The Eastern Cape health department has come under fire for what its critics say is a wholesale lack of preparedness for a surge in Covid-19 infections that it is itself predicting.
The premier’s office has warned the province may soon have to battle infection “super clusters” across two particularly vulnerable regions as well as deal with infection spikes in the two provincial metros.
A presentation by premier Oscar Mabuyane to president Cyril Ramaphosa on May 14 seems to suggest the seven-week lockdown has not helped the health system prepare enough for an inevitable surge in infections.
In a thorough report on the province’s Covid-19 mitigation and containment plan, Mabuyane indicates that just 47 out of a planned 155 ICU and high care beds are ready, 1,123 of a planned 2,481 isolation beds and 1,315 of a planned 2,626 general hospital beds.
The two metros, hardest hit by infections, have a very low public hospital ICU and high care bed availability: Nelson Mandela Metro has just four of a planned 34 and Buffalo City Metro 14 of a planned 32.
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The premier said more beds were being made available in the worst-hit western region.
R50.5m had been set aside to improve 29 health facilities and R3m for the hospitality sector, which would support the quarantining, he told Ramaphosa.
“We are investing R251m in the building of three new health facilities, with a 100-bed capacity each, in Joe Gqabi, BCM and OR Tambo (and) refurbishing hospitals in Amathole, Alfred Nzo, OR Tambo and Joe Gqabi.”
But he was deeply concerned over infection surges — what he referred to as “emerging clusters” — in the Chris Hani and OR Tambo district municipalities.
Both are poor areas that align with the CSIR’s high vulnerability index ratings. Data suggests infection rates will “exponentially increase” in these two clusters, as well as in the two metros, due to population density, vulnerability and transmission potential.
“There is a substantial possibility that these clusters could join to form a ‘super cluster’ due to a set of existing vulnerability characteristics.”
Mabuyane said to prevent the formation of the super cluster, the two district municipalities required focused data-driven interventions together with increased technical capacity and access to this capacity for vulnerable patients.
Meanwhile, several clinics and other health institutions have been hard hit by health worker protests. This will further impact the province’s ability to respond to the infection surge.
Democratic Nursing Organisation of SA (Denosa) Eastern Cape provincial secretary Khaya Sodidi said on Tuesday the organisation had repeatedly called for the filling of vacancies, more training, and better equipping and support of nursing staff in all health institutions, particularly clinics. This had not happened.
“This virus has exposed the province’s existing weaknesses. We could never be ready for a pandemic. We cannot even cope with ordinary day-to-day demand. Now we face these super clusters. The nurses are untrained, ill-equipped and afraid. Many are testing positive.”
The Public Service Accountability Monitor’s Jay Kruuse agreed there was nothing surprising in the presentation as the department’s inability to provide appropriate healthcare — outside of a pandemic — had been regularly and extensively exposed over decades.
“For too long, the Eastern Cape government has chosen to ignore or weakly attempt to refute and dilute compelling evidence showing widespread systemic breakdown and dysfunctionality within the province’s health system.”
The DA’s Eastern Cape health spokesperson Jane Cowley said primary healthcare had all but collapsed already, due largely to vacant posts not being filled. Instead the money for them was sucked into the department’s huge medico-legal claims bill, she said.