Through the eye of the storm
We were preparing for the pandemic to hit us, and had anticipated that in the worst-case scenario, we could have hospital beds in our reception area, and a tent in our parking lot reminiscent of Italy.
The hospital had been restructured into red areas (confirmed COVID-19), yellow areas (possible COVID-19), and green areas (non-COVID-19). I had drawn up the staging and treatment protocols, the donning and doffing protocols, and the intensive care unit (ICU) triage flowchart that would determine who would get an ICU bed and/or ventilator if we were overwhelmed.
The first admissions were towards the end of March. These patients had fairly mild COVID-19, and were all discharged. They were the beginning of the learning curve for the doctors and nurses who had to come to terms with a novel virus causing a new disease.
There was a lull in admissions for a few weeks, and the trickle became a steady stream and then a deluge. The weekend of 10 July felt as if all the dire predictions would come true. We were working through the night, sleeping when we could in our offices, seeing large numbers of patients, and admitting more than ever before.
A number of patients were desperately ill, and several were using high-flow oxygen with a few on ventilators. Rounds were interrupted by calls for resuscitation, and we had become inured to the calls that reported another demise.
At that stage, there were 90 patients housed in a dedicated COVID HC/ICU, three full general wards with spill over into a fourth, and a ward plus ICU for patients under investigation. The hospital was using about 2 000kg of oxygen a day, and concern was raised that South Africa would run out of oxygen.
We were more stressed and anxious than we had ever been before. Our patients were very ill, and weren’t following the usual course of any disease. COVID-19 is an unpredictable disease involving many different systems and causing bizarre complications.
We started working in teams early on: one person in personal protective equipment in the red area examining the patient while the other is in the yellow area analysing blood results, vital signs, and checking medication. This makes the rounds more efficient, and allows treatment decisions to be made jointly so that there is a surety that all bases are being covered.
We have a cardiologist attached to our team whose expertise we make full use of. We have called on neurologists and nephrologists. We have relied on surgeons, cardiothoracic surgeons, and ear, nose and throat specialists.
Our psychiatrist has provided invaluable guidance for the management of the anxiety our patients feel, and to help with the delirium that COVID-19 can cause. Our physiotherapists have united into a team, and our dietician has addressed the patient’s nutritional needs. The medical staff are working as a cohesive team to best address the patients’ needs and support each other.
We have become calmer and more comfortable with COVID-19 after seeing so many cases. I believe that Linksfield Hospital has dealt with upward of 550 cases.
We were fortunate in that we could draw on the experience of the intensivists overseas who faced this first. We know which drugs to use when, and are very proactive having instituted the use of corticosteroids from inception.
We belong to the ICU corona group where a myriad of physicians involved in intensive-care work voice concerns, ask for advice, and share knowledge. We are guided by Professor Guy Richards, the emeritus professor of the ICU at Johannesburg Hospital. He drew up the treatment protocol, and is a phone call away for advice or reassurance.
We have a unique patient population who are older than in any other hospital in Johannesburg. In line with the published data, we have seen attrition in this age group. Many of our patients have multiple comorbidities.
We quickly realised that obesity is the most significant risk factor in younger patients, and that our older patients with diabetes and hypertension are truly at risk.
We celebrate the patients who survive, and mourn many of the patients who die. When we are overwhelmed by the number of death certificates that we are completing, we do an analysis and are reassured that in spite of our patient demographics, our mortality is lower that the projected figure.
Gauteng has passed the peak, and the numbers have lowered. We currently have 30 patients who occupy two wards and several HC/ICU beds. We are using 1 000kg of oxygen only. The non-COVID-19 patients now outnumber those who are COVID-19 positive. Strict screening remains, and all staff wear masks and visors to afford protection to our patients.
And so, we are left wondering if we are in the eye of the storm or through the worst, knowing that behaviour will determine whether we have a second, more devastating, peak or not.
- Dr Carron Zinman is a pulmonologist at the Linksfield Clinic.
Couple caught in crossfire of attempted mall robbery
A young couple attempted to flee the scene of a botched armed robbery at Melrose Arch on Easter Monday, only to get caught in a hail of bullets.
Today, Brandon Regenbaum, 27, lies in hospital in a serious but stable condition under heavy sedation following a five-hour long operation to reconstruct his jaw and repair his mouth. He was shot in the face after robbers hastily fled the upmarket lifestyle mall where they had tried unsuccessfully to rob Elegance Jewellers.
His girlfriend of three years, Lorian Blechman, 25, witnessed the whole scene and luckily escaped unharmed.
The couple, who were due to leave for a holiday in Umhlanga Rocks that day, met for breakfast at Tashas. They left the mall in separate vehicles and found themselves unwittingly in the middle of a gun battle between fleeing suspects and the mall’s security guards.
