Southern Africa expected that it was going through the worst phase of Kovid-19. Then came the delta version


“It’s devastating, it’s soul-destroying,” said a senior doctor at a major public hospital in South Africa’s largest city. We are trained to save lives, but you revert to that wartime mentality. You become numb, you become frustrated.” .

“Patients are being brought in cars with critically ill patients who have been turned away from other hospitals without beds.”

Like many health workers CNN spoke to during the crisis here, they did not want to be identified for fear of reprisal from the government.

“The third wave has been far more devastating, far more massive,” the doctor said.

no more cheers

In the early days of the fight against COVID-19, South Africans cheered on health workers in the city’s neighborhood. has been over since 2.1 million confirmed cases in the country, and more than 63,000 deaths – making it one of the worst affected countries in the region per capita. More deaths suggest the toll is much higher.

The applause stopped months ago, but the impact of Covid-19 is at its worst.

Sixteen months into the pandemic here and doctors describe a system well beyond its breaking point – with insufficient beds and barely enough oxygen. Sometimes the bed opens only when the patient dies.

“There are patients who are dying waiting to be seen, while they are waiting to go to the ward. Because resources are just being overwhelmed by the attack of patients,” said the doctor, an evaluation by paramedics. and confirmed by others. Doctor.

They say that sometimes patients die when they enter the hospital, regardless of the level of care. But this wave means that tough choices have to be made and the best care may not always be given.

The explosion of cases and deaths, as well as a renewed lockdown across the region, has taken many public health experts by surprise. With low vaccination rates in South Africa, he expected another wave, but some scientists thought the worst was over.

Eventually, the southern African region was hit by the first wave and the second wave driven by the more infectious beta version discovered by South African scientists. The thinking was that immunity levels in the majority of the population could reduce future spikes.

The caveat given was always that a new version might come out, but some expected an even more permeable version. like a delta Which will soon prevail.

World Health Organization leader Dr. Humphrey Karamagi said, “When you get a new version, you can roughly think of it like getting a new virus. The progress you made through being exposed by people Yes, it will decrease.” (WHO) Africa region data, analysis and knowledge team.

First discovered in India and responsible for the massive increase in cases and deaths in the subcontinent earlier this year, the delta variant is now present in countries around the world.

South Africa enters strict lockdown to deal with 'extremely serious';  effect of delta version

According to the WHO, the type has been detected in at least 10 African countries so far, with high prevalence seen in southern and eastern Africa.

On Thursday the WHO’s regional director for Africa Matshidiso Moeti said the edition continues to “gain momentum and new ground in countries”. Moeti said new cases on the continent rose for the seventh week in a row while vaccination rates remained low.

“Africa has marked its worst pandemic week yet,” she said. And the situation is bound to get worse.

“The next few months are going to be very difficult on the continent as we look at the spread of the variant,” Moeti said.

Moeti said the rapid spread of varices on the continent is a major threat to Africa’s population, 16 million of whom have been fully vaccinated – less than 2% of the continent’s population.

displace and dominate

Karmagi said the delta’s greater transmission capacity and ability to re-infect people with previous Covid infections helped drive the spike in the region. And while countries like the United Kingdom are seeing a rise in delta infections, their widespread vaccination coverage should provide some protection against serious disease.

Vaccination coverage on the African continent is still exceptionally low – fertile ground for a new variant like Delta.

Countries have been hit by it slowdown in vaccines Coming from the COVAX Vaccine Coalition, as India has decided to stop importing the facility. and, in the case of South Africa, an austerity to strike bilateral deals with vaccine manufacturers as soon as possible.
Countries in Africa fear they could be the next India as vaccine supplies dwindle

“It was amazing how quickly the delta variant took hold,” said Tulio de Oliveira, who recently led the team at KRISP, a genomics monitoring center in Durban. “Development appears to be much faster than the beta version. Within weeks here it began to dominate and displace the beta version.”

Within hours of the variant’s discovery, the country’s COVID task force decided to put the country back into a strict lockdown, de Oliveira said. But by then, the delta was already raging in Gauteng province, the rest of the country, and the wider region.

Asked by CNN about the lack of space in hospitals and the death of patients waiting for beds, the Gauteng health department responded by sharing presentations showing the expanded bed space in the city over the past few months.

Private hospitals are also full to capacity with surgeons and other non-physicians volunteering for rounds in the Covid-19 wards.

But doctors here blame a fire at one of the city’s biggest hospitals and its decision to close one of its major regional hospitals in Nasrek before the third wave as significant failures. Also the beds need staff.

