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Alert Level 4 measures necessary but not timely – SAMA  

The announcement by President Cyril Ramaphosa to move the country to Adjusted Alert Level 4 from yesterday (28 June) is welcomed but should have been considered at least two weeks ago, according to the South African Medical Association (SAMA). The association also says while the measures announced by the President to combat the spread of the new Delta variant of COVID-19 are a move in the right direction, it remains concerned about how these will be monitored and policed.

In addition, SAMA acknowledges that the restrictions announced by the President will have severe financial consequences for many people, and that there is a fine line between people losing their jobs versus saving lives. “Ultimately, though, we must note that there was poor government planning to have healthcare facilities ready for the third wave, and we are deeply disturbed by this. It is leading to mistrust of the government, specifically the capabilities of the Department of Health,” notes Dr Angelique Coetzee, Chairperson of SAMA.

Regarding the restrictions, Dr Coetzee says SAMA called for the closing of schools three weeks ago, and also urged Cabinet to curb non-essential travel. “That these measures have now been implemented is good news, especially for struggling healthcare workers in struggling health facilities. But, to be honest, these measures should have been in place a long time ago,” she says.

She adds that some of the measures do not go far enough and should have been far stricter. “The curfew, for instance, ends an hour too early at 4am and should have been moved to 5am; it’s still cold in the mornings and many people using public transport will do so with the windows closed to keep warm. Limiting inter-provincial travel is also a good idea but at the moment there is no requirement for permission for such travel to be granted so people can still move freely between provinces, especially since no indication was given as to how this will be policed,” notes Dr Coetzee.

Another area of concern is the number of people allowed at funerals. “Funerals are possible super-spreader events, and we would have wanted to see the number of people allowed at funerals greatly reduced. Allowing up to 50 people to attend funerals will not contain the virus but may actually aid in its spreading,” notes Dr Coetzee.
 
Dr Coetzee says SAMA will study the regulations of Sunday’s announcement closely to determine exactly what is and what is not allowed such as, for instance, permits for inter-provincial travel. Apart from the measures announced, SAMA says an urgent issue that must be addressed now is the availability of oxygen for home use. Dr Coetzee says up to half of the patients receiving home-based care will require oxygen to keep them out of hospitals and that this issue must be dealt with as a priority before it's too late.   “We cannot forget that all of this is happening in the context of a struggling healthcare system, doctors who are overworked and stretched beyond their mental and physical capabilities, and a vaccination programme that is, quite frankly, stuttering along at a snail’s pace. These measures are necessary but not timely and should have been implemented weeks ago. Nonetheless, we are here now, and we need to ensure we do our best as citizens and take it upon ourselves to adhere strictly to all the protocols for our own and everyone else’s health,” concludes Dr Coetzee.
 
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FPD SCHOOL OF PUBLIC HEALTH COURSES

Dear Colleagues

As South Africa enters Adjusted Alert Level 4 lockdown, the country is nowhere near the peak of the third COVID-19 wave with the situation in Gauteng being particularly tough. The sheer numbers of people being infected with the virus are simply overwhelming and are currently adding to the already challenging exhaustion level of our medical staff, both in the public and private sectors.

Burnout and general mental health remain one of our biggest challenges throughout. SAMA is in the process of partnering with some of our stakeholder organisations in providing some measure of support. Even if it is just to be able to talk to a professional when requiring some assistance in dealing with personal challenges and obtaining some coping tools to deal with the onslaught we are dealing with currently. We are looking at introducing this service to our members and medical professionals in general, within the next few days.

I am currently being overwhelmed with enquiries from colleagues and the public in regard to the false information about vaccines being spread on social media. Anyone who creates or spreads fake news about COVID-19 is liable for prosecution. For this reason, I want to urge all our members to please verify information before you share it. Currently the vaccination rollout is our only way to ensure positive outcomes and a way to deal with the pandemic.

While we are all dealing with the third wave, I just need to also remind all that the POPI Act will be implemented as from 1 July. This will have a significant impact on how we deal with information and we need to ensure compliance or face imminent fines. The registration of Information Officers has however received an extension. Something that has slipped through the cracks, maybe because it is not perceived as having a direct influence on our profession, is the implementation of the AARTO Demerit Point System. This is also scheduled to be implemented on 1 July.

Basically, for each offence, a driver will be allocated between one and six points – depending on the seriousness of the offence. A person who collects more than 15 points will have his or her driver’s license suspended for up to three months and may need to go through the whole learner driver testing again. We will need to see how this will influence our practices; it may require a relook at HR policies and insurance.

