Maverick Citizen

Maverick Citizen: Coronavirus

Nelson Mandela Bay runs out of state ICU beds as Covid-19 cases soar

Patients line up for medical care at Nelson Mandela Bay’s Livingstone Hospital. (Photo: Donna van der Watt)

As the number of active cases in Nelson Mandela Bay heads towards 5,000, the Eastern Cape Department of Health has confirmed that it has run out of intensive care beds. A group of civil society organisations has raised concern about extreme staff and PPE shortages and the Eastern Cape Health Crisis Action Coalition said on Monday that it still has not seen the much-vaunted plan to turn around the metro’s hospitals. The premier’s office has lashed out at what was described as irresponsible behaviour by bars, shebeens and other liquor outlets in the province.

State hospitals in Nelson Mandela Bay ran out of intensive care beds on Monday 9 November as coronavirus infections in the Eastern Cape’s biggest metro edged closer to 5,000.

The district manager for the Department of Health in the metro, Dalene de Vos, said there were 4,546 confirmed cases of coronavirus infections in the metro — an increase of 692 over the weekend.

Another ambulance arrives at Nelson Mandela Bay’s Livingstone Hospital, but there is no longer space at the facility for Covid-19 patients. (Photo: Donna van der Watt)

Premier Oscar Mabuyane’s spokesperson Mvusi Sicwetsha expressed deep concern over the increase in infections and said former provincial health superintendent-general Dr Thobile Mbengashe has been appointed to implement an intensified strategy in the metro.

This comes as MEC for Health Sindiswa Gomba, who according to those who were present lost her temper at an Eastern Cape provincial legislature health committee meeting, saying that senior members of the department were making her look incompetent. Mbengashe had been replaced by the former head of the Covid-19 project management unit, Dr Sibongile Zungu, who is the acting superintendent-general.

Since the start of the crisis two weeks ago, Gomba has not said anything about the situation in the metro. Her spokesperson, Judy Ngoloyi, also did not respond to questions.

Professor Lucille Blumberg of the National Institute for Communicable Diseases said last week that Nelson Mandela Bay was the only “hotspot” in the country.

“The increasing numbers in the province and the metro is a major concern to the premier and the provincial government. He has assigned one of his special advisers, Dr Thobile Mbengashe, to work with the teams in the metro and the Sarah Baartman district to implement the new strategy approved by the executive council to prevent the second wave of infections,” Sicwetsha said.

“The executive council of the Eastern Cape provincial government took a decision to increase programmes to prevent the spread of Covid-19 infections in the province. The numbers of new infections and hospital admissions are on the increase in the province,” he said.

“The focus of the provincial government is to respond to the increasing numbers of infections in the Nelson Mandela Bay Metro (Port Elizabeth, Uitenhage and Despatch), Sarah Baartman (a large district that includes part of the Karoo, Jeffreys Bay, St Francis and Kareedouw) and in the Buffalo City Metro (East London). The premier and the provincial government appeals to the people of the Eastern Cape province to be vigilant of Covid-19 infections, take all precautions to prevent infections, lower the rate of transmission to prevent the second wave of infections by wearing cloth masks, washing and sanitising hands and by keeping physical distance at all times,” Sicwetsha said.

He said the clinical response would focus on resurgence mitigation in areas of high risk (with potential to trigger the spread of infections), public education, communication, community mobilisation and enforcement of regulations. 

“We are targeting hotspot areas with high numbers of infections because it is important in addressing the emerging surge in the province.” 

Sicwetsha said part of Mbengashe’s assignment was to make use of the resources and investments in the Metro. That included making use of the Dr Rev Mamisa Chabula Nxiweni field hospital constructed and donated to the Department of Health by vehicle manufacturer Volkswagen. 

“We have a huge problem with the behaviour and conduct of some of the patrons of alcohol trading facilities, especially the pubs, taverns, shebeens and bars. Their lack of adhering to prevention methods puts their own lives at risk,” he said. 

“If the people are not playing their part, no strategy will ever work to prevent the spread. We call on the people of our province to adhere to the guidelines they know and that they have been adhering to in the past few months. Their adherence in those months helped to reduce infections, increased recovery rate and saved many lives. We have to work together with the people of our province to repeat what we achieved previously,” Sicwetsha said.

Doctors said on Monday that most Covid-19 beds in state hospitals were filled, and almost all of the 200 oxygenated beds at the Rev Dr Elizabeth Mamisa Chabula-Nxiweni Field Hospital. Chabula-Nxiweni died of Covid-19 shortly after attending the ceremony naming the field hospital after her.

The Eastern Cape Department of Health’s Siyanda Manana confirmed that all ICU beds were now occupied.

“Livingstone Hospital (the metro’s primary Covid-19 hospital) is being overrun,” one doctor said.

All elective surgeries have been cancelled at least until the end of November.

De Vos confirmed that due to the sheer numbers of patients seeking assistance at state hospitals’ casualty units, the number of fixed oxygen points were no longer sufficient and portable oxygen cylinders had to be brought in.

