Dr Richard Friedland, Netcare CEO

Netcare CEO, Dr Richard Friedland says that
after more than three weeks following the discovery of the new Omicron variant
in South Africa, data across its hospitals and primary healthcare facilities are
demonstrating important early trends.

“Having personally seen many of our
patients across our Gauteng hospitals, their symptoms are far milder than
anything we experienced during the first three waves,” comments Dr Friedland.

“Approximately 90% of COVID-19 patients
currently in our hospitals require no form of oxygen therapy and are considered
incidental cases. While we fully recognise that it is still early days, if this
trend continues, it would appear that with a few exceptions of those requiring
tertiary care, the fourth wave can be adequately treated at a primary care
level.”

During the first three waves, the rate of hospital
admissions rose in tandem with the rate of community transmission (the number
of people testing positive).

Dr Friedland noted that in the first three waves
of the pandemic Netcare treated 126 000 COVID-19 patients across its 49
acute hospitals, of which 55 000 (44%) patients required admission and 26%
of these patients were treated in High Care and Intensive Care (ICU). Significantly,
all COVID-19 patients admitted were sick and required some form of oxygen
therapy. The high admission rate, as well as the high percentage of patients
requiring ICU or High Care is indicative of the severity of cases during the
first three waves.

“As of today (8 December), we have 337 COVID-19
positive patients admitted (72% of these patients are in the Gauteng area and 18%
in KwaZulu-Natal). Of these patients approximately 10% (33 patients) are on
some form of oxygenation versus 100% in the first three waves. Eight of these
patients (2%) are being ventilated and of these, two are primary trauma cases
that are also COVID-19 positive.”

Patients admitted for other primary
diagnoses or surgical procedures who test positive for COVID-19 but do not
require any form of oxygenation are considered to be incidental COVID-19 cases.
Currently 90% of COVID-19 cases now in Netcare hospitals are considered
incidental.

“During the first three waves, when the
overall community positivity rate breeched 26% across South Africa, we were
inundated with COVID-19 admissions to hospital. Within Netcare, we had over 2 000
COVID-19 patients in hospitals during the first wave, over 2 250 patients in
hospital during the second wave and over 3 000 patients in hospital during the
third wave. At present the 337 patients represent a fraction compared to previous
waves.” said Dr Friedland.

“The very rapid rise in community
transmission as compared to previous waves may partially explain this
relatively low hospital admission rate. However, there does appear to be a
decoupling in terms of the rate of hospital admissions at this early stage in
the evolution of the fourth wave,” suggests Dr Friedland.

Dr Friedland added that of a total of 800
COVID-19 positive patients that were admitted since 15 November, 75% of
patients were unvaccinated. Netcare has seen seven deaths over this period in
this group of patients, of which four may be ascribed to COVID-19. The ages of
these four patients ranged from 58-91 years of age and all had significant co-morbidities.
Of these patients, three were not vaccinated.

“In terms of age distribution, COVID-19 patients
admitted since the 15 November are on average younger than those seen during
the first three waves with over 71% being below 50 years of age, with an
average age of 38.5 years. This compares to only 40% below 50 years of age in
the first three waves, with an average age of 54 years.

Medicross Primary Care Clinics and Netcare
Hospital Emergency Departments

Since 15 November 2021, of the 32 000
patients seen by general practitioners across 21 Netcare Medicross Medical and
Dental Family Centres in Gauteng, 1100 tested positive for COVID-19 and were
symptomatic. In addition, over 22 000 patients have been seen through Netcare’s
Emergency Departments in Gauteng, of which 816 were COVID-19 positive.

Virtually all patients have presented with mild
to moderate flu-like symptoms, including a blocked or runny nose, headache and
a scratchy or sore throat and have been treated symptomatically.

“Early trends of this fourth wave, since 15
November 2021, when admissions began to rise, indicate a far less severe form
of COVID-19 and a probable decoupling of the rate of community transmission and
the rate of hospital admissions,” says Dr Friedland.

“Most of the cases in hospital that are
COVID-19 positive do not require any form of oxygen therapy and are considered
incidental findings. In a primary care setting, the same mild to moderate
clinical picture is being experienced. It is our considered view at this early stage
that, should this trend continue, COVID-19 may be effectively managed at a
primary care level, with the exception of certain cases requiring admission to
tertiary facilities,” he notes.

Vigilance remains critical

Dr Friedland reiterated that the best way
to support South Africa remains to take COVID-19 extremely seriously and to be as
cautious as ever.

“Netcare strongly supports the need for all
South Africans to be vaccinated, as vaccines have been proven to be safe and
highly effective in decreasing transmission and saving lives globally. 

“We have already witnessed the positive
effects of vaccination in our workforce during the third wave when there was a
significant reduction in the number of staff infections, hospitalisation and
deaths from COVID-19 compared to the previous two waves,” asserts Dr Friedland.

“We cannot emphasise strongly enough the
need for vaccination and all non-pharmaceutical precautions – particularly the
wearing of masks, which has proven to be extremely effective in preventing
transmission – to be diligently followed, as every person has a responsibility
to help flatten this anticipated new curve to avoid contracting and passing on
the virus.