Health

1. (a) Based on projections and taking into account the inflection point of the third wave, when compared to the second wave, the Department will enter the third wave around mid-June.

(b) Based on previous levels of infection, combined with the vaccination campaign we expect that the third wave will be lower than the second wave, but this is entirely dependent on community’s adherence to safety precautions.

© The Western Cape Government has established a trigger system that is guiding our response to the third wave. The trigger system aims to promote transparency using pre-defined markers which will guide our response, reduce transmissions and prepare health services.

The first trigger warning is activated where there is an increase in the demand for healthcare services over the past 14 to 21 days. During this phase, we also see that there are:

• Large increases in daily cases by more than 20% for over a week;
• Overall test positivity is over 7% for over a 1 week;
• More than 15% of hospitals have over 10% of beds occupied by COVID-19 patients; and
• Over 50% increase in pre-COVID-19 hospital oxygen use.

The Western Cape Government has learnt from the second wave of infections and has kept advanced surveillance systems in place throughout the pandemic to ensure that we can rapidly scale up.

Our 5-point plan will ensure that we prevent the healthcare system from being overwhelmed. It will also ensure that we limit the need to de-escalate frontline healthcare services; and not interrupt the rollout of the vaccine programme.

The 5-point plan focusses on:

1. Changing community behaviours to prevent infection;
2. Surveillance and outbreak response;
3. Scaling up the health platform’s COVID-19 capacity;
4. Maintaining comprehensive services; and
5. Safeguarding and protecting the wellbeing of healthcare workers.

We have enough bed capacity to respond to the increase in COVID-19 cases and assist those in need of intermediate care, high care or ICU. Through previous investments during the pandemic, we can bring online additional bed capacity, where needed. 

In learning from previous waves, we have enhanced infrastructure at existing facilities so that facilities remain on standby to come online when necessary. We also continue to closely monitor the use of beds across our province, through a centrally coordinated and professional operation, known as the Bed Bureau Management System.

• The Metro has 5041 beds
• The George drainage area has 918 beds
• The Paarl drainage area has 938 beds
• The Worcester drainage area has 769 beds

In preparation for the third wave, the Afrox Western Cape plant has committed to scaling up the provision of oxygen as required. At the same time, we will continue to monitor the use of oxygen in the province over the coming weeks.

Previous waves have taken a significant toll on the wellbeing of our staff and we have put in place an employee wellbeing programme that provides onsite counselling to staff. To promote our healthcare workers sense of safety, we also provide personal protective equipment and are committed to improving our health and safety practices. 

To ensure that we have enough staff during the peak of infections, where health workers most likely to become infected, we have appointed an additional 717 healthcare workers and support staff. They will assist with both COVID-19 treatment and in our vaccination campaign. Healthcare workers will also be offered rotational leave to rest between April and June 2021.

We have assembled a vaccinator database to ensure that the vaccine rollout programme is not interrupted by the third wave. By 16 June, we identified 5297 vaccinators on our vaccine database, of which 3398 have already received the Provincial Department of health’s top-up training.

These vaccinators include:

• 514 doctors
• 3297 nurses
• 267 nursing students
• 370 pharmacists, EMS and educators
• 214 supervisors and managers
• 98 others

We are continuing our vaccine programme among healthcare workers to promote resilience and hope. To date, we have vaccinated a total of 66.12% of our healthcare workers – this includes frontline and support staff.

2. In response to the first trigger warning system being activated, the following recommended actions were suggested to the President’s Coordinating Council when we met on Tuesday, 15 June:

Strong public messaging on the increase in cases and the need for stricter adherence to the regulated measures particular around gatherings;

Preparing to mobilize resources for a substantial surge; and

Increasing vaccinations, where and when possible.

The Western Cape Government is prepared to respond to a third wave, but we need your support to flatten the curve and save lives.

It’s up to you to prevent infections and you can do so by practicing the important behaviours that we have learnt over the past year, including:

• Avoiding gatherings;
• If you do need to meet up, make sure it is outdoors, small and short;
• Ensure your air space is protected by maintaining at least1.5m distance while wearing a mask;
• If indoors, make sure you open the windows to ensure lots of fresh air;
• Washing and sanitizing your hands regularly; and
• Staying home if you are sick.