“The robbers were running towards the Virgin Active Gym. We quickly took a different exit to avoid them, it was scary,” said Blechman.
They beckoned to each other to take an alternative exit near the Daytona shop in a bid to dodge the fleeing suspects. To their horror, they were then confronted by the robbers – who had made it to their escape vehicles – further down the road on Athol/Oaklands Drive in the direction of the N1 highway.
The couple could see the suspects’ vehicles in their review mirrors, so they instinctively swerved out of the way to allow them to speed past. There were loud gunshots, after which Blechman noticed Regenbaum wasn’t driving. She frantically called him to ask why.
He told her, “Babe I love you, but I’ve been shot and I’m going to die.”
Traumatised and still in shock, Blechman told the SA Jewish Report that she jumped out of her car and ran to him.
Speaking from hospital, she said, “There was blood and glass everywhere, and he was in a lot of pain. He told me he was dying. I remember pulling up his hand brake,” she said.
A young Jewish couple walking their baby immediately called Hatzolah, which arrived a few minutes later. While waiting for the ambulance to arrive, another witness helped Blechman to make several calls to family. She told Blechman to keep talking to Regenbaum.
“I told Brandon that help was on the way. I told him his mother and brother were coming. I asked him where I could find his Discovery medical card. I told him general things like he was going to be okay, to stay with me, to stay awake. I told him to count how long it would take me in seconds to run to my car 10m away to get my keys,” she said.
Blechman called her father, who was already in Harrismith en route to Umhlanga Rocks where they were supposed to meet later.
Regenbaum’s father, Clifford, was in Plettenberg Bay on holiday when he received the call telling him his son had been shot.
“I was shocked,” he told the SA Jewish Report.
He believes his son was shot by the robbers who may have mistaken him for a security guard in hot pursuit.
“He drives a bakkie with our company name on the side which looks like a security vehicle and even has hazard lights. The robbers had already seen him leaving Melrose Arch, and I think believed him to be a security guard. I honestly believe they tried to kill him,” he said.
“It has been a stressful, worrying time. He will recover, but it will take time. I’m angry at this senseless shooting of innocent people. My son could have died. These robbers have no respect for human life. I don’t know what there is to learn from this.”
Gauteng police spokesperson Kay Makhubele told the SA Jewish Report, “Police are investigating a case of attempted business robbery and attempted murder which occurred at Melrose Arch.
“It is alleged that an unknown number of suspects driving in two cars, an Audi Q7 and a Ford Ranger, were in a shootout with security guards after they were intercepted before the business robbery,” Makhubele said. “A man who was driving his car [Regenbaum] was shot and injured during the incident. Nothing was taken from the shop.”
While doctors have told the family the operation was successful, Regenbaum will have his jaw wired for seven weeks, and won’t be able to talk or eat solid food.
“It will be a long road to recovery,” said Blechman.
“It’s a miracle Brandon survived. It’s also freaky that we were in separate cars. If I had been with him on the passenger side of the car, I might not be here today. I was running late. Brandon needed to fetch his siddur and tefillin to assist my father with a minyan on holiday, as he is saying kaddish for my zaida who passed away last year. I believe my zaida was watching over us,” she said.
Police ask that anyone with information contact 0860 010 111.
Mogoeng comes out swinging against apology ruling
Chief Justice Mogoeng Mogoeng came out swinging in his appeal against Judge Phineas Mojapelo’s judgment ordering him to apologise for comments made about Israel.
Mogoeng criticised Mojapelo at every turn, describing his reasoning as “flawed and disturbingly superficial”. He said “the learned judge failed to deal with the constitutional right to freedom of expression and freedom of belief, thought, and opinion”.
In his 38-page appeal submitted to the Judicial Service Commission on 2 April 2021, Mogoeng reiterated why he had the right to express his support for both Israel and the Palestinians during a webinar hosted by the Jerusalem Post last year.
His appeal was in response to the Judicial Conduct Committee’s ruling on 4 March 2021 that he had 10 days to apologise for comments he made about Israel in the webinar. At the time, he said South Africa had a role to play in resolving the Israeli-Palestinian conflict, that he supported both peoples, and as a Christian, he had an obligation to pray for the peace of Jerusalem.
Africa4Palestine, the Boycott, Divestment, Sanctions South Africa (BDS SA) coalition, and the Women’s Cultural Group laid complaints against Mogoeng, saying he had flouted rules regarding judicial ethics. The matter was adjudicated by Mojapelo.
