In the third wave of the coronavirus pandemic, Gauteng’s bed space availability is in the spotlight.
According to a 6 May update from the Gauteng Command Council, the province had 4,415 beds available for Covid-19 patients. Of these, 4,064 are functional: 3,261 for admissions and 803 for Quarantine and Isolation.
This includes an additional 150 beds donated by BMW to the Bronkhorstspruit Hospital. Gauteng Premier David Makhura said last week that 5,200 new professionals had been employed to manage the additional beds.
As of Thursday, the province recorded 3,641 new cases and now has 10,382 active cases – a significant jump from the 6,712 active cases recorded on 13 May.
The Emfuleni District has the highest number of active cases at 945.
Gauteng’s cumulative total of 439,391 makes up the country’s highest percentage of cases at 27%.
Maverick Citizen previously reported that modelling from the National Institute for Communicable Diseases (NICD) shows a worst-case scenario where Gauteng will be hit harder in the third wave than in the second wave which occurred between December and January.
Currently, 1,834 people are hospitalised, of whom 573 are in ICU and High Care.
However, the chair of the Gauteng Premier’s Advisory Committee on Covid-19, Dr Mary Kawonga, told Daily Maverick that Gauteng is seeing a resurgence and “that is worrying, whether or not the province has reached a third-wave threshold”.
“We indicated that we expected to reach the third-wave threshold in three weeks from then. That timeline has not changed. The third-wave threshold for Gauteng is when the seven-day rolling average of daily cases reaches 1,580. We are not there yet. Our assessment was that if the daily rate of increase in the seven-day rolling average continued at the rate we were seeing in the week of 7 May (i.e. an average of 7% per day) then we expected to reach the third-wave threshold in the last week of May.
“The rate of increase slowed down very slightly this week, but at the rate the numbers are going we still expect to hit the third-wave threshold later next week or early the week after that,” she added.
The province took a blow when a fire at Charlotte Maxeke Johannesburg Academic Hospital affected 311 beds. The hospital had the largest Covid-19 unit.
A new hospital in Carletonville, West Rand, was opened on 14 May. Donated by AngloGold Ashanti, it has 181 ICU and High Care Unit (HCU) beds, pharmacy, admin and admission areas, radiology, laboratory, and physiotherapy units.
According to Jacques du Plessis, managing director of Netcare’s Hospital Division, Covid-19 patient volumes are “relatively low and manageable in Netcare facilities” in the province.
When it comes to the likelihood of severe illness and therefore hospitalisations within Gauteng, Professor Alex van den Heever, health and social security systems specialist at Wits University’s School of Governance, said there are “many unknowns”.
“The question is whether the second wave has impacted on the potential severity of the third wave and whether there is a degree of immunity that has built up.”
He indicated that persons who were infected in the first wave likely have some protection against severe illness but are not immune from infection, while those who were infected during the second wave are likely more immune from infection and severe illness.
“And of course there are people who have been vaccinated.”
Kawonga said based on epidemiological data and from experience from previous waves and the advisory committee’s assessment, the force of infection and peak of the third wave will likely be less than the second wave (assuming a new highly transmissible and infectious variant does not emerge).
“The population-based seroprevalence survey conducted in Gauteng during November 2020 to Jan 2021 indicates that by the peak of the second wave up to 43% of the population in some subdistricts had already got antibodies against Covid-19,” she said.
As of Wednesday, 134,420 residents (including health workers) had been vaccinated in Gauteng.
During the second wave, the province’s hospitals battled with the surge in cases. ICUs were full and by mid-January, hospital admissions had reached more than 4,100.
This time around, Premier Makhura said the province was prepared to deal with the third wave.
However, Van den Heever felt the public sector did not have enough “capability” to deal with “maximum surges”.
“I think they can deal with the relatively easy rise (in cases),” he said.
According to Kawonga, based on the number of available beds and the predicted number of cases in the third wave, and data on the rate of hospitalisation, “our assessment was that the available bed numbers will be sufficient to cater for the anticipated admissions in the third wave. Of course, the capacity to manage cases entails more than just the beds”.
Restrictions and the clampdown on superspreader events helped Gauteng curb the second wave of infections, according to Van den Heever. For the third wave, he said introducing restrictions sooner rather than later could prevent a spike in hospitalisations.
The national department of education cancelled all contact sports with immediate effect from 19 May. This is after school sports activity-related Covid-19 outbreaks in Gauteng schools were reported during the last week of term one and were gradually increasing in term two.
“It is evident that despite following the protocols as guided by the directions on extramural activities and standard operating procedure on the prevention, containment and management of Covid-19 in schools, contact sports events still contribute to the spread of Covid-19,” read a statement from the council.
In a press statement released last week, Makhura said health infrastructure was central to the provincial government’s health response. And the government’s priority was slowing down the infection rate and increasing the pace of the vaccination process.
On Sunday, 23 May, Kawonga said “our focus is on tackling the key underlying drivers of the resurgence in our setting; reducing superspreader events and ensuring everyone keeps adhering to non-pharmaceutical interventions. These are the things that reduce transmission – if we do these things well, then we will reduce the circulation of any variants that may be circulating”. DM
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