‘The infrastructure can’t cope’: South African healthcare workers struggle to deal with third wave
Dr Angelique Coetzee is a GP in the South African capital Pretoria, where she has run a family clinic for the past 33 years.
But she has never known anything like COVID-19.
She said: “If you have never been in such a situation, you can’t imagine what it is like. We’ve been dealing with 30 or 40 positive cases every day. The pressure is extreme.
“If you look at a country like Australia where they have a few cases, well I would see their national caseload in a couple of days. Can you imagine?”
When we first spoke in June, Dr Coetzee seemed on the verge of tears.
She said: “If I speak to you now, that means someone with COVID will not been seen – and there is no point trying to message. I don’t have time to answer.”
Dr Angelique Coetzee is a GP in the South African capital Pretoria
South Africa has found itself in the grips of a Delta variant-driven “third wave” of infection.
The caseload has been brutal, outstripping the first two waves by a factor of three.
The country’s acting health minister says this surge has now peaked in the province of Gauteng, where the cities of Pretoria and Johannesburg are situated but Dr Coetzee says her personal and professional burden has barely changed.
She said: “We have been seeing fewer patients on a daily basis this week but the weather is colder and COVID-19 patients are turning up with pneumonia so we are seeing sicker patients than we have been during the last three or four weeks.”
South Africa’s beleaguered public-run health system has struggled to cope with wave after wave of the virus.
Lacking sufficient beds and qualified staff, city hospitals used casualty departments as holding centres where patients wait for space to free up – sometimes for days.
South Africa’s healthcare system has been struggling with staff shortages during the pandemic
“This is the third wave we have experienced, comes less than six months (after the second) and the infrastructure can’t cope,” said Dr Coetzee.
“Most patients need oxygen and I try to admit them to hospital but because of (capacity) problems I have had to treat them at home. We have been waiting for 24 to 48 hours before we could get them cylinders, dealing with the stress of trying to manage patients without oxygen with the knowledge that if we don’t make a plan they are going to die. All this while the surgery is full, full, full. It is so very stressful.”
The extreme working patterns and the mental pressures that come with it have been felt in unexpected ways.
“I have had colleagues who have had motor vehicle accidents. One was so tired after work that he drove his car into a tree,” she said.
“The second one was hit at a crossroads – and a lady doctor reversed into a garage door because she had forgotten to open it. The most bizarre things that happen in a short space of time but it shows you the pressure they are under.”
Community groups have been running ad-hoc clinics in South Africa during the pandemic
Dr Coetzee has been operating on the very edge within a healthcare system that was been put under severe strain.
There are no support workers or home visits or specialist consultations for most people in South Africa.
Instead, GP’s like Dr Coetzee try to do it all.
“You become distant after a while but you try to carry on and on. I think that is the only way to survive it,” she said.
Yanga Booi is a 32-year-old nurse working at the intensive care unit at Thelle Mogoerane Regional Hospital in Vosloorus, on the outskirts of Johannesburg.
He says the hospital is poorly equipped and the staff have been insufficiently prepared during the pandemic.
He said: “The health system in South Africa did a complete spin when the pandemic hit our shores. We were put in the spotlight and given this false sense of heroism, but it wasn’t the right sort of attention because when we went to work, the hospital was in a worse state that than it was before.
“We were ill-prepared from the beginning, and we are still not prepared.”
The third wave has come as rioting and looting has taken place across the country
The hospital in Vosloorus provides beds and treatment but Booi says COVID testing at the facility is not reliable and patients are not properly isolated.
“We cannot be sure who has COVID because we get so many false negatives. It’s like we wait for people to get sick or drop dead, then look into the COVID thing,” he said.
“I remember admitting a patient who was negative on admission and so we didn’t isolate him. A few days later he died and we found out that he was positive.
“It’s a sad situation because the hospital does not have an isolated ICU ward for COVID patients. It’s a general ICU with isolation rooms and we admit COVID patients to it – some people have it and others don’t. We cannot be sure.”
