Eastern Cape Health MEC’s figures for Covid-19 patients in ICU don’t add up

On November 25 the Eastern Cape MEC for Health, Sindiswa Gomba, insisted that the media’s narrative that the Nelson Mandela Bay metro’s state hospitals were full, was false and that there were 38 patients in the state hospital’s intensive care unit (ICU).

Seven sources at Livingstone Hospital, the only ICU in the state hospitals servicing the metro, said there cannot be more than 12 Covid-19 patients in the unit due to staff constraints. There are another six beds in the ICU, but these were reserved for trauma patients.

For those working on the ground, Gomba’s claim that there were 38 patients in ICU was gut-wrenching as they have been held to a strict triaging code to see who qualified for ICU care due to staff constraints, and many of their patients died after not having had the opportunity to receive critical care.

The metro has a Covid-19 case fatality rate of 4.2% and, according to the Nelson Mandela Bay municipality, on Monday there were 2,745 active cases in the metro.

The presentation made by the Department of Health to the district command council on 25 November confirmed what sources at Livingstone Hospital said, that there were only enough staff for 12 Covid-19 ICU beds, but also counted one patient in the high care unit at Uitenhage Provincial and three at the field hospital in Korsten as patients receiving ICU care.

The figure of 38 featured nowhere, but later that day health spokesperson Sizwe Kupelo said a converted basement parking garage at Livingstone Hospital would be able to take 73 patients.

At the time the ward did not have access to oxygen. Kupelo said an “upgrade” was being done to ensure oxygen flow for “invasive ventilators and that this would be completed by 27 November”.

On Monday 7 December he said that the ward was fully operational.

Neither the unit at Uitenhage or at the field hospital are designated intensive care units, hospital sources said. It is understood that these discrepancies between the MEC’s statement and the reality were flagged by doctors when they met Mkhize.

The only other ICU beds in the metro’s public sector are six beds at Port Elizabeth’s Provincial Hospital’s cardiothoracic unit. But due to staff constraints there are seldom more than three beds available and none are used for Covid-19 patients.

The MEC used this figure as part of her claims that a “false narrative” was being portrayed that hospitals were full. Earlier in that week, the Eastern Cape Department of Health admitted that the public ICU beds were full.

On Monday, Eastern Cape Department of Health spokesperson Sizwe Kupelo confirmed that Gomba said there were 38 ICU patients.

A few days later the South African Medical Association (Sama) said it remained alarmed about the severe lack of leadership in the Eastern Cape Department of Health which was compounding problems in the delivery of healthcare in the province. 

“The fact that almost all critical posts at institutional and provincial level have no permanently employed leaders is of great concern; it is placing enormous strain on already overworked doctors and insufficiently resourced hospitals.

“Sama notes that while provincial Health MEC Sindiswa Gomba says there are enough beds in provincial hospitals to cope with demand, she is providing no clarity on future funding for doctors and nurses to care for patients who occupy those beds. Having available beds is not enough, the beds need to be serviced by adequately equipped staff and resources.

“The lack of funded posts puts a significant strain on doctors; the current number of staff members in most hospitals is grossly inadequate, and healthcare workers are exhausted, stressed and frustrated. This situation seems at odds with what the government is saying about the coronavirus in the province.

“The fact that many decisions have to be made centrally at the Provincial Cost Containment Centre in Bisho also means that hospitals and their CEOs are not able to respond quickly to staffing, equipment and other needs. Urgent decisions can take months to be made at the central level, leaving hospitals without the ability to respond to their own situations.

“Urgent intervention is needed in the Eastern Cape as the situation with medical care provision has already gone beyond a critical point. Unless this intervention is made with sufficient political will to ensure a successful turnaround, the problems with healthcare in the province will undoubtedly multiply,” the statement from Sama concluded. DM/MC

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