On Wednesday, health minister Zweli Mkhize announced that KwaZulu-Natal thus far had 354 Covid-19 infections, the third highest in the country. 

The province is, however, saddled with nine of the 18 Covid-19 deaths thus far recorded in the country.

At least five of these are from St Augustine’s Hospital according to the KwaZulu-Natal Department of Health. (The Netcare Group said in a statement on Wednesday morning that only four deaths had been recorded at the facility). 

In total,  the hospital has reported 66 positive cases of the virus, 48 being staff members.

“Our investigation so far has shown that there might have been a challenge [at St Augustine’s] in not following protocol,” said the province’s health MEC, Nomagugu Simelane-Zulu, at a press briefing on Wednesday evening. 

“That is why we have decided that we will have an in-depth investigation so that we are able to understand what actually happened and what has led to this facility having such a [high] number of infections, and such a number of deaths. Of the deaths that come from KZN, five of them are linked to St Augustine’s. This is quite concerning,” said Simelane-Zulu.

She said the department “will not hesitate” to hold someone to account if the probe finds negligence.

There was also a strong likelihood that nurses who work in the public sector and moonlight part-time in the private sector may have been exposed to the virus, and are yet to be identified, said the MEC.

“When we started speaking to St Augustine’s we requested a list of the employed nurses, which they have provided. But they also indicated that they don’t just have full-time nurses, they also utilise nurses that come through agencies. We have requested that list. We’ve been waiting about four days now or so.

“The biggest challenge is that nurses who come through agencies are sometimes nurses that moonlight and work for government, but they go and work for the private sector, which is not allowed. This explains why this list from the agencies is not so forthcoming, because it means some of them might be [government paid] nurses, but that are also being paid by the private sector, therefore double-dipping,” said Simelane-Zulu.

There are currently 74 patients still at St. Augustine’s.

The MEC said they would either be discharged or moved to a new facility. Those with Covid-19 would remain at the hospital.

She said once all patients were discharged, the entire facility would be quarantined and disinfected.

An online meeting had been scheduled for Monday with the CEOs of KwaZulu-Natal’s private hospitals, “not to pick on them”, but to “streamline protocols” and “raise some concerns”, said the MEC.

Dr Richard Friedland, chief executive officer of the Netcare Group, continues to distance the hospital from being at fault.

“Unfortunately, with Covid-19 people can transmit the virus before they show symptoms that can be screened for, and where one person is contagious the virus can very quickly spread to others,” he said on Wednesday.  

“The ideal would be if all healthcare facilities could test, and not just screen, every person coming into our hospitals, and to do that on a repeat basis as some may at first test negative. The reality in South Africa, however, makes this impossible, so the risk remains of Covid-19 entering our hospitals, and any other hospitals in this way, despite our best efforts to prevent this from happening.”  

He said the process to decontaminate and disinfect St Augustine’s through deep cleaning started on 2 April and “remains ongoing”.

“As an additional precaution, terminal cleaning using a high dosage of chlorine, followed by disinfection with the aid of ultra-violet disinfection robots is being done. This will be completed by tomorrow (Thursday).”

Other measures to contain the virus included the swabbing of more than half of the 1,982 people who work at the hospital, of whom 504 have tested negative for Covid-19. The results for 318 employees are still outstanding, he said. 

The hospital has contacted all patients who were treated at the emergency department or admitted since 1 March. Screening was being performed on hospital employees on a daily basis, said Friedland.

“The Netcare clinical team is working closely with [infectious diseases specialist] Professor Salim Karim, a special adviser to the Minister of Health, and a team of epidemiology and infectious diseases specialists from the University of KZN, to fully investigate the underlying cause and nature of this outbreak.” 

Health minister, Dr Zweli Mkhize has maintained that South Africa has enough PPE stock to last for up to eight weeks, but on Wednesday, National Treasury issued a call to suppliers looking for specific items.

“Due to the shortage of Personal Protective Equipment (PPE) to curb the spread of Covid-19, the National Treasury in support of the Department of Trade, Industry, and Competition (DTIC) calls on all compliant, particularly local, suppliers providing commodities listed below to direct their offers to the PMO set up for this purpose.

“The submissions will be assessed by the support team responsible for coordinating the process, exclusively for the identified commodities,” according to the notice.

Items called for were disposable aprons, protective surgical gowns, protective eyewear, surgical gloves, overshoes, protective hoods, biohazard bags, ventilators, alcohol-cleaning disinfectants and  venturi masks.

Health workers’ trade union Hospersa also put out a call on Wednesday, saying its members at St Augustine’s should down tools if they were not supplied with PPE. The union extended the call to  members at other healthcare facilities.

“Hospersa is calling on its members to down tools when PPE is not provided by the employer,” said general-secretary Noel Desfontaines. 

“We have tried to engage the Department of Health to address the issue of insufficient PPE, but our concerns have not been addressed.  We now have no choice but to call on our members to refuse to put their lives at risk and to withdraw their labour when PPE is not supplied.”

On Tuesday, the National Education, Health and Allied Workers’ Union (Nehawu) was expected to file papers with the  labour court in Braamfontein to compel government to provide PPE to public sector workers.

As reported by various media outlets, the court papers said the failure of government to provide guidelines that would mitigate any risk to employees violated the rights of health workers to perform their duties in a safe environment. 

The matter was not heard due to the papers being filed late. DM/MC