Health System Dynamic & Resource Requirement in a South African COVID-19 Field Hospital

The aim of this study is to describe the patient clinical profile, resource requirements, and health system dynamics in a field hospital during the second wave of the Coronavirus (COVID-19) pandemic, leading to the outbreak of viral severe acute respiratory syndrome (SARS-CoV-2 virus), in South Africa. By describing the field hospital in this unique setting, the investigators hope to provide an efficient guide to similar settings across low- and middle-income countries. This was a retrospective, single-center study. A total of 596 patients with confirmed COVID-19 were admitted to Mitchells Plain Hospital of Hope (MPHOH), Cape Town, South Africa, between January 1st and February 28th, 2021. Patient clinical characteristics, outcome, and resource allocation was collected. Daily hospital dynamics, including admissions, discharges, deaths and oxygen use was analyzed and compared to the local and national COVID-19 incidence rates.

The aim of the study is to amplify what is known about field hospitals in resource-constrained setting, so as to guide meaningfully the future COVID-19 public health response. Understanding not only the patient profile, but clinical resource requirements, and health system dynamic in a South African field hospital during the second wave of the COVID-19 pandemic can help in preparation for a future infection surge. This will shed light on the extent and timing of excess demand for intermediate care facilities for COVID-19 during peak infection periods in this region. Furthermore, lessons learnt here can guide efforts in similar settings across low-and middle-income countries. Data was collected on all patients admitted to MPHOH between January 1st and February 28th 2021 using notes from patient folders' and an electronic hospital records systems. Patient demographics, clinical profile, resource utilization; as well as the hospital dynamics were collected. COVID-19 incidence rates were collected from the National Institute for Infectious Diseases, South Africa A descriptive data analysis was performed to report the number, mean, median, and range of all relevant values. Hospital level data were summarized into weekly intervals, described and compared to COVID-19 incidence rates. Statistical data analysis was performed using R Statistical Computing program and Microsoft Excel.