Covid-19 breakthrough

Groote Schuur Hospital nurses with patients who recovered with the aid of high-flow nasal oxygen machines, from left, are Zukiswa Ntsunguzi, Neliswa Tofile, patient Shahied Fischer, Tracey Morris, Nonkululeko Ndinga, patient Ivan Cummings, Willem Spogter and Tasneem Taliep

Groote Schuur Hospital staff on the Covid-19 frontline have reason to celebrate after five of their very sick patients all turned the corner on the same day after being on a form of intensive oxygen therapy.

The therapy gives doctors treating seriously ill Covid-19 patients an extra step they can take before resorting to the more invasive intubation, which carries with it the risk, albeit a small one, of injury to the throat and voice box, infection and lung collapse, among other possible side effects.

The patients were discharged from the critical-care and ICU wards on Monday July 6 after being treated on the high-flow nasal oxygen (HFNO) machines.

“By being able to take five patients off HFNO machines in one day is extraordinary and a truly remarkable achievement for the dedicated staff working in the unit,” said hospital spokesman, Alaric Jacobs.

In the initial phases of the pandemic, said Mr Jacobs, hospitals had focused on intubating seriously ill Covid-19 patients, but the provincial Department of Health had promoted the use of HFNO treatment at its tertiary hospitals.

“The HFNO machine is a device which can deliver concentrated oxygen to a patient’s lungs, through long tubes which sit just below the patient’s nostrils and this decreases the work of breathing and makes sure that the body gets enough oxygen even though there is lung inflammation,” he said.

The hospital’s ICU medical manager Dr Shrikant Peters and its medical manager in medicine, Dr Laurene Booyens, both agreed that HFNO had been a success at the hospital.

“Over a period of three months, around a third of patients recover without requiring intubation, which is a significantly positive outcome compared to settings where no high-flow nasal oxygen treatment is offered. Obviously not all patients require this modality,” Dr Booyens said.

Dr Peters said the results were reassessed regularly as the medical fraternity learnt more about the management of Covid-19.

Patient Ivan Cummings, 56, from Grassy Park, and Shahied Fischer, 56, from Hanover Park, both came off the HFNO machine on the same day.

Mr Fischer, a taxi driver, said he was very thankful to be alive after having been on the HFNO machine for eight days.

“When I came into Groote Schuur Hospital on Monday June 29, I could not breathe, I thought this was the end and that I was not going to make it, but this hospital is awesome, and the staff have helped me to fight this battle and live again.”

Mr Fischer said Covid-19 had made him appreciate essential workers and the difference they were making to help patients survive.

Nurses Neliswa Tofile and Nonkululeko Ndinga also celebrated the success of the HFNO in the ward.

Sister Tofile said: “It is not easy seeing all the suffering that our patients have to go through and days like today make us feel happy because it shows that our hard work is showing results.”

Mr Fischer said it was important to follow all the Covid-19 safety precautions. “I was one of the people who did not take Covid-19 seriously, and I was not adhering to the guidelines that were given to us,” he said. “You might not be as lucky as I am, so please adhere to the guidelines.”