NATIONAL NEWS - Mediclinic Southern Africa said in a weekly update on the situation at hospitals in the group that the second wave of COVID-19 patients to their facilities continues "unabated" with significant volumes in KwaZulu-Natal, Mpumalanga, Limpopo and Gauteng.

"Demand seems to have stabilised in the Garden Route and is starting to show signs of stabilisation in the Western Cape but numbers are still very high. 

"As such we are implementing additional measures to increase capacity but our resources, notably staffing, emergency centre capacity and critical care resources, are under significant strain and in many instances, at capacity," said Dr Gerrit de Villiers, Chief Clinical Officer.

Mediclinic normally has an ICU/High Care bed capacity of roughly 1 000 beds with 850 available ventilators. Currently with the second surge of COVID-19 it is seeing experiencing occupancies of up to 90% with significant volumes of patients in emergency centres.

ICU beds and ventilators have experienced the biggest strain with some hospitals’ ICU and High Care beds and ventilators fully occupied.

"Our current ventilator capacity is under extreme pressure. We have noted an increase in demand in the last week. We have purchased additional ventilators and oxygen delivery devices (oxygenators) for certain hospitals where the infrastructure allowed for additional capacity to be deployed."

De Villiers said that the total number of admitted patients currently exceed the peak of wave one by about 75% and in some hospitals by 100%.

Where hospitals are experiencing high volumes of patients within the Emergency Centre / ICU and High Care units and are unable to accommodate any further patients in these units for a period of time, a decision will be made to implement a diversion to another hospital with capacity to avoid any individuals' care being compromised due to a delay in receiving treatment.

This policy is only implemented for short periods of time, a maximum of four hours, to clear a backlog of patients and during these Emergency Centre diversion times the EC will still assess and stabilise all life threatening cases before referring these to the closest appropriate facility.

Elective surgery
"After careful consideration and based on the continued dramatic rise in COVID-19 numbers associated with the second surge, we have terminated elective surgery in our hospitals experiencing resource constraints. This need will be evaluated on a hospital basis and reviewed regularly."

He said this is aimed at managing the risk to patients, staff and doctors while allowing service to a community in need with limited capacity. "Emergency and urgent surgery continues in all hospitals."

Staffing
Most staff who were on leave have returned early to support with the second wave of patients. "We have also reallocated key resources to hotspots, and we have provided additional training to upskill nursing staff from other units to assist in areas such as ICU and High Care."

A number of measures to assist staff in coping during the pandemic has also been instituted. This included making online resources available, offering extensive counselling at hospital level and training managers to identify and relieve stress within their teams.

"Our staffing levels are currently under pressure in regions experiencing the surge during this second wave in particular KZN, Gauteng, Limpopo and Mpumalanga."

Volunteerism
Mediclinic has a formal volunteer process in place to encourage those community members without clinical experience or those who have previously worked in the healthcare industry, who are willing and able to assist and support our healthcare workers in both a clinical and administrative capacity.

Volunteers will assist healthcare staff to focus on their core roles.

"We will provide very clear guidance to and oversight of the volunteers’ roles and responsibilities e.g. if there is a specific way the role needs to be carried out, the place of volunteering, expected hours, etc. Volunteers will receive the required training in order to feel safe and confident to carry out their expected role," said De Villiers.

Oxygen
With regard to the supply of oxygen, Mediclinic is in constant contact with the suppliers within the various regions to manage oxygen levels and ensure a continuous supply. Mediclinic has also sought to provide additional storage facilities where possible, to extend capacity.

Current levels of oxygen are stable in general and being managed and monitored on a hospital by hospital level as their capacity and needs fluctuate.

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