- The last few weeks have been "soul destroying" for staff at a hospital in Nelson Mandela Bay, where medical facilities are battling to cope, beds are running out and oxygen points are scarce.
- The metro has been declared a coronavirus hotspot.
- A doctor in the internal medicine department at Livingstone Hospital has recalled the chaotic scenes of the past weeks when infections surged.
As Covid-19 infections in South Africa increase, a medical doctor has observed that deaths as a result of the disease seem to be occurring faster and that more young people between the ages of 20 and 30 are dying.
The doctor works at Livingstone Hospital, the primary Covid-19 hospital in the Nelson Mandela Bay Metro, where staff have been fighting to keep patients alive.
The past few weeks have been chaotic and frustrating for the Eastern Cape, particularly Nelson Mandela Bay.
On Thursday, President Cyril Ramaphosa announced that the metro had been declared a coronavirus hotspot.
This followed a recommendation from the National Coronavirus Command Council in consultation with premiers, metro mayors and traditional leaders.
Uitenhage, KwaNobuhle and Motherwell are areas of concern that have been identified in the metro.
While Alert Level 1 restrictions are in place countrywide, additional restrictions were implemented in the metro from midnight. The restrictions include a 22:00 to 04:00 curfew, the reduction of trading hours for alcohol outlets from 10:00 to 18:00, Mondays to Thursdays, and restrictions on the number of people who are allowed to attend gatherings - including religious events. Only 100 people can attend indoor events and 250 can attend outdoor ones.
All post-funeral gatherings have been prohibited, Ramaphosa said.
Painting a picture of the situation at Livingstone Hospital on Thursday afternoon, the doctor, who works in the internal medicine department, said the hospital had to let two patients use one oxygen point at a stage.
At some point, patients were lying on stretchers because there was no bed space, he said.
He added:
When News24 walked through the casualty and physician on call (POC) ward on Thursday, every patient was on an oxygen point and there were almost no empty beds.
At one point last week, the casualty ward had no beds available, the doctor told News24, adding that the intensive care unit was also under pressure.
The unit initially cut down on beds but later found that what they had left was not sufficient; there were about 20 people on the waiting list.
"[In] the second surge we saw everyone was fatigued. Our whole department's morale was very down. We didn't have that same energy we did to tackle it [like we did] the first time around.
"[In] other departments, whereas there were some people to help [previously], there were less people [who wanted] to help this time around," the doctor said.
He pointed out that the situation often fluctuated; one day there were available beds and the next day there was nothing.
Corpses in wards
Livingstone has 32 Covid-19 beds for male patients and 32 for female patients. Around 30 beds are for patients under investigation (those awaiting results). The POC facilitates about 30 beds on the respiratory side.
Patients who are waiting for their test results are also transferred to Empilweni TB Hospital in New Brighton, which has troubles of its own.
Earlier this year, Empilweni was turned into a Covid-19 hospital and attends to patients who are waiting for their test results.
Ncikazi Rawana-Tsotsi, a nurse at Empilweni TB Hospital, said they were also working under pressure and that they had a shortage of non-clinical staff.
Rawana-Tsotsi said patients under investigation were also dying.
"The second wave has come back very strongly. During the first wave, we used to admit confirmed cases, but throughout that period, we only had two deaths. But now there are a lot of deaths.
"As a result, some corpses are kept inside wards for plus-minus eight hours because of this shortage of staff," she said.
The Livingstone Hospital doctor added:
Soul destroying
Walking past the mortuary at Livingstone Hospital over the past two weeks was another nightmare.
People queued to identify bodies, he noted.
He added that losing staff, including a stalwart nurse, was heartbreaking and frustrating.
"It's been soul destroying for a lot of us because every day, you're telling at least five family members that their [relative] has died. It's horrible. You pick up the phone, they [are] screaming. Then someone else picks it up: 'What's wrong, what's wrong?' Then they start screaming too… You usually endure something like that once or twice, every now [and then]. But all the time and so much is actually quite dramatic…"
Livingstone Hospital also has about 10 beds in the basement, all with high-flow nasal cannula oxygen. But the area is not fully operational yet because of human resource limitations.
The doctor said these beds were for patients who did not respond to standard oxygen treatment. The high-flow oxygen is used as an "intermediate zone" for someone who needs a ventilator.
"Some people do very well with high-flow nasal cannula oxygen, and it can be life-saving in most cases.
"So we have opened up 10 more beds [for] patients who need that extra bit, who are critically ill and would have likely died if they never got that high-flow nasal cannula oxygen."
Provincial Department of Health spokesperson, Siyanda Manana, said more doctors and nurses were being hired, and oxygen tanks were being decentralised to district hospitals where clinics can also access them.
Manana added the department was doing its best to ensure that people did not contract the virus, especially in hotspot areas such as Nelson Mandela Bay, Buffalo City and Sarah Baartman.