Robots and ventilators: How private hospitals are preparing for the Covid-19 wave

By Tuesday evening (31 March), South Africa had 1,353 confirmed Covid-19 cases, 31 recoveries and five people who had died from the disease. 

So far, private sector testing has accounted for the majority of confirmed cases and top private healthcare facilities across the country are expanding their capacity to deal with the growing number of infected persons, while implementing measures to protect patients and staff. 

Netcare, Melomed and Life Healthcare have indicated that they are either engaged in talks or have collaborated with the NICD as well as national and provincial departments of health to share resources with the public health sector. 

The National Department of Health hasn’t provided any formal communication about a public and private sector collaboration to deal with the coronavirus outbreak. 

Netcare, South Africa’s largest private healthcare network, has agreed to treat public patients on a “not-for-profit” cost-recovery basis.

“Given our limited capacity, any referrals from the public sector will be assessed and pre-authorised by Netcare on a case-by-case basis,” said Netcare group CEO, Dr Richard Friedland, in a statement released on 30 March.

Melomed said its Western Cape Hospitals would admit Covid-19 patients where there was capacity. 

Group Marketing Manager, Shameema Adams, explained: “We have been in meetings and consultation with the Provincial Department of Health and, after due consultation, the necessary arrangements have been made whereby Melomed Hospitals would be available if we have capacity to admit patients referred by the Western Cape Department of Health.”

Melomed Hospitals currently offer screening and testing services at their emergency units, through Pathcare. 

Life Healthcare didn’t indicate whether a formal collaboration had been established but according to General Manager for Emergency Medicine, Dr Charl van Loggerenberg, Life Healthcare was a “willing participant” and had been continuously engaging with the government.  

Besides ramping up their general hygiene practices by providing sanitisers and screening patients before they enter facilities, Netcare, Melomed and Life Healthcare have each scaled up their resources. 

Netcare has spent R150-million to beef up its Intensive Care Units and High Care facilities.

Friedland said that “additional ventilators, ultraviolet disinfection robots and specialised air filters to ensure appropriate disinfection measures” had been purchased. 

The ultraviolet (UV) light disinfection robots have proven efficacy in destroying viruses, bacteria and fungal spores in healthcare facilities, while limiting exposure for healthcare workers. 

Funds have also gone towards getting extra stock of personal protective equipment (PPE) for staff who are also being trained on its “correct use”, Netcare Group, medical director, Dr Anchen Laubscher, told Daily Maverick.

The public health sector has been hit hard by the global shortage of PPE, but for now private health seems to be managing. Laubscher told Spotlight in a report published on Tuesday that at this point, Netcare did not foresee a shortage of PPE stock.

Loggerenberg acknowledged that with “very few airlines flying” there were a few logistical challenges in getting protective wear. 

“Our Covid-19 task team is continuously working on plans for increasing equipment capacity. We are also working closely with other hospital groups to determine secure supply chains as a collective,” said Loggerenberg. 

Group Marketing Manager, Shameema Adams, said Melomed had allocated “all its resources and revenue” to ensure its hospitals are prepared for Covid-19. She did not specify how much money had been spent or how their resources had been allocated, but indicated that they would increase bed space where necessary.  

Laubscher said Netcare already has around 1,200 ICU beds across its facilities, but pointed out that most infected persons will not need the high level of care of a hospital setting. 

“It is important to remember that over 80% of people with Covid-19 are expected to have minor to moderate symptoms.”

But if patients are admitted for specialised care, they can be safely isolated. Netcare also has mobile and transport isolation units for the set-up of temporary isolation facilities.

Life Healthcare will increase bed space “should the need arise”, said Loggerenberg, who confirmed that their hospitals have a total of 1,050 adult ICU beds. 

“But it is difficult to ascertain whether this will be sufficient as we don’t know what the impact of Covid-19 will be in the coming weeks. Judging by the reality of what is unfolding in the rest of the world, including Europe and the US, we do believe that a lack of capacity will be a potential challenge for South Africa as well.”

Although Netcare is procuring more ventilators, Laubscher indicated that “the number of ventilators on its own” doesn’t indicate if “the necessary care can be provided for patients who are severely ill from Covid-19”.

To free up capacity, Netcare has suspended non-essential elective surgery and all three hospital groups have suspended and/or restricted visiting hours. DM