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Health system at risk as virus spreads among health workers

The SA Medical Association has warned, as the virus spreads among health workers, that if more doctors and nurses are infected at work and have to self-isolate, the health system could collapse.

The coronavirus, which first entered South Africa in wealthy people returning from ski trips to Europe, is now beginning to seep into communities from where it’s likely to spread rapidly. Business Day reports that someone from the crowded township of Alexandra, near Sandton, has now tested positive for COVID-19. However, he had travelled to Limpopo while awaiting his test result, which may have spread the disease further. A resident of Khayelitsha in Cape Town also tested positive, suggesting the spark has been lit on the spread of the virus into congested townships.

The report says an equally at-risk group is the elderly. Five elderly people at the Bill Buchanan Association for the Aged in Morningside, Durban, have tested positive for COVID-19. Four of them are now isolated in a separate building, while one is in a critical condition in hospital. The home has 210 residents, including 50 in frail care. Sixteen staff members, who had treated the patients, are self-isolating at home in case they were infected.

Meanwhile, the SA Medical Association (Sama) has said if too many unprotected doctors and nurses get COVID-19 at work and have to self-isolate, the health system could collapse. Sama chair Dr Angelique Coetzee is quoted in the report as saying: “This is an untenable situation. Frontline medical staff must be protected at all times … The reliable supply of proper personal protective equipment is simply non-negotiable”.

A growing number of health-care workers have been infected by COVID-19. According to a Business Day report, Health Minister Zweli Mkhize said a total of 13 health-care workers, including 11 doctors, have been confirmed to have the coronavirus, but none appeared to have been infected by patients.

A 70-year-old doctor in the Free State is in the intensive care unit after contracting the coronavirus. “It must be emphasised that none of these health workers were infected by patients that they were treating,” Mkhize said in a News24 report. “They came into contact with their family members, friends and other colleagues who had tested positive for COVID-19. All individuals who were identified as contacts of these health workers have been put in quarantine and are being monitored.”

In Limpopo and Mpumalanga, one medical doctor from each province had tested positive after travelling abroad on holiday. In the Free State, three doctors, one nurse and one neuro-physicist tested positive for COVID-19. Six doctors have been affected in Gauteng, Mkhize said.

“(Excluding the Free State doctor) all these health workers are in a good medical condition with most of them having mild or no symptoms,” Mkhize said.

South Africa has received very limited stock of flu vaccines, and as a consequence health workers will be given priority to receive the vaccine, Mkhize is quoted in an IoL report as saying. Mkhize said when both the public and private sectors placed their orders, which is done a year in advance, they did not anticipate the COVID-19 pandemic.

"This means that as it stands, our flu vaccines are understocked. As government we have engaged with the pharmaceutical industry and it became clear that the distribution of this vaccine has to be rationalised and prioritised. We have therefore taken a decision that health workers in the country will be given priority in receiving the flu vaccine," Mkhize said.

"This is precipitated by the fact that the country cannot afford to have them sick especially as the flu season approaches. This is one of the major lessons that we have learnt from countries that have experienced the COVID-19 pandemic. We therefore plead for the understanding of all South Africans who may unfortunately not have access to the flu vaccine this year."

Mpumalanga Health has confirmed that two doctors based at Mmametlhake Hospital had tested positive for the coronavirus, reports The Times. Department spokesperson Dumisani Malamule said the first doctor experienced symptoms of COVID-19 and was sent to a private laboratory in Modimolle, Limpopo, where she lives.

“The doctor had a history of travelling to Cape Town in February and Johannesburg a week ago,” said Malamulele. “The second doctor tested positive and has been in contact with the first since they share accommodation. She has also been asked to self-quarantine.”

Mpumalanga Health is tracing all those who had been in contact with the doctor – it is working with its Limpopo counterpart to trace contacts.

Around a quarter of doctors in the UK’s National Health Service (NHS) are off work because they are sick or in isolation, the head of the Royal College of Physicians has said. Sky News reports that Professor Andrew Goddard warned the level of illness and self-isolation brought on by the coronavirus pandemic was already seriously affecting emergency departments, particularly in the UK's two biggest cities.

"This is really impacting a lot in emergency departments and London is in a much worse position than elsewhere at the moment, but it will come to other places. The situation could either worsen as NHS staff were tested for the illness, or improve as people come out of isolation, he added. "Of course, the worry is we will lose more people to COVID-related illness," he said.

And it's not just doctors who are being affected – the Royal College of Nursing said around one in five nurses had taken time off work to isolate themselves.

[link url="https://www.businesslive.co.za/fm/features/2020-03-31-covid-19-spreads-tentacles-into-townships-old-age-homes/?utm_medium=Social&utm_source=Twitter#Echobox=1585650575"]Full Business Day report[/link]

[link url="https://www.businesslive.co.za/bd/national/health/2020-03-28-breaking-news-13-health-workers-among-the-infected-as-covid-19-tally-rises-to-1187/"]Full Business Day report[/link]

[link url="https://www.news24.com/SouthAfrica/News/free-state-doctor-in-icu-after-contracting-coronavirus-as-confirmed-cases-rise-to-1-187-20200328"]Full News24 report[/link]

[link url="https://www.iol.co.za/news/south-africa/western-cape/flu-vaccines-in-short-supply-health-workers-to-be-given-first-preference-mkhize-45716503"]Full IoL report[/link]

[link url="https://www.timeslive.co.za/news/south-africa/2020-03-31-two-doctors-test-positive-for-covid-19-in-mpumalanga/"]Full report in The Times[/link]

[link url="https://news.sky.com/story/coronavirus-one-in-four-nhs-doctors-sick-or-in-isolation-11965886"]Full Sky News report[/link]

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