The 60-bed COVID-19 field hospital run by MSF in partnership with the Western Cape Department of Health will no longer admit new patients, thanks to a substantial decrease in pressure on the health system in Khayelitsha, where 354 active cases were recorded for August 4, down from over 1000 in late June. Resources and expertise from the field hospital are already being deployed in the Eastern Cape and KwaZulu-Natal, where COVID-19 is currently surging. Moving forward, MSF calls for COVID-19 care in the country to become reactive, and that authorities ideally capacitate existing hospitals with COVID-19 wards, or create small field hospitals linked to existing hospitals, preferably on the hospital site using existing infrastructure and making use of hospital support systems.
“Without the partnership of the Khayelitsha District Hospital there would have been no field hospital. The speed at which COVID-19 is progressing now allows no time for developing stand-alone facilities, complete with critical functions such as a laboratory, x-ray, laundry and a mortuary. It is time to work with pre-existing support systems. To have an impact, you need to be ready when the wave hits,” said Dr Celeste Jonker, medical activities manager at the Khayelitsha Field Hospital.
The Khayelitsha COVID-19 Field Hospital opened June 1. It was created to support the District Hospital in its response to the peak period of COVID-19 transmission in the Cape Metro area. At its fullest, the facility cared for 52 patients, with bed occupancy above 40 percent until the recent decline in cases. As of August 5, a total of 241 people were admitted, 194 were discharged, 8 were transferred to other facilities and 5 patients remain in care. Regrettably, 34 people died.
On July 24, a team of doctors and nurses from Khayelitsha travelled to Butterworth in the Eastern Cape, where they assisted the management of the Butterworth Hospital in setting up a 30-bed field hospital in the adjacent Lilitha College of Nursing, and helped to reorganize patient flow so that suspected COVID-19 patients do not risk infecting other patients at the hospital. Two MSF nurses remain to mentor the clinical staff on COVID-19 management.
“The main resource requirement for Butterworth field hospital is oxygen, and 30 oxygen concentrators loaned to the Butterworth field hospital by MSFs Khayelitsha project will significantly reduce reliance on compressed gas cylinders as the COVID peak washes over,” said Dr Eric Goemaere, who led the Khayelitsha Field Hospital project.
KwaZulu-Natal, is another province where COVID-19 cases are steadily rising, with hospital admissions at maximum capacity in urban centres. In the town of Eshowe and rural Mbongolwane, where MSF has been supporting HIV and TB care since 2011, MSF is in the process of equipping and staffing two COVID-19 hospital wards with oxygen concentrators and biomedical equipment.
“Thanks to early procurement of the equipment and the organization’s experience in the management of COVID-19, we are now able to respond quickly as the epidemic peaks in our area,” said Dr Liesbet Ohler, MSFs medical coordinator in Eshowe.