Western Cape Health COVID-19 Platform status update - 10 July | Western Cape Government

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Western Cape Health COVID-19 Platform status update - 10 July

13 July 2020

The health platform, whilst under some pressure, is coping with the cases requiring admission.

Hospitalisation

There are currently 1 703 patients admitted in both the public and private sector facilities of which 330 patients admitted to ICU or High Care. To date, we have had 74 207 confirmed cases of which 74,8% (55 534) have recovered but also had 2 224 deaths.

 

Healthcare Worker status in the Public Sector

There have been 3 589 healthcare workers infected; 28 deaths; 2 815 recoveries (78,4%) and 746 active cases currently.

Staff category

Active cases

Recovered

Deaths

Total infected

Doctors

57

184

0

241

Nurses

342

1 490

13

1 845

Other health workers

347

1 141

15

1 503

 

Shielding the vulnerable

Persons over the age of 55 or have a chronic condition are at risk for severe COVID-19 illness and should take extra precautions to protect themselves by following these steps:

  1. Avoid getting the virus by staying home, wear a mask (when you have to go out), wash hands regularly and disinfect surfaces
  2. Look after your health by following a healthy lifestyle and take your medication regularly
  3. Get help immediately if you do not feel well
  4. If you develop COVID-19 symptoms, go for immediate testing, do not delay

The Department has implemented an action plan for Diabetics with COVID symptoms which includes expanding testing for diabetics who represent a high risk group. Our current data suggests that these patients are presenting or are being admitted too late in a very sick conditions, which has dire outcomes.

Diabetic patients are encouraged to stay home and access the Pocket Clinic WhatsApp channel to ensure their medications are delivered to their homes. Patients are encouraged to send ‘Hi’ to 087 240 6122 to ensure we are able to deliver their medication at home. 

 

Primary Health Care
Our Primary Health Care platform is an important vehicle to support our health system, so that our patients are well cared for to prevent hospitals from being overwhelmed. Through the Community Screening and Testing activities the Department has been able to screen 885 291 members of the public of which 16 789 have been referred for testing. Through our community health workers (CHWs), since 1 April we have also been able to deliver 335 320 medication parcels to the homes of those members at high risk of contracting severe COVID-19 illness. Of these 52 650 parcels were returned due to incorrect address details. We appeal to our patients to contact their local facility to ensure their address details are correct. In ensuring continued access to health care our CHWs also performed household visits to 943 982 members of the community in their homes (Metro 720 086; Rural 223 896), providing them with basic health services and thus not have to leave their homes and risk contracting COVID-19.

 
Bed Capacity
It is important to note that through its planning and modelling the Department made provision for more beds than it will require and we activate these beds as the need arises. Though the system remains under pressure our hospitals still have beds available and we are able to manage infections and admissions satisfactorily. The intermediate facilities are valuable in ensuring diminished pressure on our acute hospital beds and facilities.

Our bed bureau provisioned 4 354 operational beds of which 78 % are occupied so we have sufficient capacity, while we also have provisioned CTICC (862 beds) and Thusong (60 beds). We will soon have the Brackengate (338 beds), Sonstraal (150 beds) and rural beds (72) open bringing the total field hospital beds provisioned to 1 482. We have also provisioned 90-100 current operational (ICU/high care beds in use) but are working towards increasing this to the number to 135 but this number changes all the time depending upon availability of staff.

 
Testing
There is no backlog at the NHLS at the moment. Additional capacity has also been brought online through the private labs and the utilisation of academic institutions. This has significantly improved turnaround times to below 40 hours.


Quarantine and Isolation
We have admitted a total of 3 932 people since the start of the pandemic, with currently 615 people in isolation and 231 in quarantine in both Metro and Rural facilities

 
Intermediate Care facilities (“Field Hospitals”)
Hospital of Hope (CTICC)

  • As at 7 July and since opening, 847 patients were admitted, 544 discharged and 40 deaths to date.
  • 48% of all patients admitted to date were between the ages of 50 – 69.
  • While still early, the hospital had a spike in admissions during its third week of being open but this has gradually decreased over the past two weeks with less admissions.

Brackengate: The facility was initially earmarked to open on 10 July but this is delayed by a few days due to delays in service contracts. The Department is working towards resolving these in the coming days to open the facility on 20 July.

Thusong Centre, Khayelitsha: Since opening the facility has admitted 171 patients, discharged 112 patients but also had 24 deaths.

Sonstraal Hospital: The facility will open its first 63 beds this month.

Additional Rural beds: Additional rural beds will be brought online - 32 in Hermanus; 20 in Vredendal; 20 in George

These additional Intermediate Care beds have had a significantly positive impact on the acute hospitals and have relieved the pressure in our acute hospitals such that the occupancy in our acute hospitals is still manageable.

 

Infrastructure

Testing and Triage Centres
The Western Cape Government continues to open new testing and triage centres across the province. We currently have 19 of these facilities operational; construction of four completed (Elsies River CHC, Khayelitsha (Site B) CDC, Stellenbosch and Robertson Hospitals); 18 Centres are in construction; 13 in procurement phase, and five in planning phase.

 

Health technology
The Department had a significant platform of medical equipment assets prior to the COVID-19 pandemic including, for example, 324 ICU ventilators and 94 transport ventilators and other essential devices such as ICU- and vital signs monitors, pulse oximeters and infusion devices. We have placed orders for an additional 80 ventilators of which 10 have been received thus far.

As part of the Department’s surge response to the pandemic a rigorous process was followed to establish additional health technology needs, including equipping the two field hospitals at CTICC and Brackengate that required, inter alia, mobile/bedside medical imaging solutions. A decision-support tool was also developed to optimally manage the related processes (needs assessment, procurement and allocation) on an ongoing basis. As such, approximately R250 million was spent on health technology assets to equip health facilities providing different levels of care and ensure effective screening, testing/diagnosis, referral and treatment of patients.   

 

High flow nasal oxygen (HFNO)

This modality – distinct from intubated ventilation in an intensive care setting – and using High-Flow Nasal Oxygen (HFNO) devices in particular – has proven to be an effective, life-saving ventilatory support intervention for COVID-19 patients. More than 160 HFNO devices have now been procured with most already in daily use in 20 health facilities across the province. We use 29 tons of oxygen daily (58% of capacity) of which the utilisation changes daily but we have sufficient supply of oxygen and we monitor it daily.

 

Private Sector engagement

The Department has done the preparatory work and has signed off with four major private hospital groups (Life, Netcare, Mediclinic, NHN). We have referred 3 patients to these private hospitals to test the administrative system of approvals for basic package of care, and certain caveats.

 

Next 100 days

The Department has identified the next 100 days as crucial to refocusing the health system and health services while still managing the pandemic with continued interventions to increase immunisation coverage, TB treatment and ART uptake.

We urge all citizens to remain careful in observing the essential 5 Golden Rules of hygiene and safety. It remains important to take particular care of persons with underlying conditions and particularly Diabetes, who are at significantly increased risk of severe COVID-19. We urge these people to really take special care and to shield themselves from exposure where possible.

The protection of our most vulnerable loved ones remains in our collective hands.