Coronavirus: Gauteng’s private hospitals under pressure but not full

• Concerns were raised about the capacity of public and private hospitals
  in Gauteng to deal with Covid-19 patients.
• While public hospitals aren’t full, many are said to be stretched.
• Three major private hospital groups described a WhatsApp message,
  claiming private hospitals were placed on divert status, as “fake”.

As a surge in Covid-19 cases hits Gauteng, South Africa’s biggest
private hospital groups say they have not reached capacity in the province,
despite being under immense pressure.

They add, though, that the situation remains “fluid”, and the
critical care capacity of hospitals, in particular, is under stress.

This week, News24 reported that Gauteng’s state hospitals
were also stretched in terms of capacity, with reports emerging throughout the
week of patients being turned away from hospitals.

Gauteng health department spokesperson Philani Mhlungu said the system
was under pressure, and that patients who needed to be admitted to facilities
that were full would be referred to hospitals where there was available bed
space.

In its weekly update on Thursday, the Gauteng provincial coronavirus
command council said there were 8 301 beds available specifically for Covid-19
patients in private and public hospitals.

‘Extremely fluid’ situation

Jacques du Plessis, managing director of Netcare’s hospital division,
said the group’s hospitals were experiencing an increase in demand related to
Covid-19 patients, and that there was still space for Covid-19 and other
patients in the critical and general wards.

“The situation remains extremely fluid and we are therefore
continuously assessing the demand for hospitalisation of Covid-19 patients,
PUIs (patients under investigation) and other patients in order to manage
resources effectively in relation to changing demand.

“Should a situation present where one of our hospitals do not have
capacity at a given time, patients will be transported to and accommodated in
another of our hospitals which does have capacity,” he said.

Mediclinic’s chief clinical officer Dr Stefan Smuts said Gauteng’s
hospitals are not full at the moment.

“However, it is important to note that Covid-19 tends to place
increased demand on critical care resources particularly,” he said.

Smuts said:

Life Healthcare said the hospital bed capacity was being monitored daily
by a Covid-19 doctor committee, which worked in tandem with management.

“Life Healthcare hospitals in some regions are seeing increased
numbers, but generally remain ready and able to admit patients under
investigation (PUIs) and Covid-19 positive patients requiring hospitalisation. The
bed capacity situation is fluid and is being reassessed frequently.

“Our hospital management teams remain in constant contact with one
another, their doctors, and other healthcare professionals to ensure that
additional beds are made available in the event that this is required,”
said the group’s general manager, Dr Charl van Loggerenberg.

Overflow

But, if the situation worsens, and Gauteng’s hospitals are unable to
cope with the surge in cases, there are concerns that Johannesburg’s quarantine
facility at Nasrec is not properly equipped to deal with very ill patients.

Gauteng Health MEC Bandile Masuku said on Friday the facility was only
intended to treat stable patients, and it therefore does not have oxygen
treatment supplies.

But this could change, he said.

“We are not ruling out the fact that we might have to escalate the
service at some point,” said Masuku at a tour of the facility on Friday.

READ | Covid-19: ‘It’ll be overcrowded
in hospitals’ – Gauteng MEC predicts 300 000 cases by end of August

‘The system is buckling’

Last weekend, News24 reported that a healthcare worker was turned away
from four different state hospitals, who were unable to take her in for nearly
10 hours. The 54-year-old woman was eventually hospitalised, and died on
Thursday.

Her colleague, Dr Jenny Coetzee, said the health system is not coping
under the strain of Covid-19 and the public is not fully aware of the
seriousness of the situation.

Coetzee is Head of Prevention in Key Populations at the Perinatal HIV
Research Unit at Wits University, and founder and CEO of African Potential
Foundation.

“The concern for me is that the system is buckling,” Coetzee said.

And it’s not the fault of healthcare workers or paramedics, who are
“hugely disempowered” and are taking great strain, emotionally,
Coetzee added.

“There is a massive rush on hospitals and I think it’s happening
faster than what the hospitals are ready for. And they are buckling under the
strain.”

She said a massive, concerted national effort around non-pharmaceutical
interventions was needed.

If the country waits around for pharmaceutical interventions, like a
vaccine, it risks making the same mistakes that were made around HIV, which
included focusing too little on prevention and too much on treatment.

“Our system will collapse completely. The infections that we are
seeing now are the end of Level 4, at just the start of opening up Level 3 – so
we are not even seeing the full impact of Level 3 yet. And your average person
isn’t understanding the timeline – that there’s a lag before we see the
implications of what we are doing.”

ALSO READ | Gauteng health department probes
businessman Shonisani Lethole’s death at Tembisa Hospital

All private hospitals on divert status is ‘fake news’

This week, News24 was told that several private hospital hospitals in
Johannesburg were placed on divert status on Sunday evening, owing to a lack of
capacity.

The major hospital groups – Life Healthcare, Mediclinic and Netcare – said
the information was from a fake WhatsApp message doing the rounds on social
media and that it was not true.

Netcare’s Du Plessis told News24 that the hospitals mentioned were open
and taking admissions.

“What may happen on occasion is that, due to various reasons, for
example, such as an unexpected staff shortfall, a hospital may be temporarily
placed ‘on divert’ for emergencies, in which case, emergency medical services
providers are notified and other hospitals in the area provide cover where
needed.

“However, it should be noted that this practice has been in
existence for many years. We furthermore confirm that emergency medical care
will be provided to any person who presents at an emergency department with a
life-threatening injury or condition,” he said.

Smuts, from Mediclinic, said any reference to Mediclinic’s hospitals in
the message were false.

Life Healthcare’s Van Loggerenberg said it was not true that the group’s
facilities were full. He said it was standard practice to put certain areas of
care under “temporary capacity divert”.

“For example, should an EMS vehicle need to bring a patient with a
brain injury to a hospital and the neurosurgeon on call is not available for
immediate care, then all ‘neurosurgery’ medical emergency cases would be put on
Temporary Capacity Divert and taken to the next nearest facility until such
time that the surgeon has capacity.

“This does not necessarily mean that there are no beds available at
the hospital, but rather that the high priority and best care needed is not
immediately available.

“It is also important to note that Temporary Capacity Diverts are
constantly in flux and can change at any point within a 24-hour period,”
he said.

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