Covid-19: Mediclinic terminates elective surgeries in hospitals experiencing resource constraints

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  • The second wave of Covid-19 infections "continues unabated", with high volumes in certain provinces across SA, according to the Mediclinic group.
  • As a result, the hospital group has decided to terminate all elective surgeries at hospitals experiencing resource constraints.
  • Emergency and urgent surgery will continue, and the group is also in contact with suppliers to ensure a continuous supply of oxygen levels.

Mediclinic says the second wave of Covid-19 infections is continuing unabated and that there are significant volumes of Covid-19 patients in KwaZulu-Natal, Mpumalanga, Limpopo and Gauteng. 

The private hospital group said on Friday that although demand seemed to have stabilised in the Garden Route and was starting to show signs of stabilisation in the Western Cape, case numbers were still very high. 

"As such, we are implementing additional measures to increase capacity but our resources, notably staffing, emergency centre capacity and critical care resources, are under significant strain and in many instances, at capacity," Mediclinic Southern Africa's chief clinical officer, Dr Gerrit de Villiers, said in a statement.

ICU capacity

According to the statement, Mediclinic usually has an ICU/High Care bed capacity of roughly 1 000 beds and 850 available ventilators. 

But, in the second wave, the hospital group is experiencing occupancy of up to 90% with significant volumes of patients in emergency centres. 

"ICU beds and ventilators have experienced the biggest strain with some hospitals' ICU and High Care beds and ventilators fully occupied. Our current ventilator capacity is under extreme pressure. We have noted an increase in demand in the last week," De Villiers said.

The number of admitted patients currently exceeds the peak at the time of the first wave by about 75%, and in some hospitals by 100%, the group said, adding that additional ventilators and oxygenators have been purchased for certain hospitals.

"Our current levels of oxygen are stable in general and being managed and monitored on a hospital-by-hospital level as their capacity and needs fluctuate," De Villiers said.

He added that Mediclinic was in constant contact with suppliers in various regions to manage oxygen levels and ensure continuous supply.

Implementing diversions to different hospitals

"Where hospitals are experiencing high volumes of patients within the Emergency Centre/ICU and High Care Units and are unable to accommodate any further patients in these units for a period of time, a decision will be made to implement a diversion to another hospital with capacity to avoid any individual's care being compromised due to a delay in receiving treatment," De Villiers added.

However, this policy is only implemented for short periods of time (a maximum of four hours) to clear a backlog of patients. During these Emergency Centre diversion times, the Emergency Centre will still assess and stabilise all life-threatening cases before referring these to the closest appropriate facility.

Termination of elective surgery

Based on the continued rise in Covid-19 cases, the group has decided to terminate elective surgery in its hospitals that are experiencing resource constraints. 

"This need will be evaluated on a hospital basis and reviewed regularly. Where there is capacity, elective surgeries may continue at associated day clinics or acute hospitals. This measure is in line with Covid-19 precautions and is aimed at managing the risk to patients, staff and doctors, while allowing us to service a community in need with limited capacity," the statement read.

However, emergency and urgent surgery will continue at all Mediclinic hospitals.

Early during the pandemic in South Africa, non-urgent surgeries were shut down at state and private facilities.

Decisions were taken to either suspend or postpone elective surgeries to flatten the first-wave curve, limit patients' exposure to the virus, and free up bed space for incoming Covid-19 cases.

Mediclinic moved to suspend elective surgeries on 26 March last year. Other private hospital groups, such as Life Healthcare, Netcare and Busamed, did the same, according to a previous Health24 report.

READ | SA's largest private hospitals recruit volunteers, retired staff for second Covid-19 wave

READ | SA hospitals under 'severe strain' as Covid-19 infections surge

READ | Covid-19 reinfection: How common is it?

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