by Alex Brownlee – Actuary and Executive Head of EthiQal
South Africa recorded its first coronavirus case in early March 2020. Roughly seven months and over 700 000 positive coronavirus cases later, the coronavirus pandemic continues to take a toll on South Africa’s health system, healthcare workers, the economy and its people.
When South Africa went into a 21-day hard lockdown, health authorities were battle-planning to prepare for a pandemic believed to be one of the worst seen for over a century. Being behind the curve in a global context, South Africa’s medical industry was fortunate to be in a position to prepare and be proactive in its response to managing the local pandemic.
Although the coronavirus was relatively slow to take effect, it spread rapidly throughout the country during April and May, reaching its peak in late July with approximately 14 000 new cases and approximately 300 average deaths per day, at its highest. With mounting fears that there would be a surge in the patient load on hospitals, infections and deaths peaked relatively quickly and then subsided, largely progressing further to regional hotspots.
Medical practitioners stepped into wards and theatres to treat patients with the realisation that they could be exposed to infection and would not only be putting their lives at risk, but also those of their families and friends. Back in August, as announced by the Minister of Health, over 6 000 private healthcare workers tested positive for the virus, with a death toll of 37.
During these times, many doctors were exposed to new conditions and required to work outside of their typical scope of practice. Telemedicine was allowed to be provided to patients beyond what was previously allowed for by the regulator. This introduced new challenges and medico-legal risks to doctors during a stressful time, and where practice income was severely impacted. We at EthiQal, a leading professional medical indemnity insurer, worked tirelessly to be able to assist and support doctors by providing guidance and support, extending cover when required and providing various financial relief initiatives during these times.
The psychological effects of financial uncertainty, cash flow problems and constant worry about the possibility of infecting family, friends and patients have taken a toll on the mental well-being of many doctors and nurses, with many still coming to terms with the impact of COVID-19 to this day. The income of many doctors has been significantly reduced due to hospitals restricting surgeries to emergencies and births, as well as patients putting off seeking non-critical treatment. The effects thereof have left some private practitioners with little choice but to reluctantly hang up their stethoscopes in retirement and others to close their practice’s doors. EthiQal has noticed an almost 50% increase in policy cancellations during the pandemic period compared to the prior year, albeit still small numbers. These are related to early retirements, delayed starts in private practice and stopping clinical practising due to the impact of the pandemic. Average reductions in income amongst specialists were evident near 30%, with some severely impacted by up to 80% of income. Some of the worst financially impacted medical disciplines included GPs, cardiothoracic surgeons and neurosurgeons.
As much as becoming a doctor is a calling, no medical practitioner would have foreseen the dilemmas arising from an extreme and unprecedented event on the scale of the coronavirus pandemic. We owe it to our doctors, nurses and other healthcare workers for the bravery and dedication they have shown to care for the citizens of our country and help stop the spread of the virus.
We believe that South Africa’s doctors and their medical practices are national assets that must be safeguarded. In the wake of the COVID-19 outbreak and a looming second wave, our doctors need our support more than ever.
We salute our medical practitioners who continue to work tirelessly on the frontlines to treat our families and friends.