than anticipated.
"At the moment, nothing should alarm us. The department has been assured of oxygen supply security. Temporary staff posts have been created with contracts awarded to two nursing agencies.
"While Nasrec field hospital was decommissioned in February, more permanent beds have been added to the health system. Baragwanath and Jubilee hospitals have [an additional] 300 beds each, Bronkhorstspruit 150 and AngloGold over 170."