Doctors describe innovation, adaptation and despair as Cape Town’s famous academic hospital battles under the pandemic.
explaining how the intensive care unit dealt with the pandemic.Covid-19 required hospitals around the world to change the way that they operate, particularly ICUs. These are specialised units of a hospital for patients who are at risk of dying. These patients require constant care and specialised equipment and medicine to keep them alive.
ICU beds require a lot of surrounding infrastructure: two oxygen points, two suction points, and 14 electrical sockets. Groote Schuur found 60 such spaces that could meet the requirements of an ICU bed. 60 ventilators were acquired, including machines that had been retired. Medicine was stockpiled. But key equipment shortages were identified, including monitors and the beds themselves.
The first wave began slowly, and then quickly ramped up. After four weeks with seven Covid ICU beds in use, each subsequent week brought large numbers of patients requiring ICU treatment. At the peak of the first wave, almost 45 ICU beds were in use for seven consecutive weeks. Weekends and public holidays ceased to exist, although care was taken to ensure that doctors had enough time off to cope with the crushing demands.
HFNO was avoided initially for fear that high flow rates would spread Covid-19. But faced with a bed shortage, and with a study suggesting that the risk of spreading infection was not as great as previously feared, HFNO was introduced as a step before intubation, with immediate good results. Patients did not need to be moved onto ventilators as quickly. This eased the burden on nurses and doctors.
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