There is a flattening in hospitalizations and deaths due to Covid-19 in the Western Cape, but it is still too early to say whether it will start to decline, according to the provincial department of health.
Dr. Keith Cloete, head of department, told the Western Cape legislature on Wednesday that the rate of hospitalizations and deaths is being checked according to the models that have been drawn up. The data from the past two weeks indicate a flattening, where the models expected a further increase.
This trend is largely seen in the Cape Town metro area, while rural areas may still experience increases and will probably only have their peak later.
“It is still early days, but it really looks like hospitalizations and deaths are starting to stabilize and possibly indicate an early decline in the province,” Cloete said in a submission to the legislature’s Covid-19 ad hoc committee.
According to Cloete, the department also trusts that it picks up the most deaths due to Covid-19 and that it compares well with the Department of Home Affairs’ data.
He also pointed out that the models have been recently adapted and currently point to a longer, flatter peak of infections, which amounts to more deaths and hospitalizations over a longer period of time.
However, the scenario planning and models still contain many uncertainties, including the assumptions on which they are based and the effects of treatments such as dexamethasone, for example.
“Overall, the province is still seeing rising numbers on a weekly basis and many parts are still early in the epidemiological curve. Absolute vigilance remains essential. ”
Cloete also pointed out the significant effect that cases associated with alcohol have on hospitals’ trauma units.
Data from an electronic system that monitors the trauma units in five large hospitals in the province, indicates a decrease in trauma cases from 40% to 50% during the liquor ban and this apparently skyrocketed with the lifting of the ban .
According to Cloete’s submission, there was a need for 2.7 beds per day for trauma cases between 22 and 31 May and this increased to almost ten beds per day a week after the restrictions were lifted.
“It is almost seven additional beds that are taken up and could go to someone with Covid-19. This is a significant effect. “
The average daily deaths due to road accidents also rose from 1.4 in May to almost four per day in June.
Cloete pointed to previous analyzes of deaths due to murder, accidents and drownings, among others where there is a strong relationship with alcohol use, especially in the Cape Flats and among men.
When the ban on liquor sales was lifted, daily trauma cases increased by 62%, while trauma deaths increased by 308% and trauma admissions in intensive care units by 350%.
“As we reach the peak of the Covid-19 pandemic, our hospitals are being overwhelmed by seriously ill patients who need stabilization and treatment and need to be admitted for further care.”
The misuse of alcohol impedes the department’s ability to try to prevent deaths under the “double charge” of Covid-19 and trauma cases as the peak is reached, according to Cloete.
Meanwhile, the temporary hospitals in the Cape Town International Conference Center (Kiks) and Thusong Center in Khayelitsha have played a “massive role” in relieving the pressure on hospitals, while the department monitors with its online “bed bureau” system where beds occupied or available.
The Brackengate Field Hospital will also take in patients for intermediate care from 20 July and further alleviate the pressure on hospitals.
Cloete says the province currently has enough hospital beds for the shallower peak expected and has reduced the risk of a serious shortage of beds in high-care and intensive care units, including the use of high-flow oxygen.
“The big lesson is that the active management of people with chronic diseases is essential.”
Although hypertension is one of the most common comorbidities among Covid-19 patients, most of these patients recover and there is a greater proportion of diabetics who become seriously ill or die.
Patients with diabetes have almost a 50% chance of being admitted to hospital and 40% of these people die, according to Cloete.
Testing priorities have been expanded to include unexplained deaths and vulnerable groups, especially diabetics.
Other priorities for testing are health workers, people in hospital being examined for Covid-19 and sporadic cases or groups in rural districts where restraint is an important strategy.
Screening in communities continues in every district, with a focus on people who have symptoms and a greater risk of becoming seriously ill.
Cloete says there is also a growing health risk unrelated to Covid-19. Fewer people use the department’s facilities and do not show up for appointments, there are fewer vaccinations and a backlog with surgery.
Furthermore, there is a 20% to 50% decrease in people using the department’s psychological and psychiatric services.
The Western Cape had 79,332 cases of people with the coronavirus by Tuesday, of which 15,160 were active cases and 2,416 deaths were reported.
A total of 1,636 people were admitted to hospital, of which 300 were in the high care or intensive care unit.
Prime Minister Alan Winde said in a statement that the provincial government and the Cape Town metro had already put measures in place before the pandemic to ensure that the places that produce medical oxygen were not affected by load shedding.