Hospital capacity not ramped up enough to cope with looming crisis in Eastern Cape, report reveals

The Eastern Cape lockdown did not produce the capacity needed to fight the spread of coronavirus and there are fears the province could run out of beds for Covid-19 patients by mid-July.

Those concerns formed part of a comprehensive report compiled by the Eastern Cape provincial command council led by Premier Oscar Mabuyane.

The report, discussed on Sunday by the council, also expected that deaths in the Eastern Cape could soar to between 5,500 and 6,000 in the next three months due to Covid-19.

On Tuesday, however, Eastern Cape health superintendent-general Thobile Mbengashe said what should be remembered was that the report dealt with a worst-case scenario and health officials were hard at work ensuring the predication did not come true.

“The model on the number of deaths is not a predetermined future or prophecy. That model is a map but not the road we will travel.

“However, it shows us that if we do nothing this will be what the future looks like,” he warned.

The projected deaths are expected to occur during the peak of the virus, which is expected in October.

“If the modelling is correct, the Eastern Cape is at the start of an exponential increase in deaths over the next three months,” the report reads.

The report suggests that infrastructure and support services would have to be put in place urgently to deal with the situation.

However, it warns that based on the number of   hospital beds in the province, the Eastern Cape was not able to to manage the demands of the pandemic.

“Unless capabilities are exponentially and rapidly increased, the province will experience a situation where the demand will be exceeding supply.”

The report predicts that based on projections, demand for hospital beds will outstrip supply by early to mid-July.

“It would appear from the data that the lockdown did not produce the required increase in capacity in the Eastern Cape to deal with the future demand,” it reads.

But Mbengashe said officials were working tirelessly to ensure hospitals were well equipped with enough beds when the  virus  peak hits.

“We have 1,500 beds that are Covid-19 compliant with an additional 500 expected to be ready in two weeks,” he said.

Mbengashe said a positive outcome from the hard lockdown was that the number of beds required had been reduced.

“We can also repurpose beds to meet the demand and these figures do not include beds in the private sector which we can activate at a moment’s notice.”

He said not everyone would be hospitalised at the same time.

“Some will come and leave before other patients are admitted.”

Mbengashe said the change in people’s behaviour — social distancing and wearing masks — would also reduce the number of beds needed.

“The model is a tool for us to use as a focus point. We know what is required from us now.” 

He said the department was also working with a Port Elizabeth company to develop low-tech, non-evasive ventilators.

Non-invasive ventilation is the delivery of oxygen via a face mask, eliminating the need for an endotracheal airway.

“Most people who go into ICU for invasive ventilation do not improve. We are going to go the route of non-invasive ventilation.”

He said an additional 100 beds each for critical care were also being built for East London, Mthatha and Aliwal North.

He said  the worst effects of Covid-19 would be felt in the next three months.

“We will use an intervention where we target clusters that are rising faster.”

Mbengashe said if a specific district saw a surge in positive cases, it would be placed on lockdown.

“This will help flatten the curve and fewer people would need to be hospitalised.”

According to the report, if a number of new infections exceeded five per 100,000 people over a defined period of  time, the area would be declared as a hotspot. 

Using a model to reflect the rate of new infections and recoveries, the appropriate level of lockdown will be decided for 14 days before it is assessed again.

Nehawu regional secretary Sweetness Stokwe said the department was not handling the Covid-19 situation properly.

“They are using a helicopter view to determine how they are reacting to the virus. Mbengashe is useless. He has not acted against this virus.”  

She said Nehawu’s national leaders would visit Livingstone Hospital on Thursday and hoped health MEC Sindiswa Gomba would attend.

“Gomba and Mbengashe  must come meet us,” she said.

Stokwe said they had made various proposals to the department to help fight the virus but these were ignored.

“They must be sitting in someone’s briefcase somewhere.”

Meanwhile, the report highlights that there is high potential for a rapid escalation in the two emerging hotspots, namely in the Chris Hani and OR Tambo districts.

“There is a possibility that the two emerging clusters could join up to create a super cluster,” the report reads, adding that the rural service delivery challenges would impede the ability to respond to the infection rate.