BY DAYO ADESULU
While we are continuing to see a plateauing of new COVID-19 infections below the peak of the second wave, we are still seeing an increase in hospitalisations in public facilities and deaths province-wide.
The decision to move the country to Alert Level 3 by the President was necessary to rescue the country’s economy and to save jobs, but it now means that there is an even greater responsibility on our residents to ensure that we protect our critical care capacity this weekend. We must act responsibly at all times.
I have further requested that the Provincial Minister of Community Safety, Adv. Albert Fritz, ensure that the SAPS, other law enforcement agencies, as well the Western Cape Liquor Authority are on high alert to prevent trauma in our communities this weekend when there is usually an increase in alcohol-related harms.
The provincial health platform shows us that:
- The Reproduction or ‘R’ number is currently 1.1 and is likely to decrease next week. This indicates that the number of new COVID-19 infections is reaching a plateau.
- The proportion of positive COVID-19 tests has continued to increase, reaching a high of 42% last week. This is partly explained by a delay in testing caused by transport disruptions last week.
- Hospitalisations continue to increase in the public sector, but the percentage increases are smaller. The private sector hospitalisations seem to have reached a plateau.
- We are currently seeing an average of 2439 new diagnoses each day. We are seeing approximately 307 new admissions per day.
- Deaths have increased, with around 90 deaths each day. The Western Cape and Cape Town Metro’s excess deaths have exceeded the first wave’s peak but remain below the second wave peak, as tracked by the South African Medical Research Council.
Our healthcare system remains prepared to respond to COVID-19 related demand
We have revised our response for the third wave, with clearly identified trigger points for an appropriate healthcare response. We have done so to ensure that, at all times, our healthcare platform can respond with the necessary agility to save lives.
Insofar as our acute service platform is concerned:
- There are currently 3 433 COVID-19 patients in our acute hospitals, 1 805 in public hospitals and 1 638 in private hospitals. This excludes persons under investigation and cases in specialised hospital settings.
- COVID-19 patients and persons under investigation currently make up 29% of all available acute general hospital capacity in both Metro and Rural Regional Hospital drainage areas.
- COVID-19 inter-mediate care: the Brackengate Hospital of Hope currently has 274 patients, Freesia and Ward 99 have 0 patients, Mitchell Plain Hospital of Hope has 88 patients and Sonstraal currently has 63 patients.
- The Metro mass fatality centre has the capacity for 240 bodies and currently, 33 decedents (a cumulative total of 1 709 bodies) are admitted. The overall capacity has been successfully managed across the province.
Due to higher cases than expected last week, the probability prediction by the NICD that the Western Cape has passed the peak has decreased from 73% last week to 42% this week. This means that we are likely nearing a peak of the third wave but have not yet reached it. We must continue to be vigilant.
Western Cape health platform remains under pressure as we enter the peak
Throughout each wave of the pandemic, we have consistently scaled up our bed capacity to respond to the demand, ensuring that:
- We had a total of 1681 acute and intermediate care beds during wave 1;
- We had a total of 2330 acute and intermediate care beds during wave 2; and
- We have approximately 2690 acute and intermediate care beds during wave 3.
We have also scaled up our critical care capacity:
- We had a total of 266 ventilation and high flow nasal oxygen units during the first wave;
- We had a total of 378 ventilation and high flow nasal oxygen units during the second wave; and
- We had a total of 434 ventilation and high flow nasal oxygen units during the third wave.
We are continuing to closely monitor the usage of beds across our province, through a centrally coordinated and professional operation, known as the Bed Bureau Management System.
In the Western Cape, the total general bed use rate is at 88%, the total COVID-19 bed use rate is at 70%.
We have revised our response for the third wave, with clearly identified trigger points for an appropriate healthcare response
Insofar as our drainage areas are concerned:
- The Metro has 5065 beds, of which the general bed use rate is 95%, the COVID-19 bed use rate is 73%;
- The George drainage area has 918 beds, of which the general bed use rate is 67%, the COVID-19 bed use rate is 76%;
- The Paarl drainage area has 988 beds, of which the general bed use rate is 86%; the COVID-19 bed use rate is 88%; and
- The Worcester drainage area has 769 beds, of which the general bed use rate is 71%, the COVID-19 bed use rate is 38%.
