Collection of antiretroviral meds down by almost 20 per cent in Gauteng since lockdown started

The Gauteng Department of Health is implementing a track-and-trace plan to locate TB and HIV patients who have not collected their medication since the lockdown started.

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MEC of Health spokesperson Kwara Kekana said the emergence of the Covid-19 pandemic exacerbated the loss-to-follow-up (LTFU) rate of these patients due to high mobility and incorrect and unreliable addresses, as patients fear the stigma around TB and HIV.
The approximate number of patients who failed to collect their TB medicine is 1 090.
The number of patients who failed to collect their antiretroviral medicine is approximately 10 950.
Since the lockdown started, the average percentage reduction in medicine collections for TB is 1.4 per cent and 19.6 per cent for HIV.

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Through the track-and-trace plan, called the Ward-based Outreach Teams (WBOT), patients will be traced and treated.
Kekana said the anticipated impact of treatment gaps for TB and HIV/Aids due to lockdown measures are:
• Supply and transportation of medicine may be disrupted by flight cancellations and imposed travel restrictions.
• The unavailability of medicines may lead to treatment interruption which subsequently causes drug resistance and deterioration of patients’ health.
• Patients who do not comply with treatment remain vulnerable and may be susceptible to other opportunistic infections, with SARS CoV-2 being one of them.
• Clinicians may have difficulty managing patients with unsuppressed viral loads due to treatment interruption. These patients may end up developing complications such as immune reconstitution inflammatory syndrome (IRIS) and many other illnesses

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Surgical procedures at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH):
Kekana said CMJAH remains one of the busiest Covid-19 treating facilities in the province.
The department implemented measures to ensure some of the critical services are rendered at other facilities in order to free up resources at the hospital.

“Alternative arrangements have been made for less complex cases to be performed at Helen Joseph Hospital and other regional hospitals. Specialists (nursing and medical) from CMJAH help to strengthen capacity when needed at these other facilities. There is unfortunately limited capacity for patients who would require post-operative ICU and high care,” said Kekana.

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Cancer operations are continuing in all departments, divisions and units. There are few cancer procedures which have been deferred because the number of theatre lists available per week have been reduced. Similarly, paediatric operations are predominately semi-urgent and are therefore continuing.”

The department announced that their procedures which, due to their complexities, cannot be done anywhere else except at CMJAH.
“These patients unfortunately have co-morbidities and therefore are at higher risk in case they get infected with Covid-19,” said Kekana.

Operations:
The department announced that the operations cancelled or deferred since the lockdown started on March 27 was a total of 1 413.
It included 183 orthopaedics procedures, 499 ophthalmology procedures, 420 gastrointestinal endoscopy procedures and 32 cardiothoracic surgeries (cardiac 20 and thoracic 12).

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