Cape Town - The province's hospitals are under severe pressure as the number of patients admitted with Covid-19 continues to spike, along with an increase in non-Covid-19 trauma cases.
Experts from the National Institute For Communicable Diseases (NICD), UKZN and UCT are now also analysing the potential impacts of a new lineage of Sars-CoV-2 detected in the Eastern Cape, Western Cape and KwaZulu-Natal.
As of Sunday, the province recorded 172 154 infections and 5 488 deaths. A total of 2 335 new cases and 73 deaths were recorded within 24 hours.
In a statement on Sunday, the provincial Health Department said the 231 adult ICU/high care beds across hospitals were currently fluctuating between 80-100% capacity daily, placing enormous pressure on the capability of all facilities.
An additional 136 dedicated adult ICU Covid-19 beds were made available, bringing the combined ICU/high care beds to 367.
As of December 18, there were 2 032 Covid-19 patients in hospital, with 287 in ICU/high care.
“The 4 443 acute beds (excluding Maternity, Paediatric, Neonatal, Psychiatry beds, Red Cross, Mowbray and the TB hospitals) across the province are also taking strain, with Metro hospitals operating at 78% and rural hospitals at 89%.”
The protracted pressure on scarce health resources may result in possible delayed admissions to hospital or the possibility that certain services cannot be rendered, the department said.
“To assist the teams, the department has initiated ethics committees to support the clinical decision making. Both clinical decision making and access to certain care packages will, by necessity, be different to those experienced in normal day-to-day services – for both Covid-19 and non-Covid-19 patients.”
To further support the demand for services, an additional 829 dedicated Covid-19 beds have been made available.
The existing 487 intermediate care beds, provided by Brackengate, Sonstraal and Freesia ward (Lentegeur) are also seeing an increase in admissions. Brackengate is nearing capacity.
“To support these facilities, we will be creating an additional 263 beds within Lentegeur and Tygerberg Hospital. We have already started exploring/ implementing certain plans to further expand our capacity to deal with the increased demand for hospitalisation,” the department said.
Mediclinic Southern Africa said the numbers of patients seeking care within their hospitals in the province had exceeded numbers during the first wave of infections, and that the demand in many of its ICU and high care units had reached capacity.
Group general manager for Clinical Performance Dr Gerrit de Villiers said: “Within the last month, Mediclinic has noted an increase from less than 100 admitted Covid-19 patients, to more than 500 patients within its facilities across the Western Cape, including the Garden Route.”
In an effort to manage the growing demand, all elective or non-emergency surgery has been cancelled or postponed within the region, in an effort to create additional capacity within their facilities.
“Mediclinic has already increased the available number of beds to assist Covid-19 patients.
“We have reallocated key resources to hotspots, and provided additional training to upskill nursing staff from other units to assist in areas such as ICU and high care,” De Villiers said.
The NICD said at the weekend that although equipment had been made available, the supply of oxygen was in great demand.
“Many hospitals still require bulk liquid oxygen installations to facilitate the use of continuous positive airway pressure (CPAP) and high-flow nasal cannula (HFNC) oxygen to treat moderate to severe Covid-19 cases. The Emergency Medical Services are under significant pressure.”
The Network for Genomics Surveillance in South Africa (NGS-SA), including the NICD, UKZN, UCT and SUN, which has been monitoring changes in Sars-CoV-2, said the new lineage detected possesses between 10-20 mutations that were not previously seen in viruses from South Africa prior to September.
Scientists are working on testing what impact these mutations have on virus growth, sensitivity to antibodies, and binding to human cell receptors.
National Health Department spokesperson Popo Maja said the discovery explained the sudden increase in infections in the Eastern Cape and Western Cape.
“The discovery also points to the need to intensify preventive measures to avoid the collapse of our health system,” Maja said.
Cape Times