This demonstrates that our health platform is under pressure as hospitalisations are increasing. It is again a clear indicator that every single person in the province must be on heightened alert during this time, practising responsible behaviour at all times.
Western Cape Department of Health is meeting regularly with Afrox to ensure that we continue to have adequate oxygen supplies
I am pleased to note that both public and private sectors have successfully addressed some of the capacity challenges identified at the facility level in preparation for the third wave.
Insofar as our oxygen capacity is concerned:
- The combined public-private use is now 69.21 tons a day or 98.87% of the maximum production capacity of 70 tons per day at the Afrox Western Cape plant.
- The public sector total average bulk oxygen consumption is 39.04 tons a day or 55.77% of the daily bulk consumption of the Afrox plant.
We will continue to monitor oxygen use over the coming weeks and have started regular oxygen huddles with the Afrox team to ensure that we can scale up our provisions and meet the demand during the third wave. We are confident that we can continue to do so, with the Afrox supplies available at their plants.
We employed additional staff throughout the pandemic, and continue to do so
Throughout each wave, we have consistently scaled up our employ of healthcare staff to respond to the demand, ensuring that we employed an additional:
- 844 staff during the first wave;
- 1117 staff during the second wave; and
- Retained capacity from the second wave, while employing 804 additional. We can appoint an additional 761 and continuous recruitment is underway.
Insofar as our vaccination database is concerned, we have:
- 1147 healthcare workers and support staff appointed, including 442 interns for our vaccination drive;
- 6 101 registered vaccinators on our health platform; and
- 4 053 trained vaccinators to date.
Ensuring that we have enough staff is a crucial component of protecting our healthcare workers amid the pandemic.
We are also protecting staff’s wellbeing and safety by administering vaccinations to healthcare workers. To date, we have fully vaccinated 92 181 healthcare workers through the Sisonke programme.
I would like to again thank our frontline heroes for all that they continue to do during this difficult time, especially as we experience the pressure of yet another peak in hospitalisations.
Over 1 million vaccines were administered and 359 282 people fully vaccinated
To date, a cumulative total of 1 072 838 vaccines have been administered; of which 359 282 people have already been fully vaccinated.
In the first three days of this week alone, we have administered approximately 96 000 vaccines, and we expect to reach 150 000 vaccinations by the end of the week, albeit under vaccine availability pressures.
This is because the demand for vaccinations in our communities is far exceeding the available supplies. We also have to manage our supplies carefully, so that those over 60 returning for their second dose can be assisted. We ask for your patience and understanding in light of these realities.
We expect this balance between demand and supply to be rectified in the week after next when much higher vaccine supplies will be made available to provinces. We are also engaging with national counterparts continuously so that we get adequate supplies to match this exciting demand.
While I understand it might be frustrating during this time of pressure, I kindly ask that we continue to show care to our frontline workers at our vaccine sites. They are doing excellent work serving their communities, and they are not the reason for a lack of supplies. Please be kind.
Let’s save lives and livelihoods by staying safe
It is extremely important that every single resident take personal responsibility in protecting themselves and their loved ones during our peak.
We also need to protect our healthcare system so that we continue to save lives and livelihoods in the province.
Please:
- Wear your mask properly, covering your nose and mouth.
- Wash and sanitise your hands regularly.
- Avoid crowded places, confined spaces and close contact.
- Keep your gatherings short, small and outdoors – with lots of ventilation.
- Drink responsibly and do not drink and drive.
- Get vaccinated when it is your turn.
- Stay home if you feel sick. If you have any difficulty breathing, seek urgent medical treatment.
- Help protect those at highest risk – especially those who are older, and those with comorbidities.
- Continue to protect your family bubble.
Let’s play our part and break the chain of transmission so that we can save lives and livelihoods in the Western Cape and South Africa.