Update from the frontline

January 8, 2021

Netcare readies itself for Gauteng COVID-19 surge

Netcare assured the South African public that it was doing everything humanly possible to bolster resources in order to continue providing the best and safest care during a most challenging time for humanity.  

In an update earlier Dr Richard Friedland said that a heartening decrease in hospitalisations in the Eastern Cape has been recorded for the fourth week running. It is expected that through the month of January the region will recover to the levels of COVID-19 last seen before the second wave. Similarly, Netcare hospitals in the Western Cape (WC) have also started to reflect a plateau in the number of patient admissions.

Dr Friedland noted that the newly imposed lockdown and restrictions on alcohol sales has thankfully had a dampening effect on violence and accident-related trauma cases, which has eased the burden within Netcare’s accident and emergency departments.

“Limpopo is currently experiencing an unprecedented demand in hospitalisation with Netcare’s facility in Polokwane, Netcare Pholoso Hospital, more than 100% occupied.” 

“As part of our disaster management planning, we have commissioned a temporary Clinical Decision Unit that can accommodate up to 80 patients. This will ease the burden on the emergency department at the hospital and will enable the stabilisation of patients prior to hospitalisation.

“The fully airconditioned Clinical Decision Unit, which has received approval and support from the MEC for Health in Limpopo, will be operational as from 7 January and will provide oxygenation, ablution facilities and safe areas for donning and doffing of personal protective equipment for nurses and doctors. An additional 60 staff members have been deployed to assist at the hospital,” he added.

Dr Friedland added that Netcare facilities throughout KwaZulu-Natal (KZN) also continue to experience an unprecedented demand on bed capacity and that this is expected to continue throughout January.

“In Gauteng we are, as expected, already experiencing an alarming rise in admissions of COVID-19 patients across all our facilities and this is expected to rapidly worsen over the next two weeks,” he cautioned.

Preparations and capacity building
Dr Friedland said that given the experience of the first wave, Netcare is well equipped to maximise the group’s ability to provide care during the expected surge in Gauteng and the ongoing escalation of COVID-19 cases in KZN and Limpopo.
  • Staffing
“Netcare has called all staff back from leave and is expecting to have staff levels back to full complement by the end of this week. The company has in addition recruited several doctors and clinical associates to assist hospitals and physicians, and has also employed a number of unemployed social workers to assist with patient liaison in order to support patients and families so that clinical staff can focus solely on their clinical duties.

“We have also advertised for students to assist part time. We have received over 3 500 applications and are currently processing the applications so that the students can be deployed in various hospitals in non-clinical roles,” said Dr Friedland.
  • Equipment
According to Dr Friedland, Netcare has procured an additional 1 100 oxygenators, which will arrive in the country this week. “The machines, which can produce up to four litres of oxygen per minute each, brings the total fleet of oxygenators to 1 400 and will decrease the burden on the oxygen supply within our hospitals. We have also purchased an additional 100 high flow nasal devices, which will arrive in mid-January. This brings the total number of high-flow nasal devices in the group to 626. In addition, we have a total of 1 105 ventilators in the group.”
  • Bed capacity
Dr Friedland said that Netcare has 10 411 hospital beds in the group which includes 425 in Lesotho. This includes 5 699 beds across 29 hospitals in Gauteng and 1 956 beds in KZN across ten hospitals. The group has more than 1 716 acute care (high care and ICU beds) of which 1 055 are located in Gauteng and 261 in KZN. 
 
“We are constantly converting more beds to red COVID-19 beds to accommodate the expected surge in Gauteng. To ease the burden of our emergency departments, and to alleviate long waiting times, we are establishing Clinical Decision Units within certain hospitals. These will be by managed by our emergency department physicians in order to alleviate the pressure on beds within the hospitals,” he said.
  • Drugs, consumables and PPE
“We have purchased adequate supplies of the appropriate drugs and consumables, as well as personal protective equipment to last us throughout this second wave. We have in place strict infection prevention and control policies and principles. We demand fastidious adherence to these standard operating procedures, which are at all times aligned to the guidelines and protocols issued by the World Health Organization [WHO] and the National Department of Health [NDoH],” assured Dr Friedland.
  • Oxygen supply
Friedland noted that Netcare has already upgraded the storage capacity at most of its facilities and is in the process of completing further upgrades at 17 facilities in Gauteng.
 
“Because the country is facing such an extremely concerning surge in new COVID-19 infections, which has left many individuals anxious and concerned, Netcare will be doing its best to keep the public abreast of the developments and its efforts to ensure safe and sustainable care.” 

Human lives and safety first
“We wish to assure the public that we will continue to do the very best we can for all patients seeking care at any of our healthcare facilities, while ensuring the safety of our frontline staff, doctors, nurses and other healthcare workers. 

“Netcare and all of our hospitals continue to monitor the situation very closely in order to provide the appropriate care for each patient according to the severity of their condition. The level of treatment required is monitored on an ongoing basis to ensure the most effective use and deployment of resources for optimal patient care,” assured Dr Friedland.

“During these uncertain and difficult times, we appreciate the public’s patience and understanding, and I want to assure you that we are working as hard as humanly possible on the frontline to provide the best and safest care we can to our patients during this challenging time.

“The most effective way of preventing a humanitarian crisis is for everyone to take COVID-19 extremely seriously and be more cautious than ever. Please remain vigilant to help protect your loved ones, yourself and the healthcare system. It is critical for each individual to closely adhere to COVID-19 precautions including washing hands regularly, adhering to social distancing, and always wearing a mask in public and in the presence of others, to protect yourselves and to help prevent the spread of the virus. 

“We cannot emphasise strongly enough the need for all these precautions to be diligently followed, as every person has a responsibility to help ‘flatten this new curve’ and avoid contracting and passing on the virus,” concluded Dr Friedland.
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Naturally, this model calls for the open participation of patients, the healthcare industry, health professionals, and the Government. “The most critical elements are robust diagnosis standards, improved access to treatment, data collection and management, co-ordination of care, measurement of outcomes and ongoing collaborative research,” du Plessis says. “We need to establish rare disease advisory committees, map gaps and opportunities, establish system requirements, create a roadmap and plan a phased implementation with clear timelines.” The RDAI states that these policy development steps would be a start in quantifying the disease burden and defining standards of care. This would be followed by building and strengthening the capacity to facilitate appropriate diagnosis, treatment, continuity and data monitoring. 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About RDAI The Rare Diseases Access Initiative (RDAI) is dedicated to advocating for improved healthcare access, policy development, and patient support for those affected by rare diseases in South Africa. The initiative brings together key healthcare stakeholders, including pharmaceutical associations, funders, genetic specialists, and patient advocacy groups, to drive impactful change. About RDSA Founded in 2013, Rare Diseases South Africa (RDSA) is a non-profit organisation advocating to ensure that people living with rare diseases and congenital disorders experience greater recognition, support, improved health service and better overall quality of life. Started out of personal need following the diagnosis of organisation founder, Kelly du Plessis' son, it became evident that there was a lack of awareness and support for rare diseases in general in South Africa. 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