The Free State was one of the first provinces in South Africa to enter a third wave of COVID-19 infections. By 16 June, the National Department of Health's statistics showed the Free State has 108 515 confirmed cases and 4 612 deaths with 94 761 recoveries.
Provincial health spokesperson Mondli Mvambi admits the province's health system is under pressure but he says the situation is under control.
"Even though our healthcare system is under pressure we are indeed coping. Days are different. Today we have one available bed, tomorrow we have two," he says.
"But I can confirm that the situation is under control at our hospitals in the province. Also, we will not boast about one or two available beds. The National [District] Hospital continues to be at full capacity. At Universitas Academic Hospital we are still using the COVID-19 extension ward which was formerly used as a parking lot to accommodate the influx of patients," says Mvambi.
According to data collected by the National Institute for Communicable Diseases (NICD) in the week of 17 June, clinical information of admitted patients showed in the 35 public hospitals in the Free State, 253 patients are currently admitted, seven patients are in ICU, 14 patients are on ventilation and 154 are on high-flow nasal oxygen.
Spokesperson for Mediclinic in Bloemfontein, Barbara Steenkamp says they too are not facing a crisis.
"The number of COVID-19 admissions have been quite high over the past few weeks. However, as the situation stands today, Mediclinic Bloemfontein is coping.
"We have 82 patients, 62 of them are in [COVID-19] wards and 20 are in ICU. We have a total of 90 beds allocated for COVID-19 patients. Admissions for COVID-19 fluctuate between 18 and 19 patients per day. The statistics have more or less been looking like this for the past two weeks," she says.
"In total, we have two wards allocated for COVID-19 and two ICUs which are fully occupied. So, we have enough beds and we have enough ventilators."
Life Rosepark Hospital, however, is under pressure.
Hospital manager Hein Rossouw says the COVID-19 wards are under pressure and are experiencing a very high occupancy. Rossouw says the COVID-19 ICU has 14 patients and is fully occupied.
"COVID-19 admissions at our hospital are rapidly increasing. The COVID-19 wards are under pressure and have a high volume of admissions, he says.
Rossouw says hospitals in Bloemfontein are working together to ease the pressures and accommodate COVID-19 patients who are in need.
"The availability of COVID-19 beds is limited but we are mostly able to cope with the demand.
"We have taken key learnings from previous waves of infections to further strengthen our internal protocols. All facility hospital management teams continue to work closely with our local doctor COVID-19 committees who provide guidance in clinical decisions."
Rossouw says although the COVID-19 ICU is under pressure, they are monitoring the situation according to protocols and severity of cases.
"Our preparedness for the third wave of infections is aligned to those of the second wave where the Life Healthcare Group shifted from central decision-making to hospital-level decision-making as they were affected at different times, Rossouw says.
'Different wave but same problems'
However, some healthcare workers on the frontline have a different story to tell.
"Nurses are under extreme pressure in these COVID-19 wards. Their lives are at risk. We are still facing the same problems that we faced during the first and second waves," says President of the Young Nurses Indaba Trade Union Lerato Mthunzi.
"We work with limited equipment, we work with limited resources and there are not enough staff members. We find ourselves in a high-risk situation facing the same challenges that we have been facing since the outbreak of this pandemic.
"Our main challenges as health care practitioners are firstly poor infrastructure. The outbreak of this virus has not birthed new wards, new intensive care units, or even new hospitals. We are now creating the legacy of placing patients in tents and field hospitals. This is totally unacceptable," she says.
Mthunzi says staff shortages and limited resources are big challenges.
"When we talk of resources, we talk about the basic PPEs. There are not enough oxygen points for patients. Our members who work at hospitals such as Pelonomi Hospital in Bloemfontein, Universitas, and Bongani Hospital are working with little equipment. I am not saying the department is not trying but the demand in cases is putting pressure on the system."
According to her, many health care workers are still not vaccinated.
According to Department of Health statistics there are 24 186 health care workers vaccinated in the province.
Mthunzi says this can make hospitals super-spreaders of COVID-19.
"It is not the social gatherings, and it is not the churches. It is the hospitals that are the super-spreaders of this virus because even the simple screening process when you go to different hospitals is not consistent. We work with COVID-19 patients but [the] majority of us are not vaccinated and we do not have enough PPEs.
"So how are we going to beat this pandemic if the frontliners especially those working in close contact and are taking care of COVID-19 patients work under such terrible conditions?"
Cases increase, nurses don't
Free State Chairperson for Health and Other Services Personnel Trade Union of South-Africa (Hospersa) Peggy Motlokoa, who is also a nurse in the COVID-19 ward at Reitz Hospital in the Thabo Mofutsanyana District says the main challenges nurses are facing in COVID-19 wards are staff shortages.
"As nurses, we are burdened. The statistics are increasing, but the number of nurses is not increasing and that is really a big problem. There are many nurses who are unemployed and retired [who] can be employed so that we are not under so much pressure. Currently, at the hospital I am working in, it is one nurse [for] four patients. Being burdened with too many patients is affecting us emotionally, physically, and psychologically," says Motlokoa.
As a nurse working in the COVID-19 ward, Motoloa says, "sometimes I get [anxious] because we are scared that we will take the virus home and infect our children. Even though we are vaccinated, some people are still getting infected with COVID-19. So this means that the vaccine is not 100% safe."
A scary place
While Motoloa says she "commends government for making sure that there are enough PPEs in hospitals in the eastern parts of the province," elsewhere in Bloemfontein another healthcare worker bemoans the lack of PPE and staff.
The healthcare worker at Pelonomi Hospital that Spotlight spoke to, wants to remain anonymous.
"Isolation [COVID-ward] is a scary place to work in and the fact that there is a shortage of staff is not making life easy for us. People die in there and we are stressed. Working in the COVID-19 ward is a [totally] new experience. It is a very scary environment so we just wish the employer can consider [increasing] staff members so that our anxiety levels can decrease."
Low registration numbers
Meanwhile, as pressure builds on hospitals amid increasing infections, the provincial health department struggles to get people 60 years and older to register for vaccination on the government's electronic vaccine data system (EVDS).
At the start of the second phase of the country's vaccination rollout on 17 May, the Free State set itself the target of vaccinating 288 220 people eligible in this phase. But official statistics show that by 16 June, the Free State Department of Health has only registered 161 077 people, which includes 120 921 people 60 years and older, and 40 156 health workers. Only 105 469 people have been vaccinated to date of which 81 253 received the Pfizer first dose in the province.
Meanwhile, the provincial health department teamed up with the South African Red Cross Society (SARCS) and UNICEF for an educational COVID-19 tour aimed at getting more people to register for vaccination.
Communications officer for SARCS in the Free State Mojalefa Rabolinyane says during a week-long visit, the UNICEF truck visited towns including Botshabelo, Welkom, and Sasolburg.
"This tour is to educate people about the importance of getting vaccinated. We will be travelling to all the districts of the Free State to ensure that people know and understand why they need to register for vaccination. During this tour, we are also targeting the youth as we know that they are the ones who are best suitable to help their grandparents with registrations."
Mojalefa says the turnout has been good so far.
Mvambi says, "We know that our elderly people do not access information and technology easily, they need to be assisted. So it is our responsibility to ensure that they access information and also act upon it. We want them to register and we also want them to vaccinate," he says.