Dr Richard Friedland, chief executive officer of Netcare, recently confirmed that the surge in COVID-19 cases and high admissions to hospitals in Gauteng are directly linked to the emergence of the Delta variant in South Africa.
“Initial modelling suggested that Gauteng would experience a third wave, which would be lower than the second wave but may last longer, in other words, the so-called ‘lower for longer scenario’. This appeared to be the case until the first week of June 2021, when the daily number of positive cases started to break the trend, rising exponentially on 15 June. Since then, it has been increasing rapidly – far exceeding the peak of both the first and second waves in Gauteng. Data released on Tuesday, 29 June 2021, confirms that the Delta variant was responsible for 53% of cases sampled in early June and 75% towards the end of June,” notes Dr Friedland.
“The Delta variant is approximately 50-60% more transmissible than the Beta variant, which was responsible for the second wave in South Africa. This explains the mounting surge in cases and admissions to hospitals. Netcare is currently caring for over 2 600 COVID-19 patients across its hospitals in Gauteng. This is 45% higher than the 1 792 patients we had at the peak of the second wave, and almost 100% higher than the 1 377 patients admitted during the peak of the first wave in Gauteng.
“It also explains why we have seen whole families, school-going children, and younger people testing positive and why we have now seen the admission of patients in their in their twenties and thirties affected by the virus,” he added.
“The new COVID-19 Delta variant has been detected in at least five provinces and is now the dominant strain in South Africa. Netcare therefore welcomes the adjusted level 4 measures announced by President Cyril Ramaphosa, as this should have a material impact in helping to curtail the further spread of COVID-19 in the coastal regions, while aiding in flattening the curve.
“We however remain extremely concerned about the current situation in densely-populated Gauteng, and while these restrictions may have come too late to flatten the curve in the province, it will certainly lessen the number of infections and admissions to hospitals,” explained Dr Friedland.
Given the Delta variant’s increased transmissibility, it is now more important than ever to practise safe social distancing, fastidious attention to the wearing of masks, regular washing of hands, the use of sanitiser and avoiding social gatherings. In the absence of a completed vaccine rollout we must rely on the strictest possible non-pharmaceutical preventive measures.
“Vaccination remains a vitally important step in the fight against COVID-19, and it is crucial that individuals are registered and vaccinated as soon as they become eligible. Now, more than ever before, given the emergence of the highly contagious Delta variant, it is critical that everyone takes COVID-19 extremely seriously,” urged Dr Friedland.
Vaccination has thus far proved to be extremely effective in protecting our frontline workers. Of over 33 000 Netcare frontline workers vaccinated only 206 or 0.6% have experienced a breakthrough infection and of them, only seven required hospitalisation.
Extensive, additional preparations are ongoing at Netcare
As a result of the prevalence of the highly transmissible Delta variant, we have further strengthened and adapted our approach to ensure that we are ready, ahead of a potential surge in other provinces, to deal with the new risks in the most effective and efficient way,” he added.
Dr Friedland says Netcare’s preparations for the expected surge, especially in coastal areas, are focused on several key aspects, including additional measures to help safeguard its healthcare workers, optimising capacity to meet the demand for hospital care for COVID-19 patients, procuring additional life-saving equipment, and ensuring sufficient consumables including pharmaceutical stock.
Optimising capacity to prepare for a surge in COVID-19 patients
“We have already started scaling down on non-urgent surgery and medical admissions in our coastal hospitals, and some have suspended such surgery to rapidly create capacity for the expected increased COVID-19 patient numbers. To free up beds for COVID-19 patients, only medically necessary, time sensitive surgeries (MeNTS) will continue, based on the MeNTS scoring system, as well as emergency admission of non-COVID-19 patients,” explains Dr Friedland.
To create further capacity, plans are also in place to convert certain Medicross day theatres and other facilities to accommodate COVID-19 patients, if needed.
“Our clinical resources are being further strengthened by recruiting additional resident medical officers and clinical associates to provide continuous cover in COVID-19 zones. Several specialists have also responded to our call to join the COVID-19 teams in providing care to patients, as locally determined by hospital management and the COVID-19 clinical teams.
“To alleviate the expected pressure on our emergency departments [EDs] and to start treatment of patients as soon as possible, we will be establishing clinical decision units [CDUs] at our coastal region hospitals as a matter of urgency, in addition to those we have implemented in Gauteng. The CDUs are run and managed by the ED doctors and staffed separately from the hospitals and each consists of a number of beds, its own ablution facilities, PPE donning and doffing area and independent oxygen supply for each bed,” he adds.
Procuring additional life-saving equipment and consumables
“In addition to our already high number of ventilators and high flow nasal equipment, Netcare has procured further equipment in preparation to provide the appropriate level of care to COVID-19 patients.
“We have secured over 1 000 more mobile oxygen concentrators to bolster our fleet of 1 400 oxygen concentrators. These machines filter surrounding air, compressing it to the required density to deliver a continuous stream of purified medical grade oxygen to the patient. Importantly, this oxygen is produced without having to rely on the piped oxygen at our hospitals, thus not denuding existing oxygen capacity at the hospitals.
“In addition, we have procured another 100 ventilators, including 40 transport ventilators, which can also be used by emergency medical services personnel when transporting patients in need of oxygen. We continue to boost our extensive oxygen supply with additional bulk tanks.
Safeguarding our frontline heroes
“It is, as always, crucial to safeguard all persons working in our hospitals to the best of our ability. To reduce the footfall in our hospitals and the exposure risk this poses to healthcare workers, we have suspended visitation of patients in our Gauteng hospitals, as well as in a few of our other hospitals, unless for compassionate reasons or in exceptional circumstances.
Keeping lines of communication open
“We have employed more social workers within our facilities to counsel patients and their next-of-kin and loved ones. Next-of-kin of patients to our hospitals are encouraged to call the Netcare Family Connect Line on 0800 111 266, and one of our trained call centre professionals will facilitate a dedicated hospital representative to provide them with personal feedback daily on how their loved one in hospital is doing.
“We are glad to note that many family members are now making use of this special service to maintain contact with their loved ones. This past week alone we have connected more than 1 000 individuals with their loved ones, and we strongly encourage members of the public to avail themselves of this service.
“We wish to assure the public that we will continue to do the very best we can for all patients seeking care at any of our healthcare facilities, while ensuring their safety and that of our frontline heroes,” says Dr Friedland.
Help us to help you
“Despite the pressures placed on us, providing care is our calling, it is our driving purpose, and we are privileged to be serving our country and its people at this challenging time. In doing so, we respectfully appeal to our fellow South Africans to help us in providing them with the best possible care if they need it.
“Test for COVID-19 if you are concerned that you may have contracted the virus and seek care from your general practitioner early if you feel unwell. Many persons unfortunately still wait until their condition becomes a life-threatening emergency, which does not only endanger them but places further pressure on emergency medical services, emergency departments and hospitals,” concludes Dr Friedland.