Fear over ICU beds

Local doctors working at state hospital Covid-19 ICU wards are seeing a major increase in the number of patients and have warned of a shortage of ICU facilities as soon as next week.
Local doctors working at state hospital Covid-19 ICU wards are seeing a major increase in the number of patients and have warned of a shortage of ICU facilities as soon as next week.

Doctors and nurses working in local government hospitals have warned that the “tide of Covid-19 cases has started to come in” and that they could possibly run out of ICU ventilator space as early as next week.

The medical staff confirmed that in addition to the ICUs already reaching its capacity, with plans to extend to accommodate more ventilated bed units, there were more patients on waiting lists for transfer.

In addition, there is a critical shortage of staff with either one or two doctors per shift working on 20 ventilated ICU patients and one nurse attending to three ventilated patients.

The doctors, who have all requested anonymity as they are employees of the Department of Health and not authorised to speak to the media, also said the majority of patients in ICU on ventilators thus far have not survived.

KwaZulu-Natal has 224 ICU beds available in government hospitals and 672 in private hospitals with an understanding that if government ICU beds are full, they would use available private ICU beds. The doctors fear that the country is heading towards a catastrophic increase in cases and deaths because people are “simply not taking the virus seriously”.

In the past week, in the majority of state hospitals, doctors said they went from having minimal patients (three to five) in ICU on ventilators to reaching full capacity.

“Generally I am not one to talk publicly about work-related issues but recently I am faced with so many emotions that I feel it is necessary.

“Leave the statistics out for now. I am making an observation based on my experiences. What my colleagues and I have seen in the past week is beyond words. We are overwhelmed, afraid and shocked ... The public needs to be educated about the seriousness of the situation and should refrain from taking it so lightly. Nurses and doctors are working more than they have ever had to work in their career.

Another doctor said they feared that they would soon have to make decisions as to who would qualify to get an ICU bed and ventilator.

“Just remember that we have not reached our peak and our ICU beds are already reaching full capacity in such a short period of time.

“Who knows when we will start to see a downward trend? For now, our main concern is that we may not have enough ventilators for everyone and we may be forced to make decisions that would restrict certain patients from using a ventilator. This means we will have to start prioritising according to age and other factors,” said the doctor, who works at several state hospitals in Durban and Pietermaritzburg.

Of most concern to the doctors is that most people are not taking precautionary measures. “What concerns me is that the general public does not see what is really going on in ICU and that is why we want them to hear us message. I feel like screaming out to people when I am driving to social distance and wear masks, to stay at home, and not visit people. We are seeing just so many people who are so very sick now.”

The doctor advised that anyone with comorbid conditions such as HIV, diabetes, hypertension, cardiac and even obese patients were at high risk.

“At the moment, there have been very few patients with co-morbidities that have managed to wean off the ventilator. In the last three weeks, before the increase in cases, we had at least 10 deaths.

“All those with co-morbidities are very critical and there is an extremely poor prognosis for them,” she said.

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