Mr Booi says dozens of his colleagues have paid a terrible price over the course of three separate waves of infection in South Africa.
He said: “It is unfortunate that we have had to watch our colleagues dying from this… countless members of staff have gone, it’s not just nurses, it’s the doctors, it’s the clerks, it’s the porters.”
The 32-year old, who took up the profession when he was offered a government bursary, says he was “deeply afraid” when the pandemic arrived.
Yet 17 months later he has noticed a change in himself and others.
Yanga Booi said the country was ill-prepared for the pandemic
He said: “The loss of life has caused us to grow a thick skin, just like when we came into the profession. Our first experiences with death were terrifying but then we got accustomed to people dying and that is what has happened with COVID.
“We are used to the virus we know it is here to stay and we must find ways to keep going.”
Dr Shabir Mahdi is dean of the faculty of health sciences at Witwatersrand University in Johannesburg and is a source of expertise and fearless criticism in a country that has struggled in all aspects of its pandemic response.
Dr Mahdi says the ferocity of South Africa’s third wave of infection came as a “huge surprise”.
He said: “The current resurgence far exceeds what we have experienced either in the first or second wave in the number of documented cases. In fact, the numbers of new cases diagnosed on a daily basis is three times what it was at the time of the peak of the first and second wave.”
Dr Shabir Mahdi said the third wave in the country came as a ‘huge surprise’
However, this eminent viriologist is unsparing in his criticism of the government’s response.
While the magnitude of the Delta-fuelled third instalment could not have been predicted, he says health officials knew another wave was coming at the beginning of South Africa’s winter season.
He said: “In a province like Gauteng where 25% of the population live, our hospitals are completely overwhelmed but at the same time, we have beds that are literally vacant in the same hospitals and we can’t actually use those beds because some official in some government department forgot that you actually need to have health care workers available to actually staff those beds.”
World
Trump criticises Putin after potentially ‘historic’ meeting with Zelenskyy before Pope’s funeral
Donald Trump has criticised Vladimir Putin and suggested a shift in his stance towards the Russian president after a meeting with Volodymyr Zelenskyy before the Pope’s funeral.
The Ukrainian president said the one-on-one talks could prove to be “historic” after pictures showed him sitting opposite Mr Trump, around two feet apart, in the large marble hall inside St Peter’s Basilica.
The US president said he doubted his Russian counterpart’s willingness to end the war after leaving Rome after the funeral of Pope Francis at the Vatican.
Follow live updates: 200,000 mourn at Vatican
In a post on his Truth Social platform, he said “there was no reason” for the Russian president “to be shooting missiles into civilian areas, cities and towns, over the last few days”.
The two leaders held talks before attending the Pope’s funeral
He added: “It makes me think that maybe he doesn’t want to stop the war, he’s just tapping me along, and has to be dealt with differently, through ‘Banking’ or ‘Secondary Sanctions?’ Too many people are dying!!!”
The meeting between the US and Ukrainian leaders was their first face-to-face encounter since a very public row in the Oval Office in February.
Mr Zelenskyy said he had a good meeting with Mr Trump in which they talked about the defence of the Ukrainian people, a full and unconditional ceasefire, and a durable and lasting peace that would prevent the war restarting.
Other images released by the Ukrainian president’s office show Sir Keir Starmer and French President Emmanuel Macron were present for part of the talks, which were described as “positive” by the French presidency.
Mr Zelenskyy‘s spokesman said the meeting lasted for around 15 minutes and he and Mr Trump had agreed to hold further discussions later on Saturday.
The world leaders shared a moment before the service
Donald Trump and Volodymyr Zelenskyy meet in the Basilica
But the US president left Rome for Washington on Air Force One soon after the funeral without any other talks having taken place.
