Cape Town - The Gauteng Health Department is facing criticism for what some health experts perceive as a lack of strategy and planning in dealing with the spiralling Covid-19 infections and deaths.
On Friday, Gauteng had 123408 confirmed cases of Covid-19, with 917 deaths and 51256 recoveries and still counting.
Professor Alex van den Heever, chair of Social Security Systems Administration and Management Studies at Wits University’s School of Governance, wrote that: “...in contrast with other natural disasters, (the minister of health and the Gauteng MEC for health) could have been in control, but instead they chose not to be.
“Our resources and options were squandered. The consequences of these choices are now very much before us.”
DA health spokesperson Jack Bloom also lambasted the department for not having an adequate strategy for dealing with the peak.
“Gauteng has not done as well as Western Cape in setting up properly equipped and staffed field hospitals. The prevention strategy was not sufficiently focused and was crippled by testing delays and backlogs. Some good private sector proposals were not taken up, including a field hospital that was mooted at the Gallagher Centre.
“Gauteng has claimed that they were very effective with tracing, but the rocketing figures show that control has largely been lost in this area,” said Bloom.
But University of Johannesburg Professor Ben Smart pointed out that there had not been a widespread and effective tracing programme in South Africa. “These are most effective early on in the spread of an epidemic, when there is still a chance to contain the virus.
“Frankly, if you live in a hot spot like Gauteng or the Western Cape, whenever you go out and mingle with others... it’s safe to assume you have come close to someone with Covid-19. This will become increasingly true in the coming weeks.
“Big questions remain on whether the field hospitals in Gauteng are or will be equipped to deal with the expected influx. Many patients will need ICU care, with oxygen and intubation," said Smart. “The government has not been very forthcoming with data, but as the number of in-patients will go up fourfold in the next month, the reality is that the health services are woefully understaffed and under-prepared.
“This is despite weeks of poverty-inducing lockdown designed to provide government time to prepare for exactly this situation (note that the actual rate of infection is lower than expected, so the government cannot appeal to an unexpectedly high number of patients).
“The government will need to rely heavily on the private health sector to minimise casualties, but the private sector is busy negotiating with the government to make beds available. Possibly not great news for those who pay for medical aid, but it’s in the best interests of the country as a whole, so everyone should embrace this move as an act of solidarity," said Smart.
Independent public health practitioner Dr Shakira Choonara did not mince her words; she lambasted the Gauteng Health Department for not being transparent about the conditions of its quarantine facilities. “(In terms of) quarantine facilities, we need more transparency in Gauteng. An issue I would like to discuss is how these facilities are not tailored for vulnerable populations such as persons with disabilities, and this is actually a concern worldwide.
“Looking at the website of the Western Cape government, it is extremely robust in terms of self-assessment, resources for front-line workers and their response to the pandemic has been to an extent more transparent, so if I were to compare, the WC response leaves me personally slightly more assured, with quick responses etc,” said Choonara.
Asked what strategy could have worked to prevent the spiralling infections in Gauteng, Choonara said: “There is no clear-cut answer, not with a virus which easily spreads... not in a province and country which honestly could not afford a lockdown.
“Although, what could have been done was to be as prompt as possible, ensuring PPE immediately reached the front line... enlisting private practitioners to aid with the burden; some are sitting at home during this pandemic. It doesn’t make sense and, overall, some of these issues should have been the focus.
“Ensuring quick, speedy and safe ways to access relief measures, i.e. not long lines for grants or the population stil sitting without UIF support, etc.”
According to Guy Richards, Professor of Critical Care at Wits University, two of the biggest problems are lack of staff and an inadequate number of ventilators: “Even if you look at venues such as Nasrec, they don’t have enough staff, nor do they have the oxygen supply that you require in this situation.”
However, Gauteng Health Department spokesperson Kwara Kekana has said: “The testing strategy of the Department of Health is what can be described as targeted testing. In targeted testing, we aim to test all people with Covid-19 symptoms, with special focus on vulnerable groups such as the elderly, the frail, people with comorbidity such as Type 2 diabetes, hypertension and asthma, residents in Correctional Services, mineworkers, health-care workers”
During the Gauteng Provincial Command weekly update on Friday, Health MEC Bandile Masuku said additional beds were being created in existing hospitals: 300 ICU beds at Dr George Mukhari, 500 beds at Jubilee Hospital 500 beds, 500 at Chris Hani Baragwanath and 300 at Kopanong Hospital. He said all beds should be ready by the end of the month.
“Based on the current patient load, we have adequate PPE in stock. However, we continue to order more stock for the next phases of the pandemic,” said Masuku.