Inside Cape’s Covid-19 ward

Tygerberg Hospital’s isolation unit nurses say they are ready

SISTER Nothemba Botha is ready for whatever challenges Covid-19 throws at her inside the Western Cape’s designated coronavirus isolation ward in Tygerberg Hospital.

Botha is one of the health-care workers who received specialised training to manage infectious patients on the frontlines of the Covid-19 pandemic, which is predicted to worsen worldwide in the coming weeks.

As of yesterday afternoon, there were 24 confirmed positive cases in South Africa. Three of those were in the Western Cape, in self-quarantine at home.

Globally, there were 140 616 confirmed positive cases, 5 353 deaths and 70 655 people who have completely recovered.

Throughout the Cape province, businesses and schools have begun to take serious precautions: all eight United Herzlia Schools will remain closed until the end of the Easter school holidays after a pupil’s father tested positive for the virus.

UCT and Stellenbosch University suspended their March graduation ceremonies, Afrika Burn has been cancelled and the Cape Town International Jazz Festival has been postponed. Late last night, the Cape Epic was also cancelled.

But inside the province’s coronavirus isolation unit at Tygerberg, Sister Botha and her colleagues are calm in the face of the fight that lies ahead.

Botha has been a nurse for 12 years, and first worked at Groote Schuur Hospital before moving to Tygerberg’s infectious diseases unit three years ago. Like many, she was afraid of the virus before she understood how it is transmitted.

“For anyone, when you’ve never heard anything about such things, you will have fears – it’s natural, you are a human being. Now I’m okay, I can deal with corona, I can look after the patients. It will be easy.”

Sister Botha works a 12-hour shift in the isolation unit. She is used to working there, as it was previously used for patients with multi-drug resistant and extensively drug resistant TB, although containment rules are much stricter now.

“We are in good spirits to be on that side, since we’ve been dealing with infectious diseases that are more dangerous,” Botha said. “Corona is much better than TB because corona will be cured or go away, but you will develop complications in the long run with TB. I am more comfortable dealing with corona.”

As of last night, there were no confirmed positive patients in the isolation ward, but even those awaiting their test results must be treated as potentially infectious.

Inside the unit is a changing area where Sister Botha layers up her personal protective equipment.

First she switches her normal shoes for operating theatre boots, which then go into gumboots. Next is the blue gown which goes over her nursing uniform and the head cap. Her N-95 respirator mask goes on over the cap, with two elastic straps to secure it around her head. The last layer is goggles and gloves.

Now she is safely equipped to enter the rooms where her patients will be waiting. Each room is completely separate, housing one patient each, with its own bathroom and its own set of equipment that is never shared between rooms. The negative air pressure system ensures excellent circulation of fresh cool air in the rooms. This is an important part of preventing transmission, and also helps make wearing the clothing a little more bearable, Botha said.

“It’s hot, but because there is good ventilation it’s not that bad. We need to do this to stop the spread. If I would be exposed, I would be taking the contamination to the next patient.”

Sister Botha has to limit the amount of time she spends in a room with each patient, so she does the necessary observations and procedures and gets out in no longer than 20 minutes.

“As soon as you are done with the first patient, you don’t go in to the next one with the same clothes. You clean yourself again and take everything off. You don’t share anything, you only share yourself.”

According to the head of nursing at Tygerberg, Francilene Marthinus, this is the dangerous part.

“To put the protective clothing on is nothing,” she said. “The real danger is when you take it off. You must take it off the correct way, because otherwise you can contaminate yourself.”

Marthinus said the isolation unit nurses had been trained by an infection control and prevention nurse.

Sister Botha has two daughters, who were scared when they first found out their mother would be working with coronavirus patients, but now that she has taught them about the virus, they’re no longer afraid.

“I’m teaching them every day the best thing to stop the spread is to wash your hands, keep them away from other people, don’t touch your face,” she said. “We have to go back to basics.”

Marthinus said she was doing her best to support her nurses.

“I can understand what they’re going through and what their families are going through. It’s normal to be fearful or anxious under these circumstances. But I tell them, don’t let the anxiety interfere with your professional knowledge and ethical principles.”

| SUPPLIED SISTER Nothemba Botha.