One of Mogoeng’s most pertinent points was that “several precautions need to be sounded to avoid the trap that His Lordship Mr Justice Mojapelo unreflectingly allowed himself to fall into”. According to the chief justice, this includes the fact that “it’s necessary to distinguish between official government policy and the policies of lobby groups and non-government organisations. And it’s necessary for decision-maker[s] to tell the difference between politics and policy, which his lordship failed to do.”
He also insisted that the judge’s “insinuation that I was possibly involved in some conspiracy with the Israeli government and ‘timed’ the webinar in such a way to undermine international law or United Nations conventions/resolutions … is a material misdirection”.
Mogoeng said there was no difference between what he said and the South African government’s approach to the Israel-Palestinian conflict. “After a thorough search, I vouch for the fact that there is no official policy of the South African government that contradicts any part of what I actually said. Even the two agreements signed by President Mandela and President Mbeki with Israel don’t contradict anything I have said. I was therefore found guilty of five complaints or counts of misconduct that turn on a non-existent official policy of the South African government towards Israel.”
He emphasised that “the supremacy of the constitution and the entitlement of all citizens, including judges and magistrates, to enjoy fundamental rights cannot be wished away. Where these rights are limited by legislation or the code, a proper explanation is called for. Judges have the constitutional right to freedom of expression, association, and religion, belief, thought, and opinion. As is the case with other citizens, these rights may be limited. But the limitations must, broadly speaking, be reasonable and justifiable. They cannot be arbitrary or whimsical.”
He went on to describe how other judges had waded into political waters, including Mojapelo himself. He also described how “my brother Dennis Davis hosted speakers, including politicians, on his then Judge for Yourself eNCA television programme about the Israeli-Palestinian political situation and a range of political controversies to which leaders of political parties were invited and participated. He was exercising his constitutional right to free expression although different views might be expressed about being a regular anchor or host of a TV programme.”
Mogoeng described how other judges had involved themselves in political controversies in Fiji, Zimbabwe, and Lesotho, “And my dear brother Cameron J [Justice Edwin Cameron] essentially said what I said on the Israeli-Palestinian situation, the real difference being, unlike me, he didn’t rely on the Bible.” Yet, none of these men were hauled over the coals for their comments or actions.
A senior member of the legal profession, speaking on condition of anonymity, said, “The grounds of appeal make some sharp points against a senior retired and respected judge. It’s most unfortunate for judges to have such a public and divisive difference – both judges firing heavy ammunition at each other as to how the other has misconstrued the law. It doesn’t do much for confidence in the law and judiciary by the public generally.” He pointed out, however, that the chief justice “makes some powerful points, which need to be taken seriously”.
ISIS attack hits close to home
For most of the world, the late March attack on the coastal town of Palma may have been just another terror attack in the faraway province of Cabo Delgado, Mozambique. But for one family, it was very personal.
“The entire international community is to blame. The cousin of my very close family member was killed yesterday by ISIS [Islamic State]. Why? Because he went to build houses there as he lost his job due to COVID-19. No one came to help. Why am I posting here? Because no one even knows,” wrote Michal Gaziel on the “South Africans Living in Israel” Facebook group.
Gaziel was writing on 27 March 2021, as possibly the deadliest attack in the region unfolded. The assault started on 24 March 2021, with local militants linked to ISIS storming the area. “The attack is one of the most brutal since the insurgency began in 2017. At least a hundred fighters attacked Palma, showing the jihadis getting stronger and more brazen,” says Steven Gruzd, political analyst at the South African Institute of International Affairs.
Gaziel’s sister-in-law, Rachel Gaziel, is the cousin of the South African who was killed, Adrian Nel. Speaking to the SA Jewish Report from Tel Aviv, she (Rachel) described a “traumatic” few days as her family waited to hear about the safety of Nel, his stepfather, and his brother. “They were abandoned by the military. Two hundred people were left to die,” she says.
Nel took a job in Palma, Mozambique, to build workers’ accommodation for the Total LNG Project. Local militants who have pledge allegiance to ISIS have staged a number of attacks including capturing the town of Mocimboa da Praia, which still remains out of government hands. The violence has killed more than 2 600 people, half of them civilians. It has also forced almost 700 000 people from their homes.
From what Gaziel has heard, her cousin and others decided they had to escape. They had been hiding in the Amarula Hotel, but decided to make a break for it at nightfall, as “there was no one there to protect them”. They went in a convoy of 17 cars, and Adrian was in the first car, leading the convoy. They aimed to get to the beach. But as soon as they left the hotel, they were attacked. He was shot by terrorists.
“My cousin didn’t die quickly. He bled out. His stepfather and brother hid in the bush with his body. The place was overrun with terrorists – a lot of people were killed or captured. Many are unaccounted for,” Gaziel says.
