Cape kids’ hospital shows the way as Gauteng lags
● Cape Town’s leading specialised children’s hospital has begun taking in older patients to make more bed space available in other facilities as SA’s Covid-19 caseload soars.
Professor Mignon McCulloch, paediatric ICU consultant at Cape Town’s Red Cross War Memorial Children’s Hospital, said: “Our age cut-off for our patients was traditionally 13, but in light of the pandemic we have taken in adolescents to free up space in adult facilities.”
Yet in Gauteng, where many hospitals are overstretched, bed occupancy at the Nelson Mandela Children’s Hospital in Johannesburg is just 27%.
This despite the appointment of a provincial task team to manage bed space and ensure the sick are not turned away.
The Gauteng provincial Covid-19 command council’s data indicates there could be a need for more than 50,000 beds by next month. There are 8,300 beds in the province.
Paediatric experts say specialised children’s hospitals have a pivotal role to play in the response to the pandemic and can ease the burden on adult facilities — where the virus hits hardest — and every bed counts.
Dr Mandisa Maholwana, CEO of the Nelson Mandela Children’s Hospital, which has 143 beds, said that as of this week, after the Sunday Times sent questions to the Gauteng department of health, the hospital had been included in the department’s electronic platform to report bed availability daily.
The provincial department of health did not respond to questions.
Maholwana said in an earlier response that the hospital was a referral facility and occupancy varied according to the number of children sent to it for care. She cited staff shortages as an issue.
But the current low occupancy raises questions about whether urgently needed bed space is being effectively managed.
The hospital, built in 2017 using R1bn from the Nelson Mandela Children’s Fund, has been beset by funding shortfalls and a dearth of trained staff.
In February, health MEC Bandile Masuku said 62 of the hospital’s 401 posts were vacant, with difficulties in recruiting specialist nurses and subspecialists because of a national shortage in these fields.
McCulloch said children’s hospitals were “pivotally important in this Covid-19 era, first to alleviate the pressure on adult facilities by diverting children and adolescents, and second for children who have other ailments”.
She said taking in older patients meant the hospital’s workload had remained constant.
A study by the Children’s Hospital Association in the US reported that is not ideal to send adults to children’s hospitals because their equipment and skills are geared for much younger patients.
But the study recommended sending as many younger patients to children’s hospitals as possible so that adult facilities could handle more coronavirus cases.
Professor Andrew Argent, head of the University of Cape Town’s department of paediatrics and child health, said consolidating the treatment of children in one place had worked to free up bed space in the Western Cape.