- Certain private hospital groups in SA have suspended elective surgeries amid hospital bed and staff shortages in hospitals due to the Covid-19 pandemic
- The status of elective surgeries in state hospitals is dependent on the capacity of individual hospitals
- While the number of cases appears to be declining, health minister Zweli Mkhize has said that it's going to take a while before provincial health systems will begin to feel this reduction
Although there are promising signs of a decline in Covid-19 transmissions in South Africa, certain provinces are still battling with a high number of cases during the second wave. Private hospital groups have therefore decided to suspend or terminate non-urgent elective surgeries.
Elective surgery is surgery that can be scheduled in advance and is usually not life-threatening, explains Johns Hopkins Medicine.
Last week, Health24 reported that Mediclinic had decided to terminate elective surgeries in their hospitals experiencing resource constraints.
Their chief clinical officer for Southern Africa, Dr Gerrit de Villiers, said in a statement that the second wave of Covid infections is continuing unabated and that there are significant volumes of Covid patients in KwaZulu-Natal, Mpumalanga, Limpopo and Gauteng.
De Villiers added that although demand seemed to have stabilised on 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," he said.
Fin24 also recently reported that South Africa's three biggest private hospital groups (Mediclinic, Netcare, and Life Healthcare) have brought in extra staff in order to deal with the high number of patients and staff shortages.
Netcare suspends non-urgent surgeries
Jacques du Plessis, managing director of Netcare’s hospital division, told Health24 that Netcare took the decision just before Christmas last year to suspend non-urgent elective surgical and medical admissions to their hospitals.
This was done to ensure that maximum capacity could be made available for emergency admissions at all levels of care, both Covid-19 and non-Covid-19 related.
“However, medically necessary, time-sensitive (MeNTS) surgeries – where postponement could result in patients’ outcomes or quality of life being significantly altered – are continuing,” said du Plessis.
Du Plessis also explained that individual clinicians base their assessment and decision to perform these surgeries on the guidelines issued by the American College of Surgeons, FOSAS and SASA, and take into consideration the post-operative care that such a patient would need.
“Together with our hospital management, we continue to monitor the situation very closely in order to provide appropriate care for each patient according to the severity of their condition. The level of treatment required is monitored on an ongoing basis to ensure the most effective use and deployment of resources for optimal patient care,” he said.
Resumption of non-urgent elective surgery in Netcare hospitals will be dependent on the course of the pandemic, du Plessis said, and explained that it may be done in stages (at different times in different regions) as Covid-19 cases in the regions decrease.
“We are maintaining an abundance of caution, and strict Covid-19 precautionary measures remain in place at all Netcare Group facilities,” he said.
Life Healthcare: elective surgeries depend on individual hospital
The postponement of non-urgent surgical cases, including elective surgeries, is one measure used to reduce pressure on facilities, including staff and doctors, general manager for emergency medicine at Life Healthcare, Dr Charl van Loggerenberg, told Health24.
"Hospitals nationally are under pressure, human resources and equipment are finite, and there are constraints on the numbers of patients that can be cared for within our facilities."
In terms of the implementation of elective surgeries, van Loggerenberg explained that this is decided by every individual hospital's Covid-19 Committee – working closely with hospital management in the daily and ongoing clinical decisions affecting patients, staff and doctors to decide whether these surgeries can be performed, as well as to ensure that the situation is managed optimally within the context of the Covid-19 pandemic.
As far as elective surgeries in state hospitals go, spokesperson for the National Health Department of Health, Popo Maja, said that provincial hospitals are required to use their discretion to perform elective surgeries.
“Global health systems (both public and private) across the world have had to conceal these procedures in the second wave. It all depends on the availability of beds,” Maja told Health24.
KwaZulu-Natal Premier Sihle Zikalala last week said that hospitals in both the private sector in the province are not yet full, but that the numbers of patients in hospitals are increasing. However, Zikalala added that the province has increased bed capacity and oxygen supply, News24 reported.
Western Cape Premier Alan Winde also stated just last week that despite the country reaching its peak, there was an increase in hospital admissions over a two-day period. Winde cautioned that the province needs to be responsible as people head back to work.
Health minister Zweli Mkhize stressed that while the numbers may be declining, it's going to take a while before provincial health systems will begin to feel this reduction.