Speaking on the situation in the private sector, Craig Murphy, the regional director of Netcare’s coastal region, said they had seen a rise in positive Covid-19 admissions at the metro’s Netcare Greenacres and Netcare Cuyler hospitals. 

Meanwhile, the Eastern Cape Department of Health has resumed, after weeks of not doing so, reporting the general Covid-19 stats, but has not issued public reports on the number of active cases.

“The situation is currently progressing towards the number of admissions that we experienced during the height of the pandemic,” he said. “We are working closely with other hospitals in the area to monitor available capacity.”

Dr Charl van Loggerenberg from Emergency Medicine at Life Healthcare said he was unable to share exact figures related to admissions capacity and bed space as this changed daily. 

The hospital group has two hospitals in Nelson Mandela Bay: Life St George’s Hospital and Life Mercantile Hospital.

“We have anticipated an increase in infections in the coming weeks and all Life Healthcare hospitals, including those in Port Elizabeth, are ready and managing this. There are already significantly more patients being admitted for Covid-19 across all Port Elizabeth facilities. Current bed capacity at our Port Elizabeth hospitals is fluid and is being reassessed frequently. Our hospital management teams remain in constant contact with one another, their doctors and other healthcare professionals and private hospital groups, as well as provincial health authorities to ensure that additional beds (particularly at ICU level) are available should this be required,” he said

Meanwhile, the Eastern Cape Department of Health has resumed, after weeks of not doing so, reporting the general Covid-19 stats, but has not issued public reports on the number of active cases.

The ECSECC (Eastern Cape Socio Economic Consultative Council) ward-based Rapid Response Dashboard, which was designed to reflect real-time data and statistics, still lags by several days.

The Democratic Alliance’s spokesperson on health, Jane Cowley, said the dashboard reflected on Monday morning (9 November) that 438,024 people had been tested overall in the province, while the correct number is 519,414.

“Most frustrating, however, is that this dashboard has never been made available to the public to keep them informed, and thus empowered to make smart decisions regarding their well-being,” she said.

Thoko Mtsolongo from the Eastern Cape Health Crisis Action Coalition said it had received deeply concerning reports at the two hospitals it had visited. 

“The issues are numerous, but the most concerning is the staff shortages across all levels of health workers. There has been a high rate of departures as health workers are no longer able to cope with the pressures of the working environment at these hospitals. Doctors and nurses who have resigned, and some who have passed away, have not been replaced.

“The severe shortage of non-clinical staff persists. The temporary workers the department brought into Livingstone Hospital at the height of the first peak, work to a strict set of hours which means that doctors and nurses are still forced to take up the slack when these workers are no longer on shift. The permanently employed porters refuse to work in certain areas out of fear of contracting Covid-19,” said Mtsolongo. 

Mamela Ndamase from the Nelson Mandela Bay municipality said at this stage a triathlon event scheduled for the city later this month had not been cancelled.

She said the coalition had still not received proof of a much-vaunted turnaround plan for hospitals in the metro.

“Neither the Eastern Cape health department nor the project management unit have responded in writing to our correspondence. We have received confirmation of receipt of our letters and a promise to arrange a meeting with the acting superintendent-general, but no date has been confirmed.

“The situation around personal protective equipment is extremely concerning. We have received reports that due to budget cuts from Bisho, the amount of PPE provided only lasts a short amount of time and thereafter health workers are forced to make their own arrangements for the procurement of PPE. We are told that the Port Elizabeth depot does not deliver sufficient PPE,” Mtsolongo said.

“We are deeply concerned about the ability of [the] provinces’ health facilities to cope with the increasing number of cases, particularly in the Nelson Mandela Bay metro. It is crucial that the province scales up its ability to respond rapidly to this increasing number of cases and the potential second wave, particularly as the festive [season] approaches and an increase in interprovincial travel is expected. This means making sure that all the health workers in the province are connected to the project management unit and its proposed plan which was presented to Parliament. We have requested access to this plan, but to date have not received it,” Mtsolongo said.

Mamela Ndamase from the Nelson Mandela Bay municipality said at this stage a triathlon event scheduled for the city later this month had not been cancelled.

“The city is currently reviewing which events should be permitted in order to reduce the risk of further Covid-19 outbreaks.”

She said at this stage the city’s strategy to fight the virus was based on increased law enforcement, communication and awareness programmes.

Parts of the city were left without water on Monday after the emergency water treatment works failed and water tankers had to be dispatched.

At 3pm on Saturday 7 November, the municipality decided to close the beaches after several lifeguards tested positive for the coronavirus. The beaches were opened a day later. DM/MC

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  • I can understand and support the government’s exhortations for the citizens of SA not to become complacent with regard to Covid19 and there is clear evidence of a sharp second wave in the Eastern Cape. But if one looks at the figures for the Western Cape, Gauteng, and KZN, there is currently no evidence of a significant rise of cases in any of these provinces. So, if the Command Council believes that the Eastern Cape needs to return to Level 2 Lockdown, I can understand that but please don’t clobber the other provinces that are not showing evidence of second waves.

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