Many South Africans are worried about the available capacity at hospitals and clinics.
On 9 July, Health Minister Zweli Mkhize himself warned about the possibility of a bed shortage in the country for critically-ill COVID-19 patients occurring by early August.
The number of available ventilators in the healthcare system is another point of concern.
In severe cases, the effects of the virus impede lung function, which means patients may require assistance for breathing provided by mechanical medical ventilators.
In a presentation to Parliament on 10 April, then-acting director-general of the Health Department, Dr Anban Pillay, said there was an estimated 3,216 ventilators in the country, 2,105 of which were in the private sector.
The expected need at the peak of the virus in September would be for 7,000 ventilators, of which government would have to procure a further 1,223 for the public sector, while the remaining shortfall would be acquired by the private sector.
The fear over a potential shortage of these devices at healthcare facilities at present may lead some to attempt to acquire medical ventilators for their own private use.
However, one of the world’s largest manufacturers of respiratory solutions for both in-hospital and out-of-hospital use – Philips – said this solution is not as feasible as some might believe.
Sophisticated medical devices
Philips produces a wide range of ventilators and respiratory equipment, including the recently-introduced Respironics E30 ventilator, a scaled-down emergency device specifically aimed for use in settings without the required life-support systems.
A spokesperson from the company said it is important to understand that ventilators – even those made for use in the home environment – are not available as over-the-counter or non-prescription purchases.
Philips explained that even qualified healthcare personnel required additional training for using ventilators.
“Although ventilators might seem straightforward in that it helps a patient breathe by assisting the lungs to inhale and exhale air, they are sophisticated medical devices,” Philips noted.
“In addition to the medical qualification required to treat patients, physicians and clinicians receive in-depth training to use ventilators,” the company said.
It explained that as each respiratory disease or condition differs, they require clinicians to interpret patient-specific symptoms and indicators in order to prescribe the correct treatment.
“Therefore, all ventilator applications need to be guided by a clinician; they have to be prescribed to a patient, setup aligned to their condition, and unique indicators; and monitored by the clinician to respond to each patient’s changing condition. Like any other medical condition,” Philips said.
Unaffordable for most
Another reason why it is inadvisable to try and acquire a ventilator for private home use without the necessary trained personnel at hand is the immense cost of a unit.
According to information from medical device manufacturer Medtronic, ventilators can range in prices from $5,000 (R82,900) to $50,000 (R829,000).
Premium ventilators used in hospital intensive care units (ICUs) typically cost no less than $25,000 (R414,500).
According to the Washington Post, only around 20% of symptomatic COVID-19 patients require hospitalisation, and about 5% end up in the ICU.
With only 0.1% of confirmed COVID-19 cases receiving ICU treatment in South Africa as of 24 July, it’s clear the vast majority of people who fall ill with COVID-19 will not require ventilator support.
It’s therefore illogical to spend such an obscene amount of money on a device that will most likely not be needed by the average patient.
Additionally, the National Ventilator Project has started the production of 20,000 non-invasive CPAP ventilators.
These can provide respiratory assistance to patients with severe symptoms, while the health system is focused on procuring more complex and invasive ventilators to supplement current devices used for critical cases.