Joburg hospital doctors say failure to manage Covid-19 outbreak at initial stage left staff, patients exposed
Johannesburg - The Charlotte Maxeke Johannesburg Academic Hospital failed to get a few measures right at the initial phase of the Covid-19 outbreak, exposing staff and patients to possible infection.
Six doctors attached to the hospital and Wits University, an institution to which the hospital is affiliated, have written about their experiences there.
The article by doctors T Thomas, AE Laher, A Mahomed, S Stacey, F Motara and M Mer was published by the acclaimed SA Medical Journal.
The article discusses “our experiences at a tertiary-level institution in Johannesburg in the initial 4-month period (March 5 to July 5, 2020) of the outbreak”.
The article paints a picture of a hospital that initially battled to deal with coronavirus cases, but has since turned the corner.
One of the earlier problems was a delay by managers to create wards dedicated to treating coronavirus cases, they said. The delay possibly heightened exposure of patients.
“There was a delay in the response to create Covid-19 designated areas in the emergency wards. Achieving adequate staff allocation to these areas was also problematic,” the doctors wrote.
“Initially, there was a ‘silo’ mentality of specialities which prevented skills and resources from being redeployed towards the Covid-19 response. This may have potentially led to an increased risk of exposure and infection of non-Covid-19 patients in these areas.”
There were cases of asymptomatic patients that were erroneously diagnosed with the virus during the earlier days, the doctors revealed.
“This, coupled with laboratory delays in the processing of samples, resulted in increased exposure and heightened risk of non-Covid-19 patients contracting Covid-19 during hospital admission.”
Staff members were also exposed in various ways.
“(There was) the risk of exposure to the virus through contact with contaminated patient files, particularly in wards, outpatient clinics and the pharmacy. This was thought to have contributed to the infection outbreak among staff in the pharmacy,” the six said.
There were also instances of staff not donning personal protective equipment correctly and becoming infected, the doctors said.
“Improper IPC (infection prevention and control) practices led to several staff members being infected with Covid-19 and requiring them to be booked off from work for several days to weeks based on the severity of their symptoms.”
The hospital started doing better after it implemented a co-ordinated and multi-disciplinary management plan.
The plan was spearheaded by nursing managers, infectious diseases specialists, emergency physicians, senior clinicians, pathologists and management.
“This group would communicate daily via WhatsApp on all Covid-19-related matters and meet once weekly to address issues faced in the previous week. This led to the quick and efficient identification and resolution of problems.”
Daily morning and evening debriefing sessions were introduced in high-risk areas to assist staff with their fear of the unknown.
The six said they were sharing their experiences, hoping they could inspire other hospitals.