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OP-EDS

Be your own president, and lock yourself down to level 5

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If you struggled to imagine what was going on in Wuhan in March 2020 as I did at the time, June Gauteng 2021 is your opportunity to vicariously relive that situation. An unexplored virus. Disproportionate loss and grief. Draconian – and now not so draconian – measures of hospital isolation of the seriously ill and those home bound with infection.

The 16 months that have passed since the Wuhan fiasco, the initial knee-jerk lockdown, and the economic devastation have disempowered our authorities from implementing harsh enough measures at this sensitive time in Gauteng.

Let me share a few insights as to how rampant COVID-19 is in Gauteng at the moment. My own family medicine practice has diagnosed an excess of 20 cases a day this past week. Each patient requires a careful explanation about appropriate medication, warning signs of deterioration and, most importantly, contact tracing in a desperate attempt to curtail further spread.

Every day, our doctors admit at least one or two patients who simply aren’t coping at home. However, admission is no longer a golden bullet. Patients are often admitted via casualty, where they wait five or six hours for the availability of a normal bed. The fortunate patients who receive direct admission from home to a ward are the select few who manage to access limited hospital resources. However, being one in a hundred patients admitted with COVID-19 at a hospital like Netcare Linksfield Hospital is far from ideal. Provincial statistics are showing that 20% to 25% of admitted patients require critical-care beds. These beds are full.

Surely these problems affect only “other” people? I will let you decide. Last week, I admitted a 37-year-old man who isn’t overweight and has no comorbidities. He has now spent a week in a top facility, his oxygenation progressing from nasal oxygen, to a high-flow system, to non-invasive CPAP (constant positive airway pressure), to a full ventilator. His prognosis is guarded. Like yours, my Facebook feed is flooded with people sharing their pain about loved ones succumbing to this virus at an untimely stage in their lives.

I’m not a pessimist, and I do see various solutions. However, in the eye of a storm, we don’t go sunbathing. We have to be our own president and lock down our social lives to level 5.

I’m not concerned about risk and exposure in parks, zoos, or beaches. I’m not significantly concerned about the risk from disciplined visits to controlled institutions, with formal interactions, such as bank appointments, doctor appointments, cautious visits to quiet shops, and the like. At these monitored times, masks are worn, hands are cleaned, and distances are kept.

I’m deeply concerned about all of us who exercise the nth degree of caution in the examples above and then have our siblings over for a Sunday afternoon lunch because “they’re definitely also being as safe as we are”. This is how the vast majority of COVID-19 patients in my practice have become infected.

I’m the first proponent of relaxing restrictions wherever possible. We are all discouraged by this lockdown existence that has owned us for longer than we can clearly remember. My commitment is to encourage people to live normally as much as possible, but at the appropriate times. However, now isn’t that time. We need to be smarter than our government, and pull in the reins over this surge, which is projected to peak in two to three weeks. We certainly understand that in the longer term, children need human interaction and businesses need to operate. But, more importantly, patients requiring oxygen need supplies now.

President Cyril Ramaphosa, please notch up our province similarly, just for a short time, and urgently open our vaccine rollout to younger, healthier individuals who are also at risk. Empty vaccine halls don’t save lives. Big business in South Africa is ready to be given the license to procure vaccines in parallel.

Finally, let me remind you that waves end, vaccines work, and COVID-19 will certainly pass. Keep your head up. Be your own president.

  • Dr Daniel Israel is a family practitioner in Johannesburg.

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9 Comments

9 Comments

  1. Deanna Isaacs

    Jun 24, 2021 at 11:03 am

    Thank you for your wise words I have friends who just don’t understand what lockdown means and “only just went for a small party with family”

  2. JULIE SOICHER

    Jun 24, 2021 at 12:24 pm

    This is a brilliant article, succinctly and eloquently written.
    Thankyou for sharing your insights and wisdom
    And mostly for your massive input during these challenging times.

  3. John H Abeles MD

    Jun 24, 2021 at 1:00 pm

    Prophylaxis and early treatment using the Zelenko or Borodny protocols wound greatly reduce illness and hospitalization

  4. Toni Rowland

    Jun 24, 2021 at 5:11 pm

    What is your view of Ivermectin?

  5. Soula

    Jun 25, 2021 at 6:44 am

    Thank you Daniel! Truer words never spoken.

  6. Judith Shopley

    Jun 25, 2021 at 1:31 pm

    A sane and informative expose of the facts. I “enjoy” reading Daniels articles. I wondered about the other and I thought it might be ‘an other’ who still go for crowd events.

  7. Margaret

    Jun 25, 2021 at 2:41 pm

    I live in Canada (the province of Alberta) but read about the situation in Gauteng because I have close family there. In April and May we experienced a terrifying third wave, and at one point our per-capita numbers were higher than India which was in a hellish situation. As vaccinations increased the situation improved so much so, that next week ALL restrictions are being lifted including mask-wearing which we have been doing for over a year. We have hit 70%+ of first vaccinations, but still have a way to go and people to convince. Good luck Gauteng!

  8. Eva Gush

    Jun 26, 2021 at 6:38 am

    What a helpful article to highlight what is actually happening on the ground right now… people of all ages are getting infected and the health system in Gauteng is overburdened….
    The reference to family and friend visits over weekends is also very helpful, as we mostly tend to think these are okay…
    And then as a final point, your note around this too shall pass….
    But for the next few weeks, the call to be our own president and personally lock down as much as possible…
    Thank you Dr Israel for this article and for supporting so many people and families…
    Wishing you, your practice and all your medical colleagues strength in this difficult time….

  9. Phillip Shifren

    Jun 27, 2021 at 1:54 pm

    Well spoken. Many people are taking note and acting accordingly. However, these are the few sensible ones. If only more people will follow the rules and impose a self induced level 5 lockdown, we can contribute to alleviate suffering and heartbreak. Forego freedom of movement now and we will be rewarded with enjoyment and fulfilment later.

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