We are in the midst of a national shutdown. This shutdown has many repercussions on our economy as well as our health systems, not to mention the immense strain on our everyday routines. With this in mind, it is of utmost importance that we as Wijnland Clinic need to prepare as well as possible for the difficult time ahead. As a country we have the social obligation to prevent (as far as possible) the spread on the COVID-19 virus. In addition to this, we at Wijnland have and always will prioritize our patients and their care. We have put in place a system that advocates social distancing, wherever possible; as well as implementing strict hygiene and cleaning measures. Most of our staff will be working remotely, with only necessary staff on site for essential procedures that need to take place. Bookings for the beforementioned procedures will be carefully structured in order to adhere to minimal social contact between patients and staff.
The following medical cases will proceed as per SASOG shutdown arrangements/guidelines as planned
Consultations:
- It is recommended that urgent and emergency consultations should continue; that all surfaces and equipment be cleaned between patients, including ultrasound equipment.
- All measures that can decrease contact and increase social distancing will be implemented, including: spacing of visits to limit the number of patients in waiting rooms; telephonic follow-up consultations; limiting consulting hours to the essential; and, having administrative staff working from home where possible.
- Waiting room and nursing staff who are considered essential for consulting services will continue working, but we do explain and reinforce the importance of the above measures to all patients and staff.
Obstetric care:
- Ante-natal care is known to improve pregnancy outcomes and must continue, especially for high risk patients. Visits should not be post-phoned and antenatal admissions must continue as indicated.
- Suspected or confirmed CoVid-19 cases should self-isolate and NOT attend for normal care; these patients should be screened or consulted telephonically or face-to-face wearing PPE and in a dedicated area.
- Safety during obstetric admissions, delivery and care of neonates must be prioritized and separation between infected and uninfected cases must be practiced.
- Protocols for vaginal and caesarian delivery of women with known or suspected infection and/or pneumonia should be developed in collaboration with hospitals, made available and followed by all.
Feto-maternal care:
- Assessment and management of suspected fetal anomalies is time-sensitive and cannot be postponed, but screening and care of low risk patients may be of less importance when resources become very strained.
- Information on CoVid-19 disease during pregnancy is scarce, but it is expected that some pregnant women may become severely ill with respiratory, renal and other sequelae and will need specialized care by multidisciplinary teams.
- Maternal well-being must be priority; steroids are considered safe for lung-maturity, mode of delivery should not be determined by the infection, unless in extreme cases.
Gynaecology care:
- Comprehensive routine care must be provided for gynaecologic emergencies, and “time-sensitive conditions” including all pregnancy associated conditions, contraception, termination of pregnancy, and urgent oncology, including palliation.
- Elective surgery that cannot be postponed for 3 or more weeks, should be considered urgent and should be offered, provided a separate safe area in the hospital can be ensured.
- Non-urgent elective gynaecology surgery and all surgery which may result in relatively lengthy hospital stays, should be postponed.
Infertility care:
- Give priority to completing assisted reproduction treatment cycles for those who have started, provided this can be done safely.
Uro-gynaecology:
- Priority should be given to non-invasive and medical treatments and where possible surgery should be postponed, especially in patients older than 60 years.
Oncology care:
- Postpone cancer surgery for non-urgent cases, most pre-cancers, and for the frail, elderly and immune-compromised.
- Radiation and chemotherapy should not be interrupted, and chemotherapy should be initiated for curable new cases like gestational trophoblastic malignancy.
- Home care as well as symptomatic treatment, palliative care and analgesia must be prioritised.
Wishing all our patients the best during these trying times and stay safe!
The Wijnland Team
Emergency numbers to contact during lockdown for urgent matters only:
Sister on call: 079 526 5880
Embryologist on call: 079 831 0770
Doctor on call: 082 446 9951