Coronavirus in Cape Town: Africa’s battle against Covid-19 will be won or lost in high density areas


Surrounded by over half a million people – somewhere between the vineyards and beaches of this international destination – it is now the center of attention.

High density areas like Khayelitsha are closely watched because doctors say places like this are where the battle against Covid-19 on the African continent will be won or lost.

Western Cape is now in the middle of the peak of its coronavirus influx. With more than 69,000 Covid-19 cases and 2,066 deaths, according to government figures on July 5, it is the most affected province in the country.

“No one knew what the Covid epidemic would mean for South Africa. We had seen Covid cross Europe, we saw what he was doing in the United States and everyone was terrified of what it would mean in South Africa, “said Dr Claire Keene, medical coordinator of the NGO Doctors Without Borders.“We are facing so many failures with Covid. We have used the time well, but we will always wonder if we have used it enough, ”she said.

In Khayelitsha, Doctors Without Borders, in partnership with the country’s health service, has transformed a basketball arena into a field hospital to prepare for this wave. Workers in the maquis come out the back door and roll into tanks in the forest with oxygen cylinders outside.

There are 70 beds and just a handful of empty spaces. The patients, mostly elderly, come from the immediate vicinity, key to gaining the trust of the local community. Some come out after just a few days of oxygen and steroid treatment, while others are not so lucky.

Keene says their field hospital is a level of intensive care, but it’s much more than just a recovery room. It has become an essential way to ease the burden on local hospitals as the peak peaks.

Many are predicting a disaster in South Africa today, particularly with its high burden of HIV and TB cases and its overburdened health system.

But public health officials and doctors here concede that their earlier models – even those that allowed for aggressive locking – were too pessimistic.

Worst case scenario

“We have fewer patients than we expected, we have fewer hospitalizations than we expected. And so far we’ve had slightly fewer deaths than expected, “said Professor Lee Wallis, chief of emergency medicine for the government of the Western Cape. .

The commune of Khayelitsha, seen here in March, is a high-density area that is closely watched in the battle against Covid-19.

However, Wallis and his team plan to have 1,400 additional beds ready for the worst-case scenario. He sits overlooking a still empty room in the huge converted convention center near the Cape Town waterfront. They expect the facility to be almost full by the end of July.

Wallis says the burden of HIV has not had the impact that some feared. Comorbidities like hypertension, obesity and diabetes are much more critical, he says, which have also worsened the results of Covid-19 around the world.

The pandemic hit South Africa later than Europe and North America and experts here have had the benefit of learning from mistakes and innovations from previous hot spots.

Wallis says that the move away from ventilating patients to high volume oxygen has made an almost overnight difference in major hospitals in the Western Cape.

Now, instead of being placed in a medically induced coma and breathing through a machine, many patients of the same type are absorbing huge volumes of oxygen through masks or cannulas.

“We are looking at what is happening in high-income countries and adapting it to a low-income environment and making it work,” he says.

Although the peak in Cape Town is not as high as expected, he thinks the surge could last longer than expected by their previous models – even for several months – a situation that will severely strain the health care system and a desperate population. go back to some kind of normal.

Undertakers carry coffins after the funeral of the victims of Covid-19 at a mosque in Cape Town in June. The Western Cape province is now in the middle of the peak of its coronavirus influx.

Public health officials warn that it is far too early to declare victory against the disease, and are wary of predictions about a virus that is just over six months old.

Cape Town doctors and nurses always focus on one day and one patient at a time.

“Every death is a heavy burden for healthcare workers, but when patients come out of breath and come out, it’s a huge achievement for everyone,” says Keene.


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