She says military company Dyck Advisory Group (DAG) was in contact with her aunt, and informed her that her son had been killed, but that her husband and son had escaped. “I think they got to the beach and then were rescued by helicopter or boat. My aunt is distraught, but she thought they would all be dead. She’s grateful, but devastated.”
Gaziel says her cousin would have been 41 on 1 April. He leaves behind a wife and three young children. “His wife is distraught. How can she tell them their father is dead? He died trying to save people. We want others to know his story, and to pressurise the international community to do something. No one seems to care because it’s in Africa. We don’t want him to have died in vain.”
The Southern African Development Community said it would hold a two-day summit in Maputo on 8 and 9 April to deliberate how to address terrorism in Mozambique. President Cyril Ramaphosa will attend, accompanied by international relations and cooperation minister Naledi Pandor, defence and military veterans minister Nosiviwe Mapisa-Nqakula and state security minister Ayanda Dlodlo. Meanwhile, DAG’s contract with the Mozambican police expired on Tuesday, 6 April.
“Any country that directly or indirectly fights against ISIS is immediately seen as the enemy, and thus a legitimate target,” says Jevon Greenblatt of the Community Security Organisation. It makes no difference whether it’s the South African military or a private military group such as DAG. They see it as South Africa fighting against Islam and a justification for ‘self-defence’.
“This was made clear by ISIS’ warning in 2020 that South Africa shouldn’t get involved or it would open up a “fighting front” in our country. When it talks about a “fighting front”, at this stage, it doesn’t necessarily mean an insurgency like that taking place in Cabo Delgado, but will more likely be acts of terrorism similar to what we have seen in the United States and Europe.
“There are a number of cells and individuals, whether they be active adherents or loosely connected supporters, already present in South Africa, and we have already seen some of them commit acts of terror or crime in the name of ISIS,” says Greenblatt.
“In addition, there are a number of South Africans who have travelled to Mozambique over the past few years to join the insurgents, at least one of whom was involved in the 2016 Thulsie plot to attack Jewish targets. ISIS encourages adherents and supporters to attack Jews around the world, and as such, if they do decide to open a ‘fighting front’ in South Africa, it’s not inconceivable that the Jewish community could be selected as one of those targets.”
Should we be concerned for our safety? “Menachem Begin [former prime minister of Israel] said, ‘If an enemy of our people says he seeks to destroy us, believe him. Don’t doubt him for a moment. Don’t make light of it. Do all in your power to deny him the means of carrying out his satanic intent’,” says Greenblatt.
“There is no doubt that we should be aware of what’s happening in Mozambique, monitor it closely, and continue to put measures in place to ensure the effective safety and security of the South African Jewish community. We cannot assume that because this is happening far away, it won’t affect us.”
Greenblatt believes that “the original grievances that drove the insurgency are being hijacked by ISIS’ aspiration for global expansion, and due to its loss of a caliphate in Iraq and Syria, it’s now looking to establish this elsewhere. Africa has been touted as the new battlefield for terror organisations, with central and southern Africa emerging as their most viable option to establish an Islamic state. I believe it to be true that the new international status of this insurgency will embolden it to expand into other regions, with Mozambique’s Cabo Delgado being just the beginning.”
Says Gruzd, “This is right on South Africa’s doorstep, and it has to be taken seriously. We may start to see people fleeing to South Africa, and such instability is bad for the region. The violence is getting closer to offshore gas fields in Cabo Delgado, and is already affecting the operations of major players such as Total, which has suspended work again.” He says extreme violence, such as beheadings, continues to occur in the area.
Asked if the attack is a major event, Gruzd says, “It’s hard to tell if this is a turning point in real time. It certainly was a daring attack, and shows the rebels getting stronger and better armed. It also coincides with military training initiatives by Portugal and the United States. Only hindsight will tell if this is a turning point. What’s for sure is that the problem won’t just quietly go away.”
Terror expert Jasmine Opperman of ACLED (the Armed Conflict Location & Event Data Project) told the SA Jewish Report that this attack was expected by those watching the rising insurgency, but “what surprised most analysts was the sophistication and refinement of the guerrilla warfare, and how they executed the attack. And yet, no action was taken to prevent it.
“Why is it relevant to South Africa? The region is becoming destabilised with a human catastrophe that we haven’t seen before. It’s a calamity of which we will never know the actual extent,” Opperman says. Meanwhile, “for ISIS to propagate a leadership position is quite easy, and that message will transcend borders. It will reach ISIS-sympathisers, and we don’t know how they will respond.
“The insurgency is still in control, the government remains defensive,” she says. “It’s an insurgency that is evolving and growing, and yet, the counter-punch seems not to be forthcoming. That leaves the region vulnerable.”
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