3rd wave at George Hospital

GEORGE NEWS - A snapshot of an average day at George Hospital during the third wave of Covid-19 presents a harrowing picture.

Tasks include prioritising oxygen supply among patients and battling to coordinate beds, says hospital CEO Michael Vonk, who has sent out an urgent plea to citizens to get vaccinated to ease the burden on exhausted healthcare workers.

Vonk last week described a day in July on the national minister for health's virtual media briefing to give the public an idea of what they have to cope with during the third wave.

"On this day, 41 staff were Covid positive. We try to operate our services, but at the same time a number of our staff are sick. On top of that we would have some staff that have been exposed and would have to quarantine.

"We had 89 Covid patients of whom 24 were in critical care, and that was our maximum; we couldn't take any more. And then we see what's happening in the community. The high, high incidence in the community, over 1 000 patients per 100 000 - this disease was everywhere. George and the Garden Route have been particularly hard hit during the third wave."

3 000kg of oxygen per day

Vonk said the Afrox truck delivers every one and half to second day. "In the last 30 days we've used 91 tons of oxygen - over 3 000kg per day. A massive increase to what we would use normally. I never thought I would ever be so excited to see the Afrox truck as I am."

The pandemic also has implications for employees other than frontline staff, such as workshop technicians who sometimes are called out in the night to de-ice the system because of the amount of oxygen being vaporised. At nearly R1-million per month, the financial cost spent on oxygen is massive.

Life and death decisions

One of the most difficult tasks is being part of the hospital ethics committee that meets daily to prioritise oxygen supply and critical care resources among patients. The committee uses a standardised and evidenced-based tool (Western Cape critical care triage tool) to prioritise which patients will get ventilators and who will get high-flow nasal oxygen.

"These are absolutely devastating decisions to make. It's a decision no doctor should ever have to make," said Vonk.

"Sometimes we are forced to reduce patients to scores, but this really allows us to standardise and it shows that there is fairness and equity. This is one thing that has been immensely hard on some of the frontline staff - taking these life and death decisions."

He said patients are also transferred between hospitals to manage beds.

No surgeries

The hospital has had to stop surgery, apart from emergencies, as day wards and theatres are used for Covid patients. This has a knock-on effect on non-Covid patients waiting for operations. Coordinating beds is a daily battle of prioritising patients. "Just yesterday, there were 16 patients waiting for beds and the team would work together to see which patients they can send home and bring back the next day."

Vonk said this is something they do not want healthcare workers to go through again and the one thing that will change this, is if people are vaccinated. Most Covid patients currently ending up in the ICU or even general wards are unvaccinated.

Tourism industry must open up again

Vonk said the Garden Route is a tourist area and it is urgent to restore the livelihoods of residents.

"We really need the tourists to be able to come back to the Garden Route, we need people to be able to provide jobs, we need our restaurants, we need our tourist industry to survive. My message to everybody on behalf of the hard-working teams at George Hospital and hospitals across the country, is that this [vaccination] is the one thing we can do as a country."

The Afrox truck's oxygen delivery every one and a half to two days is a welcome sight.