Cape Town - Doctors - in the province are taking strain, fearing burnout and have warned that services may not be enough to cope with the influx of patients during the peak of the Covid-19 third wave.
Professor Lydia Cairncross, stationed at Groote Schuur Hospital, detailed that staff now to deal with patients who required surgery and non-Covid-19 patients for other illnesses which added to the strain and management.
“I am a surgeon working in the Covid-19 ward in the hospital, our high-care staff is really taking the strain. During the first and second wave, we had the non-Covid patients who were not coming to the hospital as much.
“Now in the third wave, we see it scaling up with patients coming in. We now need to open wards five to seven times a day.
“On top of that, we are seeing critically-ill patients with Covid-19 coming into hospital and needing ICU (inensive care unit) and with that you need a lot of staff to run it.
“We do see how it is affecting those who are not Covid-related, for example needing surgery, and it is a whole balancing situation and maximising and to give the best care. During the first wave people were too scared to come to the hospital,” she said.
Cairncross said staff were also impacted emotionally by the deaths of patients. She felt that if more people had been vaccinated before winter, the strain would have been lesser.
“The staff is affected because it is a person-to-person level in the Covid wards. We also need to be selective of who goes into ICU.
“What happens when we do? Then the need is greater than that of the service that can be provided. Yes, everyone is stretched and is working more hours. Our high-care staff require us to sleep in and our admissions system works on a 24-hour service, with eight-hour shifts.”
Dr EV Rapiti, who has been running his practice in Mitchells Plain for more than three decades, has also been treating patients with Covid-19.
He said he has seen more than 4000 patients since the pandemic started and he too was feeling the strain.
“I am reaching the point of burnout, this is what doctors do not speak about. We are having to see patients after hours and even virtual consultations.
“This Covid virus, while it falls into the category of flu, is a very unique virus and this virus can affect your lungs, deadly pneumonia or a crippling blood clot,” he said.
Spokesperson for the Health Professions Council of South Africa (HPCSA), Christopher Tsatsawane said lack-of-sleep fatigue could impact a doctor’s performance.
“The HPCSA would like to encourage practitioners to seek the assistance of wellness service providers so that they can receive professional guidance and counselling.
“Lack of sleep and fatigue by practitioners could negatively impact their cognitive functioning and performance, resulting in an increased risk of medical errors,” said Tsatsawane.
While the Western Cape emergency services teams are also feeling the strain, with close to 500 Covid-19 related call-outs between June 21-27.
Deanna Bessick, communications officer for Emergency Medical Services (EMS), said: “A total of 12 723 incidents were responded to by the Western Cape Government Health's Emergency Medical Services over the past week; 12 259 incidents were non-Covid-19-related and 464 were Covid-19 incidents.”
EMS director, Dr Shaheem de Vries said he commended the brave staff on the front line daily and asked people to adhere to Covid-19 regulations.
“EMS officials are placing their lives at risk and providing an essential service to the communities in the Western Cape, we’re urging individuals to support EMS officials during these dire times,” he said.
Western Cape Health Department’s spokesperson, Mark van der Heever said they had hired additional staff to assist during the current third wave and there had been no reported incidents of error due to doctors’ fatigue.
“We have also appointed 833 staff additional for Covid, 775 HCW (healthcare workers) and support staff as well as 359 interns for the vaccination drive, negotiated further contract extensions and re-allocation of staff in response to third wave and we can still appoint 753 more people if needed,” said van der Heever.
“We acknowledge the fact that our staff are and have been under pressure throughout the pandemic.
“One of the key elements in our 6-point Covid strategy is to safeguard and protect the well-being of our staff as they deal with Covid-related matters, the normal emergency and routine health services.”
Van der Heever added that they also encouraged staff to take leave when they felt the need, to recover and recuperate.
“There have been no incidents reported to the department of fatigue leading to errors by any medical practitioner. Our department has put in place several measures to look after the well-being of our staff to ensure their mental and physical health is protected.
“During the previous waves the department started a ’Healing Journey’, where staff can participate and reach out for support.
“As part of the Healing Journey, we implemented ’intentional leave’ and encouraged our staff to take leave so they can recuperate and recover after waves.
“In addition, we also have the following support mechanisms in place to offer assistance to staff: On site Counselling Clinics as part of our Employee Wellbeing Programme, PPE provision and improving occupational health and safety practice, communicating practical ways for our staff to be safe at work and fostering a culture of healing & collaborative learning.”
National Department of Health spokesperson Popo Maja said they were still collecting data on how doctors were coping during the third wave.