The Ukrainian president’s office said there was no second meeting in Rome because of the tight schedule of both leaders, although he had separate discussions with Mr Starmer and Mr Macron.
The French president said in a post on X “Ukraine is ready for an unconditional ceasefire” and that a so-called coalition of the willing, led by the UK and France, would continue working to achieve a lasting peace.
There was applause from some of the other world leaders in attendance at the Vatican when Mr Zelenskyy walked out of St Peter’s Basilica after stopping in front of the pontiff’s coffin to pay his respects.
Donald Trump and the Ukrainian president met for the first time since their Oval Office row. Pic: Reuters
Sir Tony Brenton, the former British ambassador to Russia, said the event presents diplomatic opportunities, including the “biggest possible meeting” between Mr Trump and the Ukrainian leader.
He told Sky News it could mark “an important step” in starting the peace process between Russia and Ukraine.
Professor Father Francesco Giordano told Sky News the meeting is being called “Pope Francis’s miracle” by members of the clergy, adding: “There’s so many things that happened today – it was just overwhelming.”
The bilateral meeting comes after Mr Trump’s peace negotiator Steve Witkoff held talks with Mr Putin at the Kremlin.
They discussed “the possibility of resuming direct negotiations between Russia and Ukraine”, Kremlin aide Yuri Ushakov said.
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Russia and Ukraine have not held direct talks since the early weeks of the war, which began in February 2022.
Mr Trump has claimed a deal to end the war is “very close” and has urged Mr Zelenskyy to “get it done” in a post on his Truth Social platform.
He has previously warned both sides his administration would walk away from its efforts to achieve a peace if the two sides do not agree a deal soon.
Meanwhile, the Polish armed forces said a Russian military helicopter violated its airspace over the Baltic Sea on Friday evening.
“The nature of the incident indicates that Russia is testing the readiness of our air defence systems,” they said in a post on X.
On an extraordinary day, remarkable pictures on the margins that capture what may be a turning point for the world.
In a corner of St Peter’s Basilica before the funeral of Pope Francis, the leaders of America and Ukraine sit facing each other in two solitary chairs.
They look like confessor and sinner except we cannot tell which one is which.
Leaning forward hands together in their laps, Donald Trump and Volodymyr Zelenskyy stare at each other in one photo.
In another, the Ukrainian president seems to be remonstrating with the US president. This is their first encounter since their infamous bust-up in the Oval Office.
The two leaders held talks before attending the Pope’s funeral
Other pictures show the moment their French and British counterparts introduced the two men. There is a palpable sense of nervousness in the way the leaders engage.
We do not know what the two presidents said in their brief meeting.
But in the mind of the Ukrainian leader will be the knowledge President Trump has this week said America will reward Russia for its unprovoked brutal invasion of his country, under any peace deal.
Mr Trump has presented Ukraine and Russia with a proposal and ultimatum so one-sided it could have been written in the Kremlin.
Kyiv must surrender the land Russia has taken by force, Crimea forever, the rest at least for now. And it must submit to an act of extortion, a proposed deal that would hand over half its mineral wealth effectively to America.
The world leaders shared a moment before the service
Afterwards, Zelenskyy said it had been a good meeting that could turn out to be historic “if we reach results together”.
They had talked, he said, about the defence of Ukraine, a full and unconditional ceasefire and a durable and lasting peace that will prevent a war restarting.
The Trump peace proposal includes only unspecified security guarantees for Ukraine from countries that do not include the US. It rules out any membership of Ukraine.
Ukraine’s allies are watching closely to see if Mr Trump will apply any pressure on Vladimir Putin, let alone punish him for recent bloody attacks on Ukraine.
Or will he simply walk away if the proposal fails, blaming Ukrainian intransigence, however outrageously, before moving onto a rapprochement with Moscow.
If he does, America’s role as guarantor of international security will be seen effectively as over.
This could be the week we see the world order as we have known it since the end of the Second World War buried, as well as a pope.
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