As the Covid-19 infection rate continues to climb, particularly in Gauteng, many are wondering why government hasn’t enforced even stricter restrictions to curb the virus. South Africa’s wealthiest province has been severely affected by the third wave, with Discovery Health’s Dr Ryan Noach telling BizNews (listen below) that they’re seeing “new infections 30% above where they were in the prior peak of the second wave. We haven’t seen the likes of these infection numbers in Gauteng before.” While the government may be hesitant to implement further restrictions – due to fear of weakening the already damaged economy – some are of the opinion that we take initiative and apply our own lockdown. Below, Dr Israel outlines the reality of what’s going on in hospitals. People with severe Covid-19 symptoms often wait hours for a bed – and it’s not just the elderly and those with co-morbidities suffering anymore. “I admitted a 37-year-old man who isn’t overweight and has no co-morbidities. He has now spent a week in a top facility, his oxygenation progressing from nasal oxygen, to a high-fLow system, to non-invasive CPAP (constant positive airway pressure), to a full ventilator. His prognosis is guarded.” As Dr Israel writes, he is aware of the negative impacts lockdowns may have – socially and emotionally, for example – but notes that now isn’t the time to live normally. “We need to be smarter than our government, and pull in the reins over this surge, which is projected to peak in two to three weeks.” Something of a silver lining in an otherwise dark cloud, Israel writes that waves and Covid-19 will certainly pass. “Keep your head up. Be your own president.” – Jarryd Neves
By Dr Daniel Israel*
If you struggled to imagine what was going on in Wuhan in March 2020 as I did at the time, June Gauteng 2021 is your opportunity to vicariously relive that situation. An unexplored virus. Disproportionate loss and grief. Draconian – and now
not so draconian – measures of hospital isolation of the seriously ill and those home bound with infection.
The 16 months that have passed since the Wuhan fiasco, the initial knee-jerk lockdown, and the economic devastation have disempowered our authorities from implementing harsh enough measures at this sensitive time in Gauteng. Let me share a few insights as to how rampant COVID-19 is in Gauteng at the moment.
My own family medicine practice has diagnosed an excess of 20 cases a day this past week. Each patient requires a careful explanation about appropriate medication, warning signs of deterioration and, most importantly, contact tracing in a desperate attempt to curtail further spread. Every day, our doctors admit at least one or two patients who simply aren’t coping at home. However, admission is no longer a golden bullet. Patients are often admitted via casualty, where they wait fIve or six hours for the availability of a normal bed. The fortunate patients who receive direct admission from home to a ward are the select few who manage to access limited hospital resources.
However, being one in a hundred patients admitted with COVID-19 at a hospital like Netcare Linksfeld Hospital is far from ideal. Provincial statistics are showing that 20% to 25% of admitted patients require critical-care beds. These beds are full.
Surely these problems affect only “other” people? I will let you decide. Last week, I admitted a 37-year-old man who isn’t overweight and has no co-morbidities. He has now spent a week in a top facility, his oxygenation progressing from nasal oxygen, to a high-fLow system, to non-invasive CPAP (constant positive airway pressure), to a full ventilator. His prognosis is guarded.
Like yours, my Facebook feed is flooded with people sharing their pain about loved ones succumbing to this virus at an untimely stage in their lives. I’m not a pessimist, and I do see various solutions. However, in the eye of a storm, we don’t go sunbathing.
We have to be our own president and lockdown our social lives to level 5. I’m not concerned about risk and exposure in parks,
zoos, or beaches. I’m not significantly concerned about the risk from disciplined visits to controlled institutions, with formal interactions, such as bank appointments, doctor appointments, cautious visits to quiet shops, and the like. At these monitored times, masks are worn, hands are cleaned, and distances are kept.
I’m deeply concerned about all of us who exercise the nth degree of caution in the examples above and then have our siblings over for a Sunday afternoon lunch because “they’re definitely also being as safe as we are”. This is how the vast majority of COVID-19 patients in my practice have become infected.
I’m the first proponent of relaxing restrictions wherever possible. We are all discouraged by this lockdown existence that has owned us for longer than we can clearly remember. My commitment is to encourage people to live normally as much as
possible, but at the appropriate times. However, now isn’t that time. We need to be smarter than our government, and pull in the reins over this surge, which is projected to peak in two to three weeks.
We certainly understand that in the longer term, children need human interaction and businesses need to operate. But, more importantly, patients requiring oxygen need supplies now. President Cyril Ramaphosa, please notch up our province similarly, just for a short time, and urgently open our vaccine rollout to younger, healthier individuals who are also at risk. Empty vaccine halls don’t save lives.
Big business in South Africa is ready to be given the license to procure vaccines in parallel. Finally, let me remind you that waves end, vaccines work, and COVID-19 will certainly pass. Keep your head up. Be your own president.
- Dr Daniel Israel is a family practitioner in Johannesburg