- Covid-19 health workers in a Gauteng hospital say they urgently need more staff.
- "Traffic jams" in overwhelmed facilities leave no space for social distancing.
- Staff work long hours with little time to eat and rest, and even less psychological support to deal with colleagues succumbing to infection from the virus.
The City of Tshwane, the municipal area in which George Mukhari Academic Hospital is situated, is a Covid hotspot. The hospital lies next to Ga-Rankuwa, a sprawling labyrinth of settlements that stretch to the border of the North West province, and serves a population of about 1.7 million people.
We arrived at George Mukhari late morning on 15 January and spent time in the Covid wards, including the intensive care unit, until late afternoon.
Staff nurse Lenah Lefifi is a mother of two. She has been tending to the six patients in her isolated Covid-19 ward for four hours already. All of them are on oxygen. Lefifi has another two hours to go before she can take a break.
She says: "Please write with big letters: WE NEED MORE STAFF. I've been in here since 7am. I haven't been able to eat yet."
"This second wave is chaotic. It's worse than the first wave. Our wards are always full," Lififi says.
"I'm afraid of getting the virus. We wear our PPE. It's all we can do." Would she take a vaccine? "I'm not sure. It's very new."
A nurse in an isolated Covid-19 ward gives her patients their meals. Health workers say it almost feels like they're dealing with a different virus during the second wave: There are far more patients and deaths and the disease seems more intense.
A patient in an isolation chamber is given oxygen to help him breathe.
Scientists say the new Covid variant identified in South Africa - called 501V.2 - appears to be about 50% more transmissible than previous forms of the virus. That is why we've seen so many more infections during the second wave.
Mpho Kunene is the operational manager of George Mukhari's Covid wards. She makes sure there are enough staff and equipment.
She says: "We were badly prepared for the first wave - we didn't have wards for isolation. We just nursed the patients wherever we could. Thankfully we've had renovations done for the second wave... But we don't have enough psychological support. It's difficult coming to work when you hear that a colleague has passed."
Eunice Moleshoane has been a cleaner at George Mukhari for five years. One day in June last year, she started feeling feverish.
Soon after she was admitted to the very same hospital where she works - she had Covid.
There was no special treatment for her.
"I waited in casualty for two days before I got a bed." She was discharged after about a week.
Moleshoane says: "I will definitely take the vaccine. This thing is killing us. Covid is everywhere."
The Burns Unit at George Mukhari Academic Hospital has been converted to a Covid-19 Intensive Care Unit.
It's practical because most of the rooms are isolated behind glass. In one of the rooms, two doctors, Siboniso Dlamini and Hannah Bussio, are intubating a patient in order to put him on a ventilator.
Sisters Ipeleng Nonyane and Sinah Motaung are helping. There's a lot of beeping and the health workers are keeping a close eye on the patient's vital signs.
A porter emerges from the porter room in the reception area of George Mukhari.
Porters, cleaners and hospital security guards will be part of the 1.25 million health workers that the government plans to vaccinate.
The Health Department expects one million doses of the drug company AstraZeneca's jab to arrive in South Africa in January and another 500 000 doses in February. Each health worker will need two doses, so the 1.5 million doses will cover just over half of the workers.
A security guard mans a desk at the entrance to the Accident and Emergency (A and E) ward. This is where patients arrive. It's cramped, hot, poorly ventilated and resembles something like a traffic jam. There's no room for proper social distancing.
A patient with Covid symptoms waits for treatment.
Because the new variant spreads faster than the original form of the virus, there have been more hospitalisations during the second wave. But the 501V.2 variant doesn't make people sicker; we're seeing more deaths and hospitalisations in the second wave because there are so many more cases, but the proportion of deaths in relation to the total number of cases isn't bigger than during the first wave.
The A and E ward is packed, but staff insist it's a quiet day. Patients are lying or sitting on gurneys with oxygen pipes attached to their noses and drips attached to their wrists. Oxygen suppliers say they struggled to keep up with high demand for medical-grade oxygen during the first half of January.
A patient who appears to be a prisoner is treated by a nurse. He's chained to his gurney. A correctional services officer keeps an eye on him from the doorway.
A porter wheels a gurney with a body tightly wrapped in plastic and covered in a blue sheet out of the back. He will take it to the mortuary which currently has plenty of space. The body will be placed in a special section cordoned off and marked "infectious bodies".
This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.