Doctors heave sighs of relief at immediate drop in trauma cases

Doctors running trauma units, like this crowded ward at Chris Hani Baragwanath Academic Hospital, report that the reimposed ban on alcohol sales has had an instant impact on reducing the number of assault victims, creating more space for Covid-19 patients and easing the load on medical staff. Picture: Supplied
Image: Supplied

The alcohol ban has given hospital trauma staff a vital respite as they battle to deal with critically ill Covid-19 patients flooding their facilities.

With more and more health-care workers themselves contracting the coronavirus, the number of doctors and nurses available to treat patients is dwindling.

Dr Pat Saffy, head of the emergency room at the Helen Joseph Hospital in Johannesburg, said the facility’s medical staff was down 25%.

“Our resources are stretched. Every little bit of breathing space we get helps. Many of the Covid-19 patients we receive require intensive care,” she said.

“We can receive up to 60 potential Covid-19 patients daily, with most now testing positive. We usually have two to three Covid-19 deaths daily in our department.”

With alcohol banned, our trauma patient numbers dropped. When alcohol sales were unbanned, there was a huge spike in admissions

Dr Pat Saffy

Saffy said alcohol availability made a huge difference to the level of care the hospital could provide.

“With alcohol banned, our trauma patient numbers dropped. When alcohol sales were unbanned there was a huge spike in admissions in the first week of June, especially with assaults. Motor vehicle and pedestrian accidents definitely increased.”

Saffy said that in May, when alcohol sales were still banned, the hospital would have days when it was treating fewer than a dozen assault victims.

But in June, the minimum number of assault patients at any one time was 12. “On one day in June we had 33 assault patients,” she said.

“Daily in June we averaged between 12 and 20 assault cases. That number decreased this week. Between Monday and Thursday we had 28 assault patients. The weeks just before that we had about 60 assaults a week.

“Stabbings account for most assaults. At month-end we would receive about 25 a day.”

Saffy attributed the decline in stabbings to the suspension of alcohol sales and said there were also far fewer vehicle and pedestrian accidents, especially at night.

“I’m not sure if the decrease is solely because of the alcohol ban or also the curfew.”

She said Covid-19 patients had “overtaken the emergency department completely. I don’t know how much worse it can get because we can’t cope.”

Saffy said that though the ban was controversial, it made a difference.

“No doubt, just banning alcohol sales on weekends reduced our trauma cases. My fear is that when the ban is lifted we will see the same thing we saw in June, where people behaved as though it was Christmas and became totally reckless.

“It’s difficult to say if an entire ban will help as that will fuel black markets. I believe if we had a good curfew, and properly limited alcohol sales, we would greatly reduce trauma stats,” Saffy said.

Professor Feroza Motara, head of the emergency unit at Charlotte Maxeke Academic Hospital, said the unit this week was almost back to the lower trauma caseload of the level 5 lockdown.

“It’s amazing how this has changed. When [alcohol was] unbanned, our trauma admissions on a Friday night went up to 60 cases or more. Under level 5 it was between two and three cases [a night]. This week there have been five to 10 cases a night.”

In Cape Town, the head of Tygerberg Hospital’s surgery and trauma unit, professor Elmin Steyn, also reported a drop in trauma cases since the ban was reimposed on Sunday.

“But, with the ban only beginning this week, it is difficult to judge. Normally in the middle of the month, like we are now, we see decreases in admissions. It’s difficult to say what number of cases are alcohol-related.

“Month-end, when people are paid, will be the big test.”

Steyn said the unbanning of alcohol last month had pushed the unit’s patient volumes to almost pre-lockdown levels.

“All the problems associated with alcohol were seen. Previously, with no alcohol sales or travelling allowed, we had a 75% reduction in cases.”

She said the ban could provide important insights. “With no alcohol sales allowed but people able to travel, we will hopefully see the true effect of alcohol on trauma cases. We will see if alcohol is the main culprit or if there are so many accidents because people drive badly.”

– Additional reporting by Belinda Pheto

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