The number of Covid-19 admissions to hospital is on the rise in Gauteng — which may be driven by the newly-discovered Omicron variant — as the province prepares to enter a fourth wave of the pandemic.
Fatigued health workers, who have battled the crisis for about 20 months, are already bracing for another deluge of admissions.
A doctor at Johannesburg’s Chris Hani Baragwanath Academic Hospital spoke of a steady increase in recent days and 70 adult patients admitted for illness related to Covid-19.
Although no official declaration has been made, the Gauteng coronavirus command council told a media briefing on Thursday that the resurgence of Covid-19 cases, as well as hospital admissions, was an indication that the province was entering the fourth wave.
By 11am on Thursday, 18 new patients had been admitted at Chris Hani Baragwanath’s Covid-19 ward and the doctor, who requested anonymity, said that health personnel were expecting more patients to be admitted as the day progressed.
“It had been quiet for some time but over the last week or two, the numbers started to peak,” the doctor said.
“We are seeing more younger patients, who we describe as coincidental Covid-19 patients because they are either trauma, orthopaedics or general and when we do the basic testing, they come back Covid-19-positive.”
According to the doctor, only 15 of the 70 patients had been vaccinated. About 12 of them required oxygen and two were on ventilators.
Tembisa Hospital has also seen an increase in Covid-19 patients. On 2 November, the hospital announced it had released the last two of its Covid-19 patients. A month later, the number stands at 25.
“As the fourth wave begins, we would anticipate the numbers to rise,” said Noko Pela, the hospital’s spokesperson.
Angelique Coetzee, the chairperson of the South African Medical Association, said the fact that the new admissions are mostly young people is to be expected.
“In every peak, younger people were the first ones to test positive for Covid-19 and get hospitalised. It is the unvaccinated people who are above the age of 60 that we are going to have to look out for,” she said.
Chris Hani Baragwanath hospital needs at least 400 more beds than it did in the third wave, said the doctor who spoke anonymously.
“This time around, our medical wards are full, surgeries are full, so we rely heavily on ABT [alternative building technology] to accommodate most of our [Covid] patients. It’s definitely a concern. You know that there is another wave [coming but] you don’t know what to anticipate.
“We have been going through this for over two years and from our junior staff to our senior staff, especially the junior staff, we have seen a lot of burnout, sick leave … the burden of Covid-19 disease is far too high on the staff,” the doctor added.
The National Institute for Communicable Diseases (NICD) reported that, as of 1 December, there were more than 8 561 new Covid-19 cases nationally and 6 164 (72%) of these were in Gauteng. At least 2 550 people had been admitted to both private and public hospitals.
In this past week, the seven-day average for cases has increased by 20% a day. The proportion of positive tests increased by more than 10% and the risk for one person transmitting the virus to others has increased to two people, the NICD said.
The Omicron variant is believed to be the driver behind the resurgence of Covid cases. Although hospital admissions are increasing, they are, at this stage, lower than the numbers in the third wave.
“From week 45, 46, 47, we are seeing Omicron as the dominant variant in the province,” said Mary Kawonga, a member of the Gauteng premier’s advisory committee. “A lot of work is still going on to understand the significance of Omicron, so we will report that as the data becomes available.”
The rising numbers are, however, not expected to lead to a tightening of the lockdown restrictions, which have been in place in one form or another since late March last year.
In a televised address this past Sunday, President Cyril Ramaphosa kept the lockdown at level one, but added that the national coronavirus command council would review this in a week.
While urging South Africans to remain vigilant, Ramaphosa said the Covid-19 infection rate in various parts of South Africa was on the rise and scientists were working hard to understand the new Omicron variant, and the possibility of introducing mandatory vaccinations would be discussed by the government task team.
The Sefako Makgatho Health Science University’s Professor Maphoshane Nchabeleng said: “As the president has mentioned [the government] is being careful because we do know the implications of the lockdown and the impact of it on the economy, and that is why there will be a review to see how things are going.
“For now, it is hard to tell whether there will be a stricter lockdown; it just depends on the figures of the infections. If there continues to be an increase, they will be left with no option but to bring back a stricter lockdown and that is something they don’t want to do.”
Coetzee believes that the introduction of a stricter lockdown will depend on people’s behaviour in the next few weeks.
“As long as people don’t want to get vaccinated, wear masks and avoid crowded spaces, we will continue to see these lockdowns.
“What they need to understand is that the lockdowns won’t be needed even if we have more cases of vaccinated people with mild disease. It becomes a problem when we get unvaccinated older people who end up in hospital and those will remain a concern for us.”
Scientists in Gauteng suggest that the province will reach its peak during the second week of December.