About three quarters through his just over 2,000-word speech, Health Minister Zweli Mkhize got to where he spoke of, one, the lower peak in Covid-19 patient numbers than even in the most optimistic scenario modelling, and two, how despite this, not enough hospital beds are available.

“While the model projects a lower need for hospital [non-ICU] and ICU beds at a national level, bed capacity is still expected to be breached or overwhelmed in all provinces,” said Mkhize.

“Currently, planned hospital beds in the Eastern Cape and Gauteng are projected to be insufficient for combined non-ICU bed demand and the overflow from ICU once ICU capacity has been breached. Bed capacity… is expected to be breached in the next four weeks.”

And then the health minister told MPs of his department’s “surge strategy” – and how it has repurposed 27,467 beds for Covid-19 patients to bring the number of beds to 40,309.

But the corollary of this is that for the past 104 days of Covid-19 lockdown, across South Africa just 12,842 beds had been prepared for the surge that’s not shifted from its mid-August peak.

A task team has been established to look into the impact of alcohol on the availability of Covid-19 hospital beds. An audit of oxygen reticulation infrastructure found that the priority provinces of Eastern Cape, Gauteng and KwaZulu-Natal needed to close gaps in the provision of oxygen to patients.  

Serious questions over government capacity arise, even if the World Health Organisation (WHO) has on more than one occasion praised South Africa’s Covid-19 measures.

“The storm that we have consistently warned South Africans about is now arriving. As a nation we have every reason to be united in this fight against Covid-19. We dare not be divided,” said Mkhize. 

The health minister said the fact that fewer people were infected in May and June than predicted showed South Africans had done what was asked of them in lockdown – despite the often brutal consequences as jobs were lost, incomes dried up and hunger and poverty ripped across communities.

Yet, Wednesday’s ministerial statement and numbers indicate that government’s stated aim of preparing the health system for a flattened coronavirus curve has not been achieved.

DA MP and health spokesperson Siviwe Gwarube picked up this contradiction in her hard-hitting contribution to the debate.

“The social contract that the South African public signed with its government was clear. They agreed to stay at home – at the expense of their life’s work and livelihoods – and government would build health system capacity. That contract has been breached.”

The coronavirus pandemic had found South Africa’s health system on its knees, and “is now dissipating even the parts of our system that were salvageable”.

It was Gwarube’s call on the government to place the Eastern Cape under administration that ruffled political feathers – and showed how disunited South Africa’s body politics is even in a pandemic.

It’s public how doctors are battling to find beds for Covid-19 patients – in Johannesburg, Nelson Mandela Bay, and elsewhere.

For Gwarube, the rising number of Covid-19 patients wasn’t because of an “inevitable health crisis”, but because prevention strategies were inadequate. More could, and should, be done, she told Mkhize

“You can go back to the drawing board with National Treasury and commit funds to provinces so that they can begin mounting a decent response to the pandemic. Places like the Nasrec facility [in Johannesburg] will become white elephants if they are not staffed and well-equipped in a way that can save lives. Simply having beds is but the beginning of the process.”

Other opposition parties agreed on the inadequacies of the health response – in different ways.

United Democratic Movement Chief Whip Nqabayomzi Kwankwa, who previously told the House how he lost his aunt to Covid-19, highlighted that “government has failed to put in place proper testing, and contract tracing measures… Contact tracing has completely collapsed.” 

“Healthcare workers who have decided to be whistle-blowers… those who come forward with information that could help improve the system are being targeted, victimised.”

Freedom Front Plus MP Philip van Staden highlighted often below-par conditions in quarantine facilities, adding that if it wasn’t for the private health sector, the situation would be worse.

“Yet, this government is still trying everything in its power to get rid of the private health system and replace it with NHI [National Health Insurance].”

It was Gwarube’s call on the government to place the Eastern Cape under administration that ruffled political feathers – and showed how disunited South Africa’s body politics is even in a pandemic.

“The problems that we find in the Eastern Cape are imported from the Western Cape. It is the collapse of the system here that caused the Eastern Cape problems,” said health committee chairperson Sibongiseni Dhlomo. “Don’t call for administration in the Eastern Cape when the Western Cape started the problem.”

Mkhize pointed out “we treat all provinces equally” and no one province could or should be highlighted or blamed. Each province had its shortcomings, and achievements.

“More than dividing us, the fight against Covid-19 should unite us,” he told MPs, asking them to spread the message of prevention – wearing masks and hand hygiene – in their constituencies.

“Prevention, prevention, prevention,” is how Mkhize put it. “This battle is going to be fought and won in the community.”

The Covid-19 surge has arrived, whether or not South Africa’s health system is ready. DM