'We're holding on by our fingertips': Western Cape becomes new Covid-19 epicentre

01 August 2021 - 00:00
By Claire Keeton and Tanya Farber
Western Cape health MEC Nomafrench Mbombo with farmers at a pop-up vaccination bus in the province.
Image: Brenton Geach/Gallo Images Western Cape health MEC Nomafrench Mbombo with farmers at a pop-up vaccination bus in the province.

The Western Cape is in the eye of the Covid-19 storm after it replaced Gauteng as the epicentre of the third wave. A specialist on the Covid-19 frontline at Groote Schuur Hospital in Cape Town said on Friday: “We are holding on by our fingertips. We are completely saturated.”

Covid-19 hospital admissions in the Western Cape reached 3,443 on Thursday, only marginally below the 3,545 at the height of the second wave in January. By Friday there were a record 730 patients in critical care and intensive care, 40% more than the January high.

A doctor at Life Vincent Pallotti Hospital said that more young people were being admitted to hospital and put on ventilators in the third wave and that more people were dying.

“Unfortunately we are seeing very poor outcomes this time despite the best possible management,” said infectious disease expert Dr Helen van der Plas. “I want to stress the need for vaccination to prevent people [coming to ICU] in the first instance.”

Wits professor of medicine Francois Venter said: “The deaths with the third wave are far greater than the first or second wave in most provinces.”

The province has seen a 59% increase in the average number of daily deaths from Covid over the past fortnight and this week its share of new infections nationally — 27% on Friday — overtook Gauteng’s.

It has also had the highest percentage change in hospital admissions in the last two weeks (+26%) and joins the Eastern Cape (+15%) as the only provinces with rising admissions.

All eyes are also on KwaZulu-Natal, where daily deaths have increased by 65%. In the Eastern Cape, they are up by 60%.

This week, the SA Covid-19 Modelling Consortium adjusted the probability of the Western Cape having peaked in the third wave from 73% to 42% and warned of further increases in infections in KwaZulu-Natal and especially the Northern Cape.

Consortium spokesperson Lise Jamieson said: “We expect an increase in the median number of cases in the Western Cape [+10% increase in average daily cases], the Northern Cape [+35%] and KwaZulu-Natal.

The Eastern Cape and the Free State are expected to have a similar number of cases.” The biostatistician said Gauteng (-62%), Mpumalanga (-52%), Limpopo (-68%) and North West (-29%) are expected “to decrease quite significantly”.

The only province that had seen a drop in the daily number of deaths (by around 10%) over the last two weeks is Gauteng, according to health department deputy director-general Anban Pillay. North West, Northern Cape and the Free State saw a rise of between 10% and 15%, while Limpopo and Mpumalanga were both around 42%.

The number of vaccination doses administered reached 7.5-million on Friday, and UCT economics professor Nicoli Nattrass said: “The pace of vaccinations has picked up, which is excellent, but much of this was driven by the low-hanging fruit of opening up the Pfizer vaccinations to younger age groups. The pace of J&J [Johnson & Johnson] vaccinations has been disappointingly slow in the workplace and other targeted programmes.”

From this week, vaccine supplies, which have been blamed for slowing the rollout, should be abundant. Today more than 1.5-million Pfizer doses are arriving and more than 1.4-million J&J doses are expected to be distributed from tomorrow. During the week, more than 5.6-million donated Pfizer doses are due to arrive.

Nattrass said: “As more doses arrive, and as the low-hanging fruit of the vaccine-willing is harvested, SA is likely to experience a large glut of vaccines.”

On Friday, health department deputy director general Nicholas Crisp said the pace of vaccinations in the past week had been constrained by supply. But Nattrass challenged the validity of this position, noting that “there have always been substantial unused doses in the country” and the only limit was that planners were keeping a week’s supply in hand.

SA has about 3-million doses of unused vaccines and is expecting 9-million more doses by August 15

“What was the point of keeping a week’s supply ‘in hand’ when vaccinating sites, for example in the Western Cape, could have vaccinated more people if these doses had instead been provided to them?

“Fortunately we now have millions of doses arriving into the country, so any artificial shortages created by supply management decisions will hopefully be a thing of the past.”

UCT professor Jeremy Seekings, director of the Centre for Social Science Research, said the government should be doubling the current rate of vaccinations to 2.5-million doses a week through August given the available vaccine stock.

SA has about 3-million doses of unused stock and is expecting 9-million more doses by August 15, Seekings said. Another 21-million doses are expected in September.

“Given the expected supply, there will be more than enough doses to vaccinate every adult in the country by Christmas. Can the government deliver? Its performance hitherto does not inspire confidence,” he said.

Professor Glenda Gray, the co-principal investigator of the Sisonke implementation study, said the national rollout was going very well. “It is wonderful to see the pace picking up and it is important to keep up this pace,” she said.