Emergency rooms in South Africa have adapted to the challenges brought by the coronavirus. 

Emergency rooms (ERs) or casualty departments are sometimes the first stop for patients needing care outside of of normal office hours or in serious accident or trauma scenarios. The coronavirus and covid-19 pandemic has meant extensive changes to the way these spaces operate and how their staff conduct themselves. 

Dr Evelyn Gordon who runs an accident and emergency unit at the Life Bedford Gardens Hospital in Bedfordview, says that casualty numbers have dropped since the lockdown as patients are reluctant to venture out of their homes. 

“This is because they do not come to the doctor for every little thing. Another reason is the fact that people are staying at home and are therefore not being exposed to all sorts of infections and ultimately not getting as ill,” Gordon said. 

Life Healthcare, owner of Bedford Gardens Hospital is a private hospital operator with 41 emergency healthcare facilities nationwide. They have reduced access to the hospital by stopping visits to patients by family and friends, halting all elective surgeries and preventing unauthorised persons from accessing their facilities except in the case of emergencies. 

Gordon said, “Everyone is screened at the hospital entrance and they have to wear a mask. We treat everybody as a covid-19 case until proven otherwise.” 

Hospitals like Milpark in Johannesburg have put up outside screening facilities to check patients before they enter the facility. Neill Moross who visited the emergency room at Milpark Hospital as a patient on April 10 said, “I was screened before I was allowed to enter which included the checking of my temperature, a series of questions being answered regarding my travel plans and inquiries about those I have been in contact with.” 

The second cause for concern is the exposure to covid-19 and the possibility of contracting it doctors and nurses face. Gordon said, “Although most of us are healthy and we take precautions, there is always that chance, a chance no one wants to take.”

To help protect themselves, those working in the emergency rooms are made to wear gloves, masks, face shield and protective gowns as well as shower thoroughly before going home. Gordon said, “There are some issues that I have found while working in an accident and emergency unit during this time.” The first issue she has identified is the workers demanding access to tests which in her opinion is using the resources ineffectively. She added that people who are symptomatic should be tested as there are a limited number of tests in the country.

Another of country’s biggest private healthcase providers is Netcare 44 emergency departments. Dr Freiland, Netcare group chief executive officer said in a media release that, “We have also implemented comprehensive measures to detect, identify and respond appropriately to any suspected or confirmed cases of COVID-19 at any of our group’s facilities.”

However, Kingsway Hospital in Durban, is one of the two Netcare hospitals that had to close due to an outbreak of covid-19 among staff and patients. The outbreak had reported begun in the emergency room when a patient with a suspected stroke and was covid-positive was brought in on April 4. 

St Augustine’s, another Netcare hospital in Durban, stopped the admission of new patients on April 9 after 48 staff members tested positive. It is not clear where the initial infection came from. 

The mandatory requirement to wear a mask, while important for the safety of staff and patients, presents a new problem for Gordon.

“You can’t see some of the social cues. For me that is a concern, a concern about the contact and creating relationships as well as the diagnosis process of gathering how someone is feeling and what they are feeling,” said Gordon. 

FEATURED IMAGE: Emergency rooms like this one at Milpark Hospital in Johannesburg are adapting to the challenges brought by covid-19. Photo: Neill Moross.