Cape Town faces a dire ICU bed shortage

• Western Cape has reported 65% of SA’s tally of approximately 26,000 Covid-19 cases

Cape Town is running dangerously low on public hospital ICU beds, as Covid-19 fells key health-care workers and plans to requisition beds from the private sector are taking longer than anticipated.

The Western Cape has reported 65% of SA’s tally of approximately 26,000 coronavirus cases and is scrambling to expand its capacity to care for severely ill patients.

A hint of the city’s looming ICU bed crunch was given by private hospital group Netcare on Monday, when it told investors it expected the Western Cape would need its services within the next week.

A further sign of the city’s deepening Covid-19 crisis came on Tuesday in a report from the Medical Research Council, which showed a sharp spike in natural deaths in Cape Town in the week to May 19.

Cape Town’s public hospitals have 135 ICU beds, but fewer than 100 are available because so many health-care workers have Covid-19, according to the head of the Western Cape health department, Keith Cloete. So far 1,010 public-sector health-care workers have been confirmed with Covid-19 in the Western Cape, 462 of whom have already recovered. But 542 health-care workers, including 333 nurses and 32 doctors, are on sick leave with Covid-19. Six health-care workers from the province have died from the disease.

The national Covid-19 epidemic model, calibrated to the latest data from the Western Cape, projects that patient numbers will peak at close to 200,000 symptomatic cases in late June or early July and that the province faces a shortfall in hospital beds almost double its initial projection five weeks ago.

It is now anticipating needing 7,800 hospital beds at peak, instead of 6,200, and faces a shortfall of 3,350 acute and critical-care hospital beds instead of 1,750.

The model, built by a consortium co-ordinated by the National Institute for Communicable Diseases, projects that Covid-19 will kill 9,300 people in the Western Cape. The province is building field hospi

tals that will provide 1,428 acute beds, including an 847-bed facility in the Cape Town International Convention Centre and a 300-bed facility in Khayelitsha. However, these facilities will not have ICU beds.

Cloete issued an urgent appeal to the national health department to finalise negotiations with private health-care providers to bolster the Western Cape’s capacity to care for critically ill Covid-19 patients.

Discussions have been held with private hospitals, specialists, pathologists, radiologists and administrators.

Public health consultant Nicholas Crisp, who is assisting the national health department, said consultations with private health-care providers had been “extremely complex”, but the process was close to finality.

“There are figures on the table. A proposal is going to the director-general to take to the minister,” he said. “I know how pressing it is, but it could be financially risky for provinces.”

President Cyril Ramaphosa has committed an additional R20bn to the health budget for combating Covid-19, but details of how the funds are to be split between the provinces have yet to be finalised.

Work was also under way to create mechanisms to enable health-care professionals in the private sector to take up temporary or part-time positions in public hospitals, said Crisp.

9,300 the number of people expected to die from Covid-19 in the Western Cape