Cape Town - Medical staff at Groote Schuur Hospital are facing a trauma wave treating as many as 1 000 patients a month, 100 of which are gunshot wounds.
They caution that the staggering statics are untenable as they brace for the Easter Weekend and a spike in Covid-19 case.
A total of 60% staff at the hospital have been vaccinated with the Johnson and Johnson vaccine.
The Western Cape Department of Health (WCDH) said they were close to completing their batch of the phase 1 roll out after 38 699 health-care workers were vaccinated out of the 44 308 vaccines received in the province.
The second batch is expected to start in April with a further 15 980 doses as part of the Sisonke programme.
This will bring the total allocation to the Western Cape to 60 000.
Doctor Deidré McPherson, a trauma and critical care surgeon and specialist at Groote Schuur Hospital, has been working in trauma for three years and general surgery for five years. She said figures mimicked data of 2019, before lockdown.
On average, their trauma ward would be filled with 1 000 patients, being treated for trauma such as assault to motor vehicle and pedestrian accidents to penetrative trauma like gunshot wounds and stabbings.
When level 5 restrictions were set a year ago, the hospital saw an 80% decrease in admissions for trauma patients with just 270 case a month and only 20 gunshot patients for the month.
During lockdown levels 3 and 1, the hospital returned to treating between 790 to 1000 trauma patients, with 16 to 20 gunshot wounds per week and three per day.
McPherson added level 3 and 1 mimicked similar figures: “There is not much difference between level one and level three in relation to trauma incidents like gunshot wounds, stabbings.
“However, the big difference is between level 5, level 3 and level one.
“With Level 5 270 patients (2020) were only seen for the month and if you compare this to before 2019, before all of this happened, we saw 950 to1000 patients for the month.
“When Level 3 came, the figures began to look the same as that of 2019.
We began seeing 790 to 1000 patients per month.
“This includes blunt and penetrative trauma, assault, community assault, motor vehicle and pedestrian accidents.
Penetrating includes stabbings and the gunshot wounds.
“Gunshot wounds, on average we see between 16 to 20 per week now.
“That is three gunshot wounds per day.”
McPherson added during Level 5 their trauma wards could make space for patients who were high-risk and potentially had Covid-19 and for those critically-ill with the virus.
She said the decrease in trauma intakes made room for better planning for the virus.
“During Level 5, 10 percent of trauma was gunshot wounds. There were 20 gunshot wounds per month.
It gave us surge capacity to make space for the patients during the pandemic.
She said when trauma patients needed surgery, it increased occupancy because of the length of stay in the hospital.
She explained that between January and February when lockdown eased to level 1, patients treated for violence-related incidents like gunshot wounds double, from 145 to 302 per month while traffic-related injuries also saw an increase with 68 in January to 92 in February.
When asked whether alcohol was a contributing factor to these increase figures, she said: “If you look at it as a whole, Level 5, had the restriction of movement. It (alcohol) can have a contribution,” she said.
“Now people are walking to school, going to work and as humans we are social and interaction is also a contributing factor.
“When we do our statistics, we cannot say if trauma incidents are related to alcohol.”
She added that with the present high-pressured environment in trauma, they constantly need to be a step ahead in protecting themselves against the virus and know the risk of infection.
They carried out continuous training programmes and debriefing sessions for staff.
“We have to deal with the fact that some staff will get sick, some will get Covid, we made plans to cover staff especially like the doctors.
“Covid-19 does add to the stress and you also have that worry of infection.
“We treat each patient as high risk, when they come in, they are critically injured and they cannot speak and we cannot screen them at that moment.
“We have to manage these patients as if they are Covid positive because they are unable to do the screening process.
“We need to take the necessary PPE precautions.
“Our big fear, the way of managing patients changed, trauma is a very interactive thing.
“You need to examine and touch the patient.
“Trauma, we do a lot of invasive procedures and there is always a risk that you can contract it and are at risk to your colleagues and your family at home.
“There is that extra stress added to the normal stress of working in trauma.
“It is a high pressure environment but we made plans, we do training every week on how to put on a PPE, how to do certain procedures on patients in order to protect ourselves.
“We meet every morning to discuss what has happened and there are wellness sessions also offered .”