Photograph — WHO

Of all the countries hit by the COVID-19 pandemic in sub-Saharan African, South Africa is the hardest hit with 48,285 cases as of June 7, 2020. For months, the government has been in talks with private firms and medical associations ahead of a probable scenario where public hospitals run out of critical care beds.

But a recent report indicates that the government has agreed on how much it would pay private hospitals and medical practitioners to treat severely ill COVID-19 patients if public hospitals run out of space. The fee covers the cost of using the bed, paying a team of specialists to treat the patient and additional services including pathology and radiology.

According to a statement by Anban Pillay, the Health Ministry’s Deputy Director-General for National Health Insurance, an agreement was reached on a daily fee of up to 16,000 rands ($950) for COVID-19 patients that get treated in critical care beds in private hospitals. He added that with the new “high-level” agreement with the private sector,  health departments in the country’s nine provinces will sign “service-level” agreements.

The importance of the Intensive Care Units (ICU) in hospitals cannot be understated for the treatment of critical COVID-19 cases.  Over 60 percent, about two-thirds, of  ICU beds in South Africa are found in private hospitals. 

In 2007, a national audit of critical care resources was conducted for all public and private sector ICU and High Care units in the country. It was found 23 percent of public and 84 percent of private hospitals have ICU/HC units. This translates to 1,783 ICU beds in public facilities and 2,385 in private facilities.

A 2020 report, however, indicates that the country has about 7000 ICU beds but only about 3000 are available for use. This puts the country in an awkward position as its healthcare system is not prepared for a surge in COVID-19 cases. According to the report, it is projected that slow response to the virus outbreak could result in anywhere between 87,900 and 351,000 deaths that could depress the country’s health system. It also estimates that for an infection rate of 10 percent, more than 100,000 people will require a form of hospitalization at some stage and a 20 percent rate, more than 500,000 would need hospitalization.

As the new coronavirus began to take a toll on Africa’s most industrialized economy, the poor state of its health sector became obvious, struggling to provide adequate health services for its population. With the private hospitals partnering with the government to treat COVID-19 cases, the government should anticipate an increase in infection among patients and staff of the designated private hospitals.

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