The national lockdown has bought the country some time to get health facilities ready for a surge in Covid-19 coronavirus cases.
In a matter of months health facilities and healthcare workers had to put in place new infection control measures and prepare for the anticipated surge in cases.
Professor Shabir Madhi, an infectious disease expert at Wits University, says the lockdown was important because health facilities were not ready. But, speaking on a Daily Maverick webinar over the weekend, he also stressed that only so much could be done and health systems couldn’t be built in three to five weeks.
George Hospital is no exception.
At George Hospital, a 266-bed level-two hospital that services the Garden Route area, management and health authorities have been putting heads together to prepare for Covid-19.
By Monday the Western Cape had the highest tally of both confirmed Covid-19 infections and deaths of all South Africa’s nine provinces: 5 621 and 106. The vast majority of the province’s cases are more than 400 kilometres down the N2 from George in the Cape Town area.
By Friday, the Garden Route district had 64 confirmed Covid-19 cases. While this is low compared to Cape Town, numbers are expected to rise all over the province and hospitals are in a race against time to ready itself for screening, testing and treating infected patients.
Getting ready for the surge
George Hospital is the referral hospital for all health facilities in the Garden Route and Central Karoo districts – which includes the District Hospitals of Knysna, Mossel Bay, Riversdale, Ladismith, and Oudtshoorn. Level-two hospitals such as George Hospital typically provide specialists’ services like occupational therapy, oncology and chemotherapy, ophthalmology, orthopaedics and orthopaedic aftercare, and pacemaker testing.
Nadia Ferreira, principal communications officer for Garden Route and Central Karoo districts, told Spotlight they hadn’t yet admitted a Covid-19 positive case at George Hospital, but they had been doing vigorous screening and testing.
Ferreira said the hospital had designed and custom-built a complete virus testing unit in record time and that a building on the hospital grounds was transformed into a Testing and Triage Centre.
Ferreira said similar facilities are already operational at Tygerberg, Paarl and Khayelitsha hospitals. The virus testing unit at George hospital was one of 17 such facilities planned for the province.
“These facilities have been designed to relieve the pressure on emergency services, and allow for patients to be tested, assessed and assisted separately from the other services,” Ferreira said.
The unit enables the hospital to test and screen everyone that enters the hospital premises for Covid-19.
Anyone who visits George Hospital has to enter through the unit and must be screened upon entry and where necessary, swab samples will be taken and send for testing.
George Hospital CEO Michael Vonk said that architects and other experts were called in to help. “A mechanical engineer designed the ventilation system which is important to keep the public and staff safe,” he said.
“Most of the building work was done by the hospital workshop staff with the support of an electrician and plumber. It was quite a challenge to obtain materials during lockdown.”
Vonk said a tent would be erected to add waiting space at the hospital. Two six-seater golf carts were used to transport patients, where needed, from Testing and Triage to the emergency centre.
Vonk explained screening at the unit was a quick process.
“The person’s temperature is checked with an infrared thermometer and a few quick questions are asked. If the person meets certain criteria, swab samples will be taken for testing.”
The hospital has its own National Health Laboratory Service lab, but all Covid-19 swabs are sent to laboratories in Cape Town for testing.
As Spotlight and others have reported, turnaround times for test results can be a problem.
Premier of the Western Cape, Alan Winde, said last week that in the last two weeks the province more than doubled the total number of tests conducted as part of a targeted testing strategy aimed at identifying pockets of infection.
Business unusual
George Hospital, like most facilities across the province, has restructured its service package.
The hospital has diverted all resources to essential and emergency services, resulting in all non-urgent surgery for gallbladder removal, cataract, elective removal of tonsils, elective knee replacement, hysterectomy among other elective surgeries being cancelled for the time-being.
All outpatient department visits have been rescheduled for a later date except high-risk antenatal clinic visits, dialysis treatment and emergency cancer treatment.
The hospital also rescheduled all day-theatre cases, and some planned surgeries. Surgeries that need to be performed within three months will go ahead.
The hospital is working around the clock to ensure that though more focus is being given to Covid-19 patients, the health of other patients is not compromised.
“Notwithstanding the inconvenience and impact on patients, with restructuring comes the mental burden on staff as it is a massive change which is most often accompanied by anxiety,” said Ferreira.
“It is therefore important that each person take responsibility for their own health, especially chronic lifestyle diseases. On a positive note, we’ve had fewer trauma cases. It is important for the public to remember that we are still there to render a service for trauma cases,” she said.
Hospital capacity
The hospital has two separate isolation wards for Covid-19 patients.
“The current capacity is adequate for the current need,” Ferreira said referring to bed capacity.
“Bed numbers will constantly change in line with need.”
One Covid-19 ward is an intensive care ward, and one a general ward and has capacity for maternity patients.
“We have adequate staffing at present to treat all patients at George Hospital with 750 medical staff,” Ferreira said.
“We also had limited stock of Personal Protective Equipment which is [also]globally the case. Staff are naturally also concerned about the well-being of their families at home. Good communication within the facility has been a very high priority. We streamline communications and keep staff informed,” she explained.
Vonk was full of praise for the staff at the hospital.
“Staff at George Hospital see this [pandemic] as their opportunity to really respond to their calling and commitment to the community. We have been working hard to prepare for the influx of Covid-19 patients as best as we can. We have been encouraged and even inspired by many people and organisations who want to assist us at this time, making available resources,” Vonk said.
*This article was produced by Spotlight – health journalism in the public interest. Like what you’re reading? Sign up for our newsletter and stay informed.
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