“The bed is just a piece of furniture, you need staff and oxygen, nurses and supplies,” said one doctor, who helped set up Nasrek and spoke on condition of anonymity because they are still part of the territory. work inside.

overcoming natural obstacles

In recent weeks, Namibia, one of the worst-affected countries in the world, neighboring South Africa to the northwest, has been a sad example of the power of the new version.

In 2020, Karamagi and his team of data scientists at the WHO’s African Headquarters in Brazzaville, Republic of the Congo, predicted that COVID-19 would have a very different trajectory in some parts of the continent than in countries such as the US, Italy and the United States. UK, where cities were brought to their knees.

In contrast to dire predictions of devastation in Africa, with COVID-19 heavily weakened health systems, their modeling suggested a mixed picture with some countries escaping the worst-case scenario due to young populations and so-called “socio-ecological” factors. went.

People queue for a COVID-19 test in Windhoek, Namibia.

Namibia seems to be a perfect example: a large country with a population of about 2.5 million, with a generally warm climate, and limited large-scale movement of people relative to other countries.

“There are three waves in Namibia. The first two waves were very small and the health measures brought them under control. But this wave is very high. You can see the impact of the transmission potential of the virus,” Karmagi said.

The presence of the delta variant was only confirmed by government scientists this week, but by then it was one of the worst-affected countries on Earth, despite the renewed lockdown.

“In every hospital you have 25 to 30 people on the waiting list. The system is overloaded, key people are dying because they can’t find beds,” Dr. Danny Jordan, a renowned general practitioner who works in the country. The capital, Windhoek, and the coastal city of Swakopmund.

He said, “You have come to a point where they need to decide who will make it. Elderly patients are being taken out of the ICU knowing that it will kill them to give a chance to someone younger. will give.”

The state morgue in Windhoek has been completely submerged. The video clip, seen and certified by CNN, shows the bodies being kept in white bags three depths apart.

“Now they have to use a rotation system, swap the carcasses kept in the freezer overnight and then do it again in the afternoon to prevent thawing,” said a person familiar with the operation. Morgue told CNN.

A spokesman for the President of Namibia confirmed that the morgue in Windhoek was at full capacity.

“Our mortuary was designed to deal with deaths that occur under normal circumstances and we are now dealing with extraordinary circumstances. This is not a challenge that is unique to us, as COVID-19 has put pressure on health systems around the world. inserted,” Dr. Alfredo Hengri said he had built up additional capacity to deal with emergencies.

make room when no one

The situation in Namibia is so bad that doctors like Jordan must resort to treating patients at home. The same is happening in Gauteng, the epicenter of this wave in South Africa, but on a much larger scale. And sometimes care at home isn’t enough to keep sick patients alive.

“Delta has created complete chaos, a lot of patients are suffering, their oxygen levels are dropping rapidly – ​​there are patients who are suffering and there is no hospital space, no ventilators available. There is chaos in a way, said Mohammad Patel, a paramedic with Pulsat EMS.

Patel and paramedics across the city are working with the charity Gift of the Givers. In their warehouse, filled with food and emergency supplies for crises around the world, a team loads oxygenators in the back of a pickup.

They distribute them to patients across the province to reduce the load on hospitals. Covid-19 is unlike any emergency they have ever dealt with.

“The difference is when you go into a war zone or a natural disaster, you have an idea of ​​the level of damage that the disaster is. But it’s very unpredictable. We’ve never seen anything like this before,” Dr. Yakub Esak, medical coordinator of Gift of the Givers.

The COVAX vaccines are pictured arriving in Tunisia.

But with hospitals at full capacity in both the public and private sectors, the charity has gone a step further, building a 20-bed clinic in five days for patients who can’t find beds.

Patel and his team enter a home in Lesia, a south suburb of Soweto, to find a 67-year-old patient who tested positive for the coronavirus 17 days ago. After getting up to walk, an oximeter shows that his oxygen concentration level drops into the 60s. Healthy adults should read in their nineties.

“We’re going to fix you up, right,” Patel tells the patient. He is the first patient to reach a community centre-cum-clinic attached to a mosque. Patel is confident that he will achieve it now.

But patients in Johannesburg’s hospitals are still battling this delta wave, and doctors and nurses are suffering from them.

Doctors say that sometimes patients are not able to reach the ward despite the best facilities.

But this week, the doctor we spoke to said his hospital was struggling to wrap up bodies quickly enough to free up space.

“Patients are looking up to us, they’re counting on us to do our best, but that’s not good enough. There’s a feeling that no matter how much I do, it’ll be the same tomorrow and the next day. And the next day and the next day,” he said.

CNN’s Bethlehem Feleke and Niamh Kennedy contributed to this story. Reporter John Grobler contributed reporting from Windhoek.

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