As the country rushes towards an anticipated spike in Covid-19 cases, the Western Cape's largest hospital is already under pressure, with a need for more nurses and many of its ICU beds occupied, according to staff who spoke to News24.
As the province continues to account for well over half of the national number of coronavirus infections, Tygerberg Hospital is already under pressure.
Doctors and medical staff at the state facility earlier this week reported that over 200 nurses had been off ill, as the infection rate in the Western Cape increased by hundreds daily.
On Wednesday, 11 262 cases were confirmed in the province.
A total of 211 people died of Covid-19 in the Western Cape, while 5 105 have recovered.
There were 470 people in high care in hospital, while 143 were in ICU.
Those on the frontline told News24 a shortage of nurses was their biggest issue.
On Tuesday, staff explained that the hospital's intensive care unit had 48 beds. Of these, 25 are for Covid-19 patients, and all are occupied.
The hospital wards for treating Covid-19 patients were also full, News24 was reliably informed.
What this means, one staff member explained, was that those in need of ICU beds "won't be able to get one until someone dies".
A tent erected for screening and testing is being turned into a field hospital because of a lack of beds and all departments at the hospital have had to send personnel to assist with screening and swabbing, as well as doctors to the ICU and the dedicated coronavirus wards.
News24 reached out to the hospital for comment on their current situation on Tuesday. Despite committing to furnishing a response by Wednesday, none had been received.
The Western Cape health department has since said that Tygerberg's ICU beds situation should not be seen in isolation from the rest of the province's ability to accommodate Covid-19 patients.
Twenty kilometres away, the Mitchells Plain District Hospital is also under pressure.
"All elective surgeries have been postponed during Covid-19 and only lifesaving, obstetrics and gynaecology procedures are currently being conducted," provincial health department spokesperson Monique Johnstone told News24.
She confirmed that staff members at the hospital have tested positive and are in self-isolation, together with their close contacts.
A hospital source told News24 that at least six staff members had tested positive in its operating theatre, and a further seven were quarantined and awaiting results. The hospital did not confirm the exact numbers.
Hospital management was concerned about their employees' health and safety, she continued, and were mindful to ensure a safe work environment in line with the departmental guidelines, while also emphasising adherence to Covid-19 safety measures to prevent transmission in the workplace.
In Mitchells Plain, 1 095 people had tested positive for the coronavirus by Wednesday.
Many people were presenting to the hospital's triage and testing tent as local cases climb.
Every person is screened and tested before being allowed into the hospital to prevent and control the spread of the virus in the hospital.
"The hospital has made four wards available to accommodate and treat active Covid-19 positive patients and those under investigation for the virus. All non-Covid-19 patients are treated in separate wards," she said.
The hospital's emergency centre has been divided into two areas to ensure a separate and secluded entrance for patients presenting with respiratory or Covid-19 signs and symptoms.
Western Cape Premier Alan Winde said his administration had been working around the clock to ensure it is prepared, so that those who require healthcare get it when they need it. This included the conversion of the Cape Town International Convention Centre into a temporary hospital facility, which is currently under way. It will provide 850 additional beds at the peak of the pandemic.
"It is estimated that 200 admissions and 200 discharges will be managed per day during the peak," he said.
"We will open additional temporary hospitals along the R300 in the metro, in Khayelitsha and in the Cape Winelands, that will collectively provide an additional 616 beds.
"This is in addition to the Western Cape's 2 162 (includes 658 through expansion) general care beds and 150 ICU beds that exist in central and regional hospitals across the province."