A South African ER Doctor and a Third Wave

About 4 weeks ago, it started getting bad again. Almost like before Christmas, which was like a war zone, I won’t lie. And when your face is pressed up against that suffering and death, it is hard not to think the worst and get pulled into the abyss.

Submitted 30 June 2021

About 4 weeks ago, it started getting bad again. Almost like before Christmas, which was like a war zone, I won’t lie. There were (now and back then) no beds in Gauteng … at all. We were lining patients up in the ER, fully ventilated. Patients who should have been in ICU (and ER nurses working as ICU nurses … bless them). Patients doubled up in cubicles, on chairs, the floor, out the door, down the pavement. Ambulances being turned away … everywhere. Not quite as bad as December. But enough for all of us to lose the will to live. How on God’s green earth do we do this again?!? When Covid is bad, it is horrible! And when your face is pressed up against that suffering and death, it is hard not to think the worst and get pulled into the abyss.

We got a message a few days ago saying that there are ethics teams to assist us with choosing who gets the ventilators. ICU patients from state hospitals are receiving full care in our unit for weeks, there is no place in the state to transfer them to. Nowhere. Some die, most get better, some eventually go up to the ICU on the hospital’s account when there is a bed. I double up in the ER and at night in the ICU.

Pregnant patients getting emergency c-sections to get the little preemies out before mum dies. It’s horrible and heart-breaking and gut-wrenching. People in their 40’s dying and leaving children and families. They have risk factors though. Being overweight is a big one this time round.

But one needs to remember, it is winter. Respiratory tract infections happen every year (Lancet published virus profiles about a month ago … lots of influenza A which is unusual … most of these are usually done on kids. Normal suspects such as RSV etc. A few Covids). Hospitals are often full, although granted, not like this.

We have lost the Charlotte Maxeke Hospital … one of our biggest hospitals, still closed after the fire, with all its capacity and staff. The field hospital at NASREC is gone (where has it gone…???? And all the equipment, where is that???). We have lost huge capacity in Gauteng!

We created a makeshift High Care ward in December … I thought we were being rock stars and saving lives (we were), but some entitled, unaffected individual took a photo and we got such negative press … it broke all the exhausted nurses and the doctors. Another 30 beds gone. We turn ambulances away now, we’ve never done that.

What do we expect if we lock people up and then let them out? We are going to have these waves and compressions. It’s not just magically going to vanish! You’re going to be exposed to it. You will either not be affected, get sick to various degrees, live or die. That’s just the way viruses work. I’ve worked through swine flu, bird flu, all sorts of other nameless lurgies because we didn’t measure them: XDR TB, meningococcal meningitis and Ebola. Only for Ebola did I use PPE. The rest, not even a mask. Some of us got sick, most of us didn’t. Those that got sick: most lived, some didn’t. Many more of my colleagues were lost to suicide than infectious diseases.

The real credit must go to the nurses. The sisters I work with in our unit are honestly incredible humans. But they are properly exhausted 16 months into this! Apart from the first 3 months where it was eerily quiet and we all took a cut in remuneration and the practice took out an insane loan to keep going (and still paying off), it hasn’t stopped. They have horrible hours and are paid so poorly. They deal with so much abuse, and I’ve never seen them give up. Nor stop fighting for each patient. Special humans. Many have Covid (again) despite having their vaccinations. They are moving to government [hospitals] because they have shorter shifts and are paid better. They are moving overseas because they are needed and are paid better with better hours. Often, it’s not even a shortage of actual beds that we’re dealing with, it’s that there is no nursing staff. The nursing sisters are doing their best. They are finished, exhausted and drained.

The system has been broken for a long time. It is just highlighted now. Particularly for people who thought they were “safe” with their top-end medical aids. Some of the blame also rests on individuals. We cannot only blame the government. Blame is easy. Accountability, not so much.

The hysteria calmed a bit by last Tuesday. Last night was quiet (all relative chaos, mind). I think (personally) we have plateaued. I may be wrong, it may just be a brief respite. Everyone will say the lockdown worked. More people will lose jobs, more children will become suicidal, and the psych wave will hit us again shortly (but now without medical aids because jobs are lost). The parasuicides, the depression and the anxiety in all its forms. The untreated chronic illnesses.

There is more… patients coming in with severe vaccine side-effects after being coerced into getting them, lives forever changed. Heart attack patients with no one to treat them, specialists in tears because they’ve had to let their staff go as there is no income.

Honestly, it has been brutal. It is brutal. But so is watching one of our best violinists busking for a loaf of bread because the symphony orchestra is on hold, the small business and hospitality owners losing everything, people being made to feel guilty of wanting to live and to love.

I think we should stop counting. We had time to prepare. That didn’t happen. We need to push through and choose life. Not count numbers. The cost, either way, is overwhelming. I’m so dreadfully sorry for anyone who lost a loved one … we, on the ground, gave our all. But the fear and the blame and the guilt and the coercion and the isolation and the loss of freedom must stop.

The violation of our liberty is an unacceptable casualty. Loss of freedom of speech, freedom of movement, economic freedom, autonomy over your body … our history has bled for that. It cannot be relinquished because of fear. Reason cannot be traded for hysteria.

Photo by Matt Hardy on Unsplash

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Publisher’s note: The opinions and findings expressed in articles, reports and interviews on this website are not necessarily the opinions of PANDA, its directors or associates.

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