Covid-19: Elective surgeries to return in Western Cape as it eyes Level 1 due to decline in cases

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  • The Western Cape Health Department is planning to restart elective surgeries at public hospitals after experiencing an overall decline in Covid-19 infections. 
  • Premier Alan Winde is hoping the recovery will be good enough to go to Level 1 within the next few weeks for the return of international flights.
  • Cases on the Garden Route in the southern Cape are not declining yet, and 32 nurses and six doctors have been sent to help teams there. 

The Western Cape Health Department is planning to resume elective surgeries at public hospitals as soon as Covid-19 cases and deaths continue to decline in the province. 

However, the head of the provincial health department Dr Keith Cloete said this would have to be done carefully, as areas in the province peaked and declined at different rates. 

"It is going to be slower because of the Covid reality," said Cloete.

It would probably also involve having a Covid-19 test before going for surgery. If a patient had Covid-19, the procedure would probably be delayed until they were better. 

The provincial government was confident that it had enough beds and equipment to cope with another rise in cases, and to manage current and new cases. 

There were no testing backlogs, and there was enough capacity should it be needed. 

State of Covid-19 in the Western Cape (Dr Keith Cloete, Western Cape Department of Health)

The field hospital at Thusong Centre in Khayelitsha had already been moved to Butterworth, where partners Doctors Without Borders would continue their work there to help the Eastern Cape. The Hospital of Hope at the Cape Town International Convention Centre discharged its last patients on 14 August.

Khayelitsha was the first suburb to spike in the province, and the first to decline in numbers of cases and deaths.

Smaller facilities were also readied for more patients, and the Brackengate field hospital would remain open with a bed capacity of over 300. 

These facilities included the Sonstraal Hospital in Paarl with 63 beds ready out of a planned 150, with five patients already admitted. Mitchells Plain would have 60 in a facility renovated at a cost of R10 million by Gift of the Givers, Hermanus 32, Vredendal 20, George 40, while other hospitals had created extra capacity.

Rural regional hospitals also had critical care capacity with staff from the Cape metropole helping there.

Oxygen consumption was currently at 54% of capacity.

Cloete said data emerging showed that the fatality rate of people in the high risk group stood at 4.5%, and the positive testing rate was 15 out of 100 tests. 

They were also studying the data on 4 818 "excess deaths" between 1 January and 6 May, but noted that these were also declining, as were registered natural deaths.

Excess deaths were the number of deaths beyond what was considered normal for a period of time if there had been no pandemic, according to Our World in Data. Some question whether the true figure for Covid-19 should be higher due to the excess deaths.

With continued vigilance and monitoring for new hotspots or surges, the province believed case numbers would carry on dropping.

On Wednesday, the national Health Department reported 596 060 confirmed Covid-19 cases in South Africa, with 3 916 new cases identified. Of those, 103 210 were in the Western Cape. Of the 12 423 deaths, 3 675 were in the Western Cape. The national recovery rate was 82% on Wednesday - 491 441 - which translated to a recovery rate of 82%.

Covid-19 cases reported on August 19 (Department of Health)

A source at a private hospital said they were also working towards bringing patients back for elective surgeries, but in a cautious and safe way. 

"It has to happen. Especially for people who are being treated for cancer so that they do not go into Stage 4," the source said on condition of anonymity.

The source added that people would also have to be mentally prepared to go back to a hospital or a clinic, and get used to visiting people there again, after the fraught past few months.

Cases at schools were declining alongside overall figures for the province, so the next phase of pupils and teachers going back to school on Monday should be able to do so safely, as long as social distancing, mask wearing, hand and surface washing, and alternating classes were continued.

The department was shifting to its recovery plan, which included vigilance, monitoring and its own seroprevalence testing to supplement planned testing by the National Institute of Communicable Diseases, and the Human Sciences Research Council.

Cloete said vigilance and monitoring could continue for between one and two years, depending on when a vaccine was available.

Covid-19 peaks and declines in the Western Cape (Dr Keith Cloete, Department of Health)

The department hoped to use the Covid-19 tracing systems to bring TB patients back for their treatment. 

Its diabetes medicine delivery and monitoring programme continued, with a call for anybody with diabetes to go for a Covid-19 test as soon as they showed symptoms, as they were at greater risk of becoming more ill.

Premier Alan Winde said the province could get to Level 1 of the lockdown with constant vigilance, and maintaining all of the Covid-19 prevention guidelines. 

The country was currently at Level 2, which meant a reopening of almost all of the economy. 

Winde said getting to Level 1 meant getting international flights back, which would help save the hospitality industry, and prevent further unemployment and poverty. 

He said the province was still waiting for money promised by the national government to help manage the crisis. 

"There was some 'bookkeeping'," said Winde of the R5.3 billion involved.

"We have had to find it within our own budget." 

Regular meetings with national government counterparts had also been scaled back, but there would be regular reporting.

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