Funeral parlours are battling to cope with demand as Covid-19-related deaths around the country rise daily, and government is increasing capacity in cemeteries to cater for the deluge.
Meanwhile, doctors working at hospitals in Gauteng, which is now the country's Covid-19 epicentre, are having to decide who will and will not get treated with scarce ventilators and oxygen after hospital admissions in the province skyrocketed over the past 10 days.
South African Covid-19 cases have surpassed 250 000 and are now among the fastest-rising numbers in the world.
According to Vuyo Mabindisa of Vuyo's Funeral Services in Soweto, they used to bury about 35 people a week, but that number has jumped to about 50 people a week, with an average of 10 to 15 deceased people a day.
"You can say that we are now in peak season," said Mabindisa.
Gauteng is in crisis as all state hospitals have reached capacity.
"We are starting to experience oxygen shortages in public hospitals and clinics, and doctors and nurses are now having to decide who gets oxygen to keep patients alive and who doesn't," said Dr Francesca Conradie, deputy director of HIV research at Wits University.
TOWNSHIP FUNERAL PARLOURS NOT COPING
Sibongile Zikalala, who works as a funeral administrator at a funeral parlour, said it was scary working in such an environment because they did not always know who was carrying the virus.
"The biggest danger is that some people don't tell us the truth about whether they have been in contact with the deceased or not, which makes it scary for us," she said.
When Zikalala showed City Press the parlour's storage facility this week, she said that it could only cater for 24 bodies at a time, but the company was busy building another storage facility to keep up with demand.
Township communities are the hardest hit. In the past eight days, statistics show that the highest number of cases that have been recorded are from the City of Johannesburg's region D, which consists of Doornkop, Soweto, Protea Glen and Dobsonville.
Mabindisa said most funeral parlours in townships, including his, would not make it financially because they were burying people on credit.
"We have a serious challenge with the department of home affairs, which is on a go-slow, so families of the deceased person are not able to get the death certificates in time to claim from their insurance policies, so we end up burying people on credit," said Mabindisa, who is also the spokesperson for the SA Funeral Practitioners Association.
He said that, although the months of May, June and July were generally peak season for funeral practitioners, this year's numbers had left them without the capacity to deal with burials.
This has created a backlog in many privately owned mortuaries. Health and safety regulations had also made their operating conditions difficult.
"According to the regulations, a Covid-19-positive person must be buried within 48 hours and, before they leave the hospital, they must be put in a sealed plastic bag. That's why, in some cases, the families of the deceased end up burying a person without knowing whether that person is the right one or not," he said.
Zikalala said that, on average, a dead body spends about six days in the mortuary before it is buried, but Covid-19 regulations precluded them from keeping them for that long.
"As you can see outside, we have empty coffins that are ordered on a daily basis, but they already have people waiting for them. On Mondays, we get between 15 and 16 bodies from Baragwanath and Andrew Mlangeni hospitals, so we are very busy," she said.
Zikalala said that, due to the backlog, they have had to resort to renting storage facilities from smaller parlours.
Read: ‘Gauteng is not digging 1.5 million graves'
A funeral parlour worker in Alexandra told City Press that it was hard dealing with Covid-19-related cases because of the strict regulations, and because of hospitals that fail to disclose the cause of death.
"The hospitals themselves sometimes do not tell you the truth – that this person died of Covid-19. So you go and fetch the body thinking this is a normal case, but when you get the autopsy report, you get a big shock when you realise that this person actually died because of the virus."
She said that some funeral parlours had opted to turn down cases related to Covid-19 due to the complications created by the regulations.
‘THIS STORM SHOULD NEVER HAVE HAPPENED'
Professor Adrian Puren from the National Institute for Communicable Diseases said the country was now in the eye of the Covid-19 storm and bracing for the peak. Not only had the number of cases increased markedly over the past few days, but so had testing.
Data released by the health department on Friday indicated that 56 663 tests had been done since the previous day's report – 40 980 in the private sector.
"We haven't reached the peak yet, so we are going to see much larger numbers as we head towards it [between July, August and September]. We are now really on the upward trajectory of the disease. This particular surge wasn't unexpected after we moved from the stricter levels of lockdown, such as level 5, to allow for more mobility to get the economy going again," said Puren.
He added that estimates were that between 8 million to 15 million people were moving around as a result of the change in lockdown levels, meaning that more people were in contact with each other.
"So the numbers [of people infected] aren't unexpected, but that doesn't mean we should not make every effort to limit transmission as far as possible," he told City Press on Saturday.
Professor Alex van den Heever, chair in the field of Social Security Systems Administration and Management Studies at the Wits School of Governance, was more critical about government's reiteration around "the coming of the Covid-19 storm".
"I've seen it repeated again and again that there was this expected 'storm'. This is just not true – the storm should have never happened," said Van der Heever.
Van den Heever charged that, had government implemented a prevention strategy to suppress the epidemic, it would have prevented health services from being overwhelmed.
But, he said, the state had neither implemented an effective prevention strategy nor properly prepared the health services.
"By April, they should have been testing and tracing as a preventive strategy to protect frontline workers ... Everything now points to [the fact that] we have completely missed the boat in terms of prevention. Bracing for a storm is deflection – you don't predict it, you prevent it. There's no model that predicts a prevention strategy … If the models projected this, it means the model discounted any form of prevention [being effective]," he said.
Gauteng Health MEC Bandile Masuku has announced that an additional five field hospitals would be set up in addition to the site at Nasrec, which has 1 000 beds.
New sites in Diepsloot, Soshanguve, Midrand, Daveyton and the Tshwane Show Ground would mean 3 920 beds would be available for Covid-19 patients. The SA National Defence Force was assisting in this effort.
All intensive care beds located at the George Mukhari, Chris Hani Baragwanath and Ashanti Gold hospitals will be available at the end of this month, and will cater for 1 575 patients.
The provincial government is also working closely with its national counterpart and the private healthcare sector to boost capacity.
"We have enough hospital beds to meet the demand for the foreseeable future," Masuku said.
An additional 440 health professionals had been appointed and a further 400 nurses still needed to be employed.
Provincial governments are waiting for the national command council to find out if their proposed strict lockdown interventions will be approved.
Education and Youth Development MEC Panyaza Lesufi announced on Friday that 105 schools had been closed down for decontamination after Covid-19 cases were reported, or due to the lack of protective gear.
Some schools were disrupted and shut down due to health concerns and others were shut down due to service delivery protests.
Lesufi said that the province had put in a request for the defence force to help decontaminate schools.
So far, 956 individuals have tested positive in Gauteng's schools, with Tshwane and the City of Joburg representing the highest numbers.
"The escalation in the number of reported Covid-19-positive cases among pupils and teachers is the single biggest factor affecting school openings or closures from one day to the next. Importantly, these include lead teachers in the upper grades, as well as school principals in some cases," Lesufi said.
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