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One of the most jarring aspects of South Africa’s recent surge in COVID-19 cases has been the near-total collapse of the Eastern Cape’s healthcare system.

As confirmed infections spike in a number of provinces, that isn’t a problem unique to the Eastern Cape, either, and Groote Schuur nurses have gone on the record to talk about the strain and stress they are under, as well as the strain on the resources available to them.

I’ve heard a few ‘so what’ responses from South Africans about contracting the virus, with the reasoning being that the majority of people infected recover and, in some cases, a feeling that even if things go wrong, that medical aid we’re all forking out for each month will ensure adequate treatment is received.

Ask Dr Adam Barnes, however, and you might get a rude awakening, with the doctor recounting his stories from battling in the front lines.

Writing for TimesLIVE, Barnes covers the struggles faced with regards to long shifts, a lax approach from the public, and other things we’ve seen many healthcare workers touch on.

Where things get really interesting is when Barnes talks about access to private hospitals, relaying the story of seeing someone without medical aid who requires treatment:

The patient who was tubed was a “private” patient. That’s someone who doesn’t have a medical aid who presents to a private hospital. Our job in that situation is to stabilise and provide any required intervention that will save a life. He was stabilised. The next step was to transfer him.

This is where it gets dicey. Of the nine possible government hospitals that have the ability to manage a ventilated patient, none of them had space. There are no beds. That patient then qualified to be ventilated in a private ICU…

Whilst that patient without medical aid qualifies for a ventilator, other patients with medical aid that are exhibiting milder COVID-19 symptoms have been turned away

Barnes stress that “There. Are. No. Beds.” (his emphasis), and this means a nasty surprise for those expecting to waltz into a private hospital if things go wrong:

All SA doctors work in government hospitals early in their careers, so we’re quite used to telling people that the resources are limited. But private patients are not used to being told no…

Beds aren’t guaranteed for anyone regardless of who pays monthly or what kind of money you have. Medical aid gives you an option, not a guarantee. It’s our job to make the decisions as to who qualifies for those beds. Those decisions are sometimes difficult, but they aren’t influenced by a medical aid card or a bank statement…

Dr Adam Barnes

Resources are absolutely stretched. Realistically, the resource that’s most stretched are ICU beds rather than general wards. But that’s essentially what you need if you’re admitting someone with Covid: access to the oxygen and ICU.

There are many reports, mostly on social media, about hospitals being empty – usually shared by those who seek to downplay the dangers presented by COVID-19.

In response to that, Barnes says:

But the thing is, their ICUs are still full. So if you need hospitalisation for a respiratory problem, you can’t get it at the moment, although if you fracture your ankle you could probably be admitted without a problem…

We know the surge is coming, and we aren’t sure we will handle it. For a health system that was struggling before Covid, things are about to break. There’s very little way to sugarcoat it, and I am a relatively optimistic person.

You can read Barnes’ full article here.

I like to think that, as we endure day 103 of our national lockdown, most South Africans understand that this virus is not to be taken lightly. At the same time, the desire to see friends and family remains strong, and certain lockdown regulations are being flouted.

When weighing up the pros and cons of any gathering, just remember that forking out for medical aid each month doesn’t mean you can take undue risks.

One more time – there are no beds.

[source:timeslive]