COVID-19: A visit to Tygerberg Hospital’s ward D-10
Following an official announcement on the number of infected COVID-19 cases by the Minister of Health Dr Zweli Mkhize on Wednesday, the Western Cape Premier Alan Winde confirmed that the province had identified its first case of COVID-19.
Mkhize’s announcement took place shortly before an official media tour of Tygerberg Hospital’s isolation unit. Tygerberg Hospital is one of the designated facilities to treat people with COVID-19.
The province’s first case, is a 36-year old man who returned from his travels to Europe on 9 March. He was tested in a private health facility and is now in self-isolation, according to Winde. The premier would not reveal more information about the patient or where in the province he is from.
Dr Jantjie Taljaard, infectious disease specialist at Tygerberg Hospital said three more patients who presented with COVID-19 symptoms are currently in isolation at the hospital awaiting their test results.
“We just want to make it clear that South Africa does not have a widespread outbreak of COVID-19 at the moment,” he said.
When asked why the confirmed case was in self-isolation as opposed to the isolation unit at Tygerberg Hospital, Taljaard said that there were two options for isolation once a case has been confirmed, self-isolation according to the World Health Organisation’s guidelines and being isolated in a hospital. The latter is only necessary if the patient is sick enough to need it.
“We’d prefer not to admit people unnecessarily to the hospital,” he said.
Taljaard said that South Africa has had the opportunity to build on the experience of clinicians and epidemiologists worldwide who already had to handle the COVID-19 outbreak.
“We are well aware of the potential risks, but the message is that there is no outbreak (in South Africa) at the moment and there is an opportunity to prepare properly, not to panic but to have a measured approach,” he said.
The first South African case of COVID-19 was identified in KwaZulu-Natal (KZN) last week.
On Wednesday, the number of cases confirmed by the National Institute for Communicable Diseases (NICD) stood at 17. These include eight cases in KZN, six in Gauteng, one in Mpumalanga, one in the Free State and the Western Cape’s single case.
An appeal for calm
Winde, together with the Western Cape MEC for Health Nomafrench Mbombo called for calm among the province’s residents and asked the media to stick to its original purpose in visiting the hospital.
“We are here today to come and have a look at the readiness of Tygerberg Hospital, and the quarantine space,” Winde said.
The space, referred to as Ward D-10, is an Infectious Diseases Ward, equipped with four isolation rooms with en-suite bathrooms, according to Dr Dimitri Erasmus, CEO of Tygerberg Hospital.
Taljaard explained the protocols in place for transporting any patients who may have COVID-19 into the ward. He stated that the entrance where the media was being briefed, Entrance number 5, will be the designated entry point for these patients.
“This entrance has been identified because it is separate from the mainstream entrances for personnel and patients…it is probably the safest and most practical entrance.”
Taljaard further stated that the hospital will normally be forewarned that the patient is coming, most likely by an official from a port of entry. However, screening at port entry points does not guarantee every case of COVID-19 will be picked up. So far, 16 of South Africa’s COVID-19 cases are imported cases where infection took place in Europe and the United States. The case in the Free State is the first case infected through local transmission.
In a case where local transmission occurs the alert will presumably come from a source besides an official from a Port of Entry, although Taljaard did not elaborate on the other sources of such an alert.
“Ports throughout the world would at best identify 20% of infected cases coming through their ports. This is not the ideal way of doing it, but at least it is the first net that is thrown to pick up cases,” Taljaard said.
A look at ‘the safest ward’
The hospital’s Infection Prevention and Control Team will oversee the process of moving a potential COVID-19 patient into the hospital, by clearing the area around the entrance as well as the route to the ward, said Taljaard.
The media was taken on this route, first through the entrance where they were greeted with staff armed with large bottles of hand sanitiser. Then up one of two lifts, squashed together like sardines to the 10th floor. Then followed a short walk down a corridor to Ward D-10.
Ward D-10 has a single entrance, more staff with hand sanitiser, and the occasional doctors and patients who had to squeeze through the clusters of journalists with difficulty. The ward has a long corridor with rooms on either side, and a door with a small window at the end. This window revealed the interior of the isolation ward.
Before allowing the media access to the window, Marina Aucamp, clinical programme coordinator for Infection Control at Tygerberg Hospital gave a demonstration of the protective equipment any medical staff member entering that unit had to wear.
Afterwards, she told Spotlight that this ward is actually the safest ward in the hospital, as they already know what is wrong with the patients and can take the necessary precautions.
Aucamp said that the ward treats various infectious diseases, and generally has a lot of Tuberculosis cases. According to her the isolation ward had not been in use for a while until it got its current occupants.
“Luckily there were not any cases that needed the isolation ward so we could convert it quite quickly,” she said.
Relax, we’ve got this
Mbombo, when asked whether she expects more COVID-19 infections in South Africa replied “Of course!”
“We want to show that our system is ready. But we won’t be able to say that there won’t be any Coronavirus cases. It is expected that there would be more,” she said. “What matters is that (we) identify and contain,” she said.
“So, relax, we’ve got this,” she added.
Winde echoed the sentiment, giving straightforward advice for how the province’s residents should react to COVID-19.
“Remain calm, follow hygiene practices. If you have travelled overseas or have come into contact with someone from overseas, follow the process of contacting the call centre,” he said.
*The call centre is run by the NICD and can be contacted on 080 0029 999