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According to Professor Andrew Boulle, two thirds, or 66% of Covid-19 patients in the Western Cape who enter ICU units have died, based on the most recent data. And this represents a total of 18% of all patients admitted to hospital.
The province still maintains that around 90% of people who contract the virus will not need any hospitalisation at all, and can self-isolate at home.
Reasons for modelling
Winde said: “Just over a month ago… we had our professors and doctors presenting scenarios we were building our health preparedness plan on,” he explained.
This included the number of ICU beds, personal protective equipment (PPE), Triage and Testing Centres at healthcare facilities, and general hospital beds, for example.
The temporary field hospitals at the Cape Town International Convention Centre (CTICC), in Khayelitsha and the Cape Winelands were among these facilities.
Winde said they had continued to check data and scenarios with a range of “top specialists”, including the scenario-planners, epidemiologists, and also bodies such as the Actuarial Society of South Africa and the Modelling and Simulation Hub of South Africa.
Boulle said that, according to their previous projections, “it didn’t seem any country would reach 1 000 cases per million – or very few would”.
Such an incidence in the Western Cape would have been “an unfortunate scenario”, but one which the provincial health authorities would have been able to handle, in terms of capacity.
More recently, a number of groups presented new hospitalisation and mortality data, which had been calibrated to be relevant to the Western Cape province, and also incorporated global learnings.
There had been difficulties, though, such as undiagnosed cases, and challenges with testing.
Beds shortfall
Five weeks ago, the conservative expectation was that 6 000 acute beds would suffice. This was based on a somewhat “flat trajectory”, with a peak later in the year.
As at 24 May in the Western Cape, the number of cases since March – when the pandemic broke out – included 2 226 admissions, of which 11% were treated in ICUs.
The new peak was expected in late-June and early-July.
This would require a new, higher total of beds – 7 800 in total, comprising 6 300 non-ICU beds and 1 500 ICU beds.
Provincial Health Head Keith Cloete said, based on the new predictions, they would need around 1 600 more beds to cover the shortfall.
In this scenario, the clinical platform would come under “tremendous pressure”.
Western Cape Health Minister Nomafrench Mbombo said: “South Africa is not going to be able to run away from the fact that we have a pandemic. Trust means a lot, transparency means a lot.”
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Hence today’s comprehensive briefing, with the latest predictions. “Every day we learn a lot. Every day is a lesson to be learned,” she said.
The Western Cape health department is working with private hospitals, specialists, administrators, laboratory services and other private medical services, to prepare its intensive care and critical care capacity.
Cloete added: “The one big stumbling block is the issue of price.” In other words, the price at which the private health sector rendered its services to the state.
Cloete said they had urged the national health department to expedite these negotiations, as a matter of urgency.
