Leadership and early strategic response to the SARS-CoV- 2 pandemic at a COVID-19 designated hospital in South Africa

Abstract

African countries are preparing to face the outbreak of COVID-19, which the World Health Organization declared a Global Public Health Emergency of International Concern on 31 January 2020 [1] and a pandemic 40 days later. [2] COVID-19 is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The virus, emerging in early December 2019 in Wuhan, Hubei Province, China, [3] has since spread explosively throughout the world. Most of Europe and the USA has been severely affected in recent weeks despite their relatively high income per capita and robust public healthcare systems. In contrast, African countries are poorly resourced, have a sizeable vulnerable population, and in recent years noticeably demonstrated vulnerability to epidemics. [4] Many South Africans of all ages have significant risk factors for severe COVID-19 outcomes. The pre-existing colliding epidemics of HIV infection and tuberculosis (TB), as well as the high prevalence of non-communicable diseases such as hypertension, diabetes and cardiovascular disease, place a large segment of the population at high risk. [5] This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

The impact of COVID-19 on routine patient care from a laboratory perspective

“…TBH is a tertiary teaching hospital affiliated to Stellenbosch University and was the dedicated COVID-19 referral centre for Western Cape Province during the pandemic. [3] As this was a laboratory study and no clinical or medication information was available, laboratory results were used as a proxy for patient follow-up. Data were extracted from the NHLS laboratory information system (LabTrak) from 1 March to 30 June for 2017, 2018, 2019 and 2020.…”

“…Globally, there have been few studies examining the effect of the COVID-19 pandemic on routine patient care and follow-up. To our knowledge, there are only three such studies in SA, [3][4][5] and none specifically looking at the effect on biochemical laboratory tests.…”

Correlating arterial blood gas, acid–base and blood pressure abnormalities with outcomes in COVID-19 intensive care patients

“…The institution provides a tertiary service for a large population and its bed capacity and critical care services were escalated in anticipation of the COVID-19 surge. 21…”

Implementing a video call visit system in a coronavirus disease 2019 unit

“…This minimises contact between the staff and shared surfaces. 2 A separate device was allocated to each ward. To promote awareness of the VCV, we placed posters in English, Afrikaans and Xhosa at the entrances and appointed a Video Call Champion (VCC) in each ward.…”

“…1 In hospitals, this has led to many changes, including the prohibition of visitation and the use of personal protective equipment (PPE), such as masks and face shields by the staff. 2 These measures prevent the spread of infection amongst the staff and patients, but for the individual hospitalisation is lonelier than ever. There is no visiting hour to look forward to, and the interaction with the staff is buried behind the layers of plastic, the face is barely visible.…”