The restrictions imposed in and the timing of the implementation of the Level Four lock-down measures once again reflect the fact that the authorities “do not listen to us”, SA Medical Association chair, Dr Angelique Coetzee, told Med Brief Africa this morning.

“Only when the Indian, or Delta variant came along did they wake up, otherwise they would have just carried on despite our looming third wave warnings,” Coetzee added, reiterating the now common assertion that some of the measures are not strict enough and were too late to make any difference to the current third wave situation for the practising doctor.

“Our patients are still sick with COVID-19 and we don’t see the incidence coming down. Maybe a little in a couple of weeks’ time, but no real difference.”

Accessibility to the relevant authorities such as the D-Gs and the premier, she indicated, had been difficult: “We asked for a meeting with the D-G, nowhere to be found, same with the premier.”

Suggesting the removal of the incumbent minister had been one of the main reasons “why nothing is happening currently”, Coetzee added that it also made it “extremely difficult to address them themselves especially if you ask for a meeting”.

“When we say there is a problem they need to start listening to us. They don’t. It’s politics, that’s all I can say.”

Turning to day-to-day issues facing practitioners treating private COVID-19 patients at home, Coetzee said that immediate access to oxygen was a big problem: “Treating our patients at home is fine, we can handle that, but what we need is oxygen! For most scheme members, it generally takes three days to approve oxygen which, as you can imagine, can be a very stressful time lapse for both the patients and us, the doctors.”

Keeping in personal touch with patients, Coetzee had found, was critically important. Asked whether or not telemedicine had proved useful in treating patients at home, Coetzee was adamant: “You can’t and shouldn’t treat COVID-19 through telemedicine. You, the doctor, should physically see the patient. You might think they won’t want to come into the practice, but you’d be surprised! I see my patients on a weekly basis, some very sick patients, but that’s how we get them better. I think they are so glad just to get out of bed!”

The SAMA chair went on to acknowledge that there were concerns among some pharmacists about COVID-positive patients going into pharmacies personally to collect their scripts and should actually be advised by their doctors not to: “Yes, that should be the advice, to get someone to collect your medication for you. But not all patients have someone to do that, so we just advise them to be as quick as they can in the pharmacy adhering to all the necessary COVID protocols.”

Concluding on probably the biggest Level 4-associated issue, the shortage of hospital beds, Coetzee acknowledged that this continued to be a critical issue but that the so-called bed shortage was not the real problem.

“We don’t have enough beds, that’s true. But remember, we use the term ‘beds’ and the public see ‘beds’. But in real terms we do not have enough doctors and a big worry for us at SAMA is not enough qualified ICU sisters to deal with this pandemic situation. Most disturbing,” Coetzee said, “to have those not qualified working in ICU.”