To say that the novel coronavirus swept into the country with great force and placed the country’s healthcare system under stress is to understate what happened. It took just a month to move from the World Health Organisation issuing a global pandemic alert to our country recording 100 deaths. It took just 78 days from recording our tragic first one hundred deaths to more than 5 000 South African lives lost. It took less than a month to move from our routine and familiar world to a travel ban, empty streets and deserted restaurants.
Brave and courageous doctors and nurses had no time to consider and make elaborate plans for something still on the horizon – they needed to keep pace with admissions, with deaths, with the need for oxygen and to respond to desperate cries from patients, many stunned by the severity of the virus. So too, hospitals had precious little time to respond – but they did.
At an organisation level, a concerted response became critical. Within weeks of the first identified case in the country, private hospitals – led by the Hospital Association of South Africa – approached the Ministers of Health, and Economic Development and Competitiveness to ask them to facilitate increased flexibility in the system. Both Ministers acted quickly and hospitals were granted permission to internally organise and increase bed numbers by re-designating licensed beds and re-circumscribing wards to ensure they were up to the task of caring for large numbers of infected patients if required. Simultaneously, National Institute for Communicable Diseases and National Department of Health protocols were adopted, staff were accordingly trained, and additional and necessary equipment procured.
HASA joined with hospital groups, media groups, the National Department of Health, the National Institute for Communicable Diseases, and the newly formed Business 4 South Africa group comprising business representative organisations, to create and implement public awareness campaigns, mostly using National Department of Health communication materials from the campaign web site (http://www.sacoronavirus.co.za).
Private hospitals in affected areas put elective surgeries on hold, mostly at great cost to patients waiting procedures, and to hospital group operations, as the country settled in during extensive lockdowns for the titanic and draining fight that lay ahead.
Private hospitals joined together in a facilities work stream under the Business For South Africa (B4SA) umbrella, to work collaboratively and in support of the Government-led pandemic response, with Hospital Association of South Africa providing coordination in meeting, atomic enable critical decisions to be taken in many rapidly unfolding areas such as the provision of Personal Protection Equipment, testing, ventilator availability, and other critical matters. Crucially, HASA was instrumental in collating and providing a range of data from the pandemic that was required by a number of entities, including the National and Provincial Departments of Health, and the National Institute for Communicable Diseases.
HASA also engaged with the South African Nursing Council to facilitate the temporary restoration of nurses who wished to volunteer for the pandemic response.
An example of early interactions with provincial Departments of Health that bore fruit was the collaborative partnership between the private hospitals, often represented by HASA Board members and executive staff, and the Provincial Administration of the Western Cape. The parties, for instance, agreed a Service Level Agreement that enabled public Covid patients to be treated in private facilities. Moreover, private hospitals joined the Western Cape Silver Command from April 2020 to contribute to the provincial pandemic response under the leadership of the Western Cape Department of Health. The Western Cape Department of Health Learning Collaborative was established to enable learning from the pandemic – private hospital groups presented case studies in this forum with participation from academic experts. Finally, private hospitals participated in the Western Cape Joint Operational Committee that was established to allow for discussions on ongoing operational matters within the healthcare sector.
A key contribution that private hospitals made to the national pandemic response was through the creation of a dynamic online platform that provides details of available Covid beds around the country. With bed numbers and locations changing constantly during surges, this tool is of great benefit for triage and the national pandemic response.
With vaccines now rolling out, private hospitals continue to make a significant contribution by vaccinating healthcare workers, training vaccinators, making vaccinations sites are available; and by contributing along with many other role players under the leadership of the National Department of Health to the building of the vaccine registration system. Private hospitals’ main contribution however, has been in the treating tens of thousands of patients who have needed help and care since the virus arrived so dramatically on our shores.
The Hospital Association of South Africa is proud to represent the private hospital sector and to have stood should-to-shoulder with so many who have contributed so much in this pandemic response. In particular, we recognise and thank the South African medical army, our healthcare heroes, and appreciate the strong leadership from the President, and the many spheres of government. In particular, we acknowledge the work of the Sisonke team whose tireless work and determination brought vaccines to healthcare workers.
