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Too little information of ventilator use in SA to predict patient survival rates

A snapshot of mortality among COVID-19 patients on ventilators in South Africa is sobering, but too small and incomplete to provide a reliable picture of patient survival, reports The Times. Most people with COVID-19 who go onto mechanical ventilators will die, international studies show. “Outcomes internationally have shown mortality rates of 60% to 95% in many countries, including the US, China and Italy,” said Wits University infectious diseases specialist Dr Jeremy Nel.

The National Institute for Communicable Diseases COVID-19 hospital sentinel surveillance report found that nine out of 10 patients ventilated in public hospitals die. It found that the death rate in private hospitals was a lower 30%. This does not match global trends and Nel said the outcome was probably because the sample of 61 was too small and the time period too short.

“Almost half the ventilated patients in the private sector data were still on a ventilator at the time the statistics were calculated, and so the number of deaths in this group can be expected to rise with time,” he said. “The numbers reported from the state sector are very small at this point, and so drawing firm conclusions isn’t wise. In addition, the surveillance data is not comprehensive – many hospitals aren’t yet included – and so the results of the surveillance may not be generalisable across the country.”

Professor Guy Richards, director of critical care at Charlotte Maxeke Johannesburg Academic Hospital, said the management of COVID-19 patients in both public and private hospitals in Gauteng followed a similar approach. “Essentially, we try to avoid mechanical ventilation,” he said, listing critical steps, including high-flow nasal oxygen, they would take to treat COVID-19 admissions before ventilation might become necessary.

The report says the doctors noted that the health of patients being admitted to public hospitals often does not compare to those insured patients being admitted to private hospitals, making comparisons between patient outcomes unscientific.

[link url="https://www.timeslive.co.za/sunday-times/news/2020-05-10-covid-19-pandemic-ventilator-death-toll-sobering-but-not-conclusive/"]Full report in The Times[/link]

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