Page 7 - ONLINE – Nursing Matters October 2020_Vol 11

current issues

Nurses matter: Protecting COVID-19 spreads quickly. Transmission is mainly through suppliers who could provide quality, affordable equipment at
airborne droplets from an infected person breathing, coughing
the quantities requested.
healthcare workers during the or sneezing and then a close contact inhaling these virus-laden In parallel, SAHCS worked with the South African Society of
droplets. The incubation period for COVID-19 from exposure
to symptom onset is 5–6 days but can be as long as 14 days.
Anesthesiologists (SASA), the National Department of Health
COVID-19 pandemic According to the latest information, COVID-19 can spread (NDOH) Occupational Health & Safety (OHS) Quality
for up to 2 days prior to symptom onset or by people who
Assurance Committee, SAHPRA (South African Health Products
are asymptomatic, for 7–12 days by people with moderate
Regulatory Authority) and the NRCS (National Regulator for
infections, and up to 2 weeks by people with severe symptoms. Compulsory Specifications of South Africa) to help develop
One in five people require hospitalisation, so making PPE regulations that will extend far beyond the COVID-19 response
Vanessa van Schoor, Yolanda Ndimande available to healthcare workers has been a top priority. to establish a policy for the regulation of quality respiratory
Healthcare Worker PPE Shortages & Stockouts Support Project, protective equipment (RPE) for the private and public sectors.
Southern African HIV Clinicians Society, Johannesburg, South Africa SAHCS has worked through various channels to find and offer This document sets standards for procurement and testing for all
support for healthcare workers, from general practitioners, respirators and masks supplied to healthcare workers working
dentists, nurses and physiotherapists, to those working in in high-risk situations, enabling them to check the quality of what
‘We all feel the stress on our body and minds. Tired after just an 8-hour shift … and we are used to working longer hours. I think hospitals and clinics, care homes, police stations and schools. is supplied. It also requires distributors to do regular quality
emotionally it is starting to take its toll. It is difficult to get PPE and the courier costs are killing us. I even took out an additional loan As far as possible, SAHCS found and shared links to the few testing and to replace sub-standard equipment.
on my house just to cover the extra PPE and medication … I am a proud person who does not necessarily ask for help, but if I carry
on with my service of seeing 100–120 patients a day, then I’m not going to survive.’

When COVID-19 was first diagnosed in South African in early The Southern African HIV Clinicians Society (SAHCS) office Special precautions must be taken by healthcare
March 2020, everyone struggled to cope with what was phones started ringing and emails poured in as the first workers who are in direct contact with patients who
here and what was still to come. By June there were 1 700 COVID-19 cases were reported. Members and individuals from may have COVID-19. PPE use can be broken down
healthcare workers who had tested positive for COVID-19 in the public and private sectors contacted us for PPE information into three different levels of patient care:
the country; by July that number was 3 000, and the latest data and support. In response, SAHCS launched the PPE Shortages
published by the Ministry of Health on 11 September 2020 and Stockouts Project to track and escalate these requests. A
put this number at 32 429 healthcare workers, with nurses team at Rysis Software helped establish a website to collect 1) Aerosol-generating procedures in COVID-19 high-risk areas
accounting for more than half the cases. Obtaining quality, detailed information on PPE needs so that the SAHCS could • Mask: N95 or equivalent
affordable personal protective equipment (PPE) has been collate and share this information with key stakeholders to seek • Visor or goggles
one of the greatest challenges for South Africa during these solutions. This was much more difficult and took far more time • Apron or gown: fluid-resistant
challenging times. than anticipated. • Gloves: non-sterile

2) High-risk areas with confirmed COVID-19 patients
• Mask: surgical
• Visor or goggles
• Apron: plastic
• Gloves: non-sterile

3) Low-risk COVID-19 areas
• Mask: surgical mask in clinical areas; cloth mask in non-
clinical areas

Can PPE be reused?
…the families are bringing the dead in their cars and want us to see them first before they go to the mortuary…it is just the need of the
families for a professional person to say, “Yes, you are right, they are dead. It is heart breaking. Usually PPE is discarded after a single patient or procedure, but
with an acute shortage of PPE, the WHO and CDC considered
We are mainly a private clinic, but we also provide family planning, baby immunizations, anti-natal care, HIV and sexual support extended use and/or reuse of certain items. SAHPRA supports
during the stage 5 lockdown. We are the only private clinic in town that is still open. We have gone through the process of cordoning the extended use of respirators for a maximum of 6–8 hours (as
off and we screen everybody at our door for temperature and hand sanitizer. All linen is removed, and beds are cleaned after each specified by the individual manufacturer).
patient. I set up a tent for the patients with fever and the others I see in the clinic, just to keep the clinic safe. We usually see 100-120
patients per day but now only 20-50 at stage 3 lockdown. We are 5 primary midwifery sisters and 4 admin staff.

We cannot get N95 or 3-layer masks at our current suppliers. We are paying R150 for an N95 mask, we cannot carry on with Source: South African National Department of Health IPC Guidelines
prices being so high.

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