'Immense impact on frontline workers': Western Cape health head reflects on four COVID-19 waves
It's been 22 months since Western Cape health department head Dr Keith Cloete's "last normal weekend", as his family has taken to dubbing the few days before the pandemic reached local shores. He recalls the weekend, towards the end of March 2020, clearly. The Cloete family had joined some friends for a weekend away in Scarborough, ahead of his appointment to the head of department role in April. Yet he spent very little time watching the sun set or listening to the ocean, he was instead in a series of meetings, preparing for the inevitable arrival of COVID-19 in the province. It's been a long two years since that weekend in March. Cloete has steered the department through four waves of the pandemic, four variants of COVID-19, more than 540 000 cases and 20 000 deaths.
In the department's weekly digital briefings, Cloete has become the face of the province's COVID-19 response. He is the one to unpack the latest statistics and reassure the public on the health system's capacity to deal with the pandemic. But it's not a role Cloete ever envisioned for himself.
Born in District Six, Cloete was the third of four sons. His father was a teacher, and the family followed his postings to Piketberg, the Hex River Valley, and later Worcester. While living in Piketberg, at around the age of four or five, Cloete's grandparents and extended family were forcibly removed from District Six and were relocated to Elsies River. It was here Cloete would spend his school holidays, with what he describes as a "tight-knit family", and where he first realised his calling.
From a young age, Cloete aspired to follow in the footsteps of his cousin, Professor William Pick, who ultimately became the president of the South African Medical Research Council. As a child, Cloete recalls spending school holidays with Pick and being inspired by his work.
"From my earliest memories, I always said I'm going to become a doctor. One of my biggest influences was my cousin. In our family, he was the first to study medicine and become a doctor. I always spent time with him in Elsies River, seeing him as a role model serving his community," said Cloete.
Cloete completed his medical training at the University of Cape Town in 1988, with a burning desire to prove his worth throughout his studies.
He said, “My father told us that you can be whatever you set your mind to. Let nobody determine who you can be and what you can be. When I went to UCT it was with a drive to prove that I deserved to be there. Nobody was going to tell me that I don't deserve to be in medical school and nobody was going to tell me that I don't deserve to be a doctor."
Cloete's dream for himself was to serve underprivileged communities but in 1994 he realised that there were ways to do that beyond providing a medical diagnosis. With the country in the throes of change, Cloete decided to make a change for himself and he left his days in hospitals to join the Department of Health.
Preparing for a pandemic
Despite the many unknowns that COVID-19 brought, the pandemic was a scenario that Cloete was not wholly unprepared for.
In 2006, in the wake of the SARS outbreak, Cloete was assigned to a task team that developed a pandemic response plan for Parliament. The plan looked at the possible diseases that could cause a pandemic and plotted responses to potential outbreaks. It was this work that Cloete referred to once COVID-19 started spreading in South Africa.
But he largely attributes the department's success in managing outbreaks to the robust healthcare system in the Western Cape. "In the Western Cape, we have an incredible system. So when the pandemic really hit, in a way there was a sense of calm. We had had so many dry runs in preparing for other diseases, such as Ebola," said Cloete.
"There were already people and systems in place. It was just about pulling those together."
The department also has the support of a strong community of experts and has maintained a "powerful data centre" to keep track of diseases such as TB and HIV, both of which were essential in charting infection rate and allocating resources.
It's been a gruelling marathon of 22 months, but there have been moments of hope for Cloete and his team. Some of Cloete's highlights include establishing an 800-bed temporarily hospital at the CTICC in only a matter of weeks, and then following this with a mass vaccination centre at the same site.
But he is most proud of the level of care the department provided to Western Cape citizens during the pandemic: including the delivery of three million health parcels, telephonic support for high-risk patients who contracted COVID-19 and mobile vaccination sites dubbed "vaxi taxis".
It's a pride that Cloete struggles to conceal, he tears up talking about the scores of emails he's received, thanking the department and healthcare workers for going above and beyond in providing care and access to vaccination.
He said, “Occasionally I open an email and read the most amazing human story, of someone that has written to me to say thank you… I've read stories of people coming into the system and the same healthcare workers that are so under pressure, treat them from a place of kindness and compassion.”
But the team has suffered crushing blows. Cloete's lowest point was in December last year, when the department lost 57 healthcare workers to the second wave. He has also found it difficult to deal with what he calls "vicious vitriol" from COVID-19 denialists and anti-vaxxers.
"You must realise the immense impact on frontline workers and what they've had to go through personally. Young doctors and nurses have been losing their optimism, feeling helpless as they watch people dying from what could be a preventable disease. Those same healthcare workers must go home and must protect their own families from possible contact and then return to work and see waves and waves of people dying. You can imagine how demoralising it is for the staff members when someone says COVID-19 doesn't exist," said Cloete.
As the province faces its fourth wave, Cloete says the department will continue to be, "... led by science and evidence."
"Even if this wave feels different, we look to science and data to guide our response," he said.
"Our system has been tried and tested, we've been there and we know what we can cope with. There is more confidence. But at the same time, the system is dealing with everything else we haven't been able to attend to for the previous three waves, such as chronic diseases, mental health and trauma cases. We can cope with COVID-19 but we also have to cope with all these other things," he said.
Source: News 24