In the past few days, I’ve been asked by many why I haven’t sent out my weekly Covid-19 update in nearly three weeks, as I have done at least once weekly since the start of the pandemic in March 2020.
The truth is that I’m tired and busy.
Let me give you a picture of what Johannesburg is like at the moment.
Because, I think, people are going about their lives as normal, continuing to deny the severity of the epidemic by socialising, eating out and having playdates, and continuing to debate whether they actually need to complete their 10 days of quarantine after an exposure, Gauteng has now surpassed the peak of the first and second waves, and it looks like we are gaining momentum rather than slowing down.
While people follow the local infections numbers, which “only” added 4 000 to 6 000 cases daily over the past few weeks and only recently picked up to more than 10 000 cases per day, there hasn’t been enough emphasis on the fact that 60% of these daily new cases have been in the geographically smallest province – Gauteng.
For the past two weeks it has been increasingly difficult to find a hospital bed, both private or public, in the province.
Ambulances wait with sick patients in parking lots outside hospitals, trying to get a space for patients in casualty.
People struggling to breathe queue up outside the casualty ward hoping to get in and get some oxygen.
These are people who have already been treated at home by their doctors, but have progressed past the point where home treatment can help them.
In my small practice, I am currently managing dozens of patients at home who are infected with Covid-19. Some of these are in family groups where everyone at home is sick.
The strain of virus we are seeing is extremely contagious and jumps from one person to the next in a matter of days.
Of the patients at home, several are on home oxygen, many are on strong medications such as cortisone and anticoagulants, and some have needed hospital admission.
For the record, some of these patients have been on Ivermectin.
Several of my current Covid patients have had one dose of the Pfizer-BioNTech vaccine. Of these, two have Covid pneumonia, demonstrating that one vaccine dose three weeks ago is not yet effective.
Three of my patients received the Johnson & Johnson vaccine over a month ago and have had relatively mild illness.
This week, for the first time, it has been a struggle to find enough oxygen for patients needing it at home. The major oxygen suppliers now have waiting lists. Most “hospital at home” management and nursing services are at capacity.
I have spent hours on some days phoning hospitals and begging for beds for patients only to be told that there are no high care or intensive care unit beds in Gauteng.
General practitioners (GPs) are forced to manage patients at home who fit the criteria for hospital admission.
We are told to send our patients via casualty, where they will be triaged so that those who need it most will get a bed.
We don’t want to do this as we know our patients will spend hours in casualty and possibly be sent home.
State hospitals are sending home patients with oxygen levels in their 70s.
Some of my GP colleagues are managing hundreds of patients at home on their own every day.
These patients need close monitoring, including of vital signs, blood tests and sometimes chest X-rays in order to assess and administer the correct medication at the appropriate time.
Every day we answer dozens of questions from people who have been exposed at school, at meetings, at lunches and at parties.
Every day we send dozens of patients for tests, of which larger and larger percentages come back positive (22% positivity in South Africa).
#COVID19 UPDATE: A total of 51,301 tests were conducted in the last 24 hrs, with 10,510 new cases, which represents a 20.5% positivity rate. A further 118 #COVID19 related deaths have been reported, bringing total fatalities to 58,441. Read more: https://t.co/UcyTcfpWO5 pic.twitter.com/RZ9oMX0ISy— NICD (@nicd_sa) June 18, 2021
Every day I send out quarantine and isolation information and have to convince people that they still need to quarantine for 10 days even if they have tested negative.
Remember, you are not fully vaccinated until at least two weeks after your second Pfizer-BioNTech dose.
There is no rush to have a second vaccine before 42 days and it is not a good idea to queue at crowded vaccine centres. Rather wait for your appointments.
Even when fully vaccinated, there remains some risk of getting infected while the volumes of unvaccinated people remain high and the virus spreads rampantly.
. Avoid gatherings;
. Wear your masks (double-mask if in a high-risk place);
. Social distance;
. Stay in ventilated spaces;
. Wash and sanitise your hands; and
. Try to get a vaccine if you qualify (teachers are soon to receive theirs and hopefully those aged over 50 will follow).
As busy and tired as I am, doctors nurses and other frontline workers are much busier and more tired.
So please take this seriously for the next few weeks and don’t add to the statistics.
Dr Fanaroff is a medical practitioner