Confirmation was received from the Department of Health that there is no funding available for the midyear Intern placements. In terms of the Health Professions Act, the DoH has a duty to enrol eligible applicants in their positions for Internship. This matter is currently being investigated by our SAMA Legal Department and possible legal action on behalf of our members is being considered.

In conclusion, some good news. Following intervention from SAMA, MPC is currently integrating the CPD Management platform with the HPCSA system. This will enable seamless updates of CPD portfolios between healthcare practitioners and the HPCSA system. We are proactively monitoring the process to ensure it is complete as soon as possible without interruption. Our members can therefore look forward to less time spent trying to upload certificates, and have the peace of mind that attendance to CPD events will automatically reflect against their MP number with points being allocated accordingly.

Thank you for all your efforts and for the work you are doing during these trying times.

Be safe.
Yours in Solidarity

Dr Angelique Coetzee
SAMA: Chairperson

SAMA outraged by the complete mismanagement of the internship programme by the government

SAMA outraged by the complete mismanagement of the internship programme by the government. The South African Medical Association (SAMA) is outraged by the complete mismanagement of the internship programme by the government. The continuous failure by the state year after year to allocate medical interns puts the future of these junior doctors in serious jeopardy. 

A total of 288 medical interns who graduated in March and April are awaiting compulsory and constitutionally mandated placement at public health facilities. SAMA says unless all interns are placed by the end of today, 1 July, it will take the government to court on behalf of the junior doctors.

SAMA would like to remind government that internship is a statutory component of medical training instituted by government in order for doctors to complete their medical training and, as such, it is their responsibility to ensure that all doctors who meet the criteria and standards set by the Health Professions Council of South Africa (HPCSA) through their universities, are placed immediately post qualification so as to execute their civil service without unnecessary delay.

“It’s absolutely scandalous that these interns cannot be placed, especially at a time when our country so desperately needs every available hand to deal with the COVID-19 third wave sweeping across South Africa. This raises serious questions about the millions of Rands spent on Cuban doctors, Digital Vibes, and other questionable PPE tenders. It’s outrageous and deplorable, and someone now needs to be held accountable for these massive failures,” says SAMA.

SAMA says through not ensuring the placement of the interns, the Department of Health and the Minister of Health are in contravention of their constitutional obligations to ensure eligible applicants are placed as interns.

“The department and the Minister are not fulfilling their duties as prescribed in the legislation and it’s having a major impact on the professional lives of young doctors who have worked extremely hard to get to this point, only to falter because of the ineptitude of officials. This is a serious situation, created through what can only be described as the mismanagement of healthcare provision in our country,” notes Dr Coetzee.
 
SAMA  says South Africans should be enraged at this situation, particularly as there are many hospitals struggling with a lack of doctors during a time when they are actually most needed.

“Doctors are overworked and fatigued, and many are facing mental and physical burnout. Yet, when there are doctors available to help alleviate the burden they cannot be placed. Essentially, patients are suffering, and people are dying because there aren’t enough doctors to care for them. And there aren’t enough doctors because money has been spent on other projects instead of on the proper provision of healthcare in our country. That is outrageous,” concludes Dr Coetzee.

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‘Impossible’ NHI tax will hit South Africa hard

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According to health department's spokesperson, Foster Mohale, these were rare glitches which they were closely monitoring.

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South Africa is in the grip of another resurgence of Covid-19. Gauteng province, the country’s economic hub, where 25% of the population live, is the epicentre. But infection rates are expected to rise in other major provinces as well. To ease pressure on the health system and slow the rate of transmission, President Cyril Ramaphosa recently announced tighter lockdown restrictions. Shabir Madhi is the director of the South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit and co-founder and co-director of the African Leadership Initiative for Vaccinology Expertise at the University of the Witwatersrand. He spoke to The Conversation Africa to shed some light on South Africa’s situation.

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SA health products regulator, Sahpra close to finalising decision on Sinovac vaccine approval

The South African Health Products Regulatory Authority (Sahpra) will reveal whether the Coronavac vaccine developed by Sinovac will be approved for use in the coming days.

CEO Dr Boitumelo Semete-Makokotlela provided an update on how far the institution was with vaccine registrations and approvals on Thursday morning.

She said a decision about whether it has approved Sinovac's vaccine for use in South Africa was “close to being finalised and will be communicated to the company within the coming days".

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