Must watch: How to build a hospital in ten days
We have two prime examples in our country of how cost can escalate when large scale construction projects are undertaken in the form of the Kusile and Medupi power stations. In a recent presentation to the portfolio committee on public enterprises; it was revealed that construction costs for the two power stations have increased to R300bn – R145bn for Medupi and R161.4bn for Kusile. Industry expert Chris Yelland reckons these estimates are low and the total bill is probably closer to just under R450bn. Putting aside all the other issues with the two power stations, the costs could have been avoided if the construction process did not take so long. And to be fair, it is not only here at the southern tip of Africa that escalating costs and an extension of building deadlines are a problem. In the United Kingdom, the budget for a high speed railway line, the HS2 that will link the South and the North increased from an original estimate of £34bn to £106bn. Added in the mix are environmental groups and local communities who are intent on blocking the line through their backyards every step of the way. If there is one country where long delays, environmental groups and cost overruns are not a problem; it is China. Reuters estimated that the Chinese government displaced 1.5 million residents of Beijing to build stadiums for the 2008 Olympics. As the Geneva-based Centre on Housing rights and Evictions (COHRE) put it, in China demolition and large construction projects "is characterised by arbitrariness and lack of due process." China has again rewritten the manual of super-fast construction in its rush to build two new hospitals in Wuhan, the city at the heart of the coronavirus outbreak. It is nothing short of miraculous as time lapse videos released by the People's Daily have shown. – Linda van Tilburg
Small weapons are the most potent in virus fight: David Fickling
By David Fickling
(Bloomberg Opinion) – How do you turn a disease outbreak into an epidemic? The best way might be to mix infected people with the healthy for long periods in crowded conditions, and then move them around to new locations.
That's worrying, because that more or less describes the situation of many people at the centre of China's coronavirus outbreak.
Yang Zhongyi, a 53-year-old woman in Wuhan with feverish symptoms, has been unable to get full-time admission to hospitals or testing in the city for two weeks but has been put on drips in un-quarantined areas in four separate hospitals in the city, according to a Reuters report this week. It said she spends her days queuing for treatment.
Other reports of patients with suspicious conditions being bounced between healthcare facilities without admission and videos of overcrowded waiting areas paint a similar picture.
Hospitals are meant to be places where disease is cured — but they can also be where it's most effectively propagated. That's particularly the case with coronaviruses: The 2015 outbreak of Middle East Respiratory Syndrome in South Korea took place almost entirely within healthcare settings, with just a handful of transmissions outside of hospitals. About a fifth of people who caught Severe Acute Respiratory Syndrome worldwide were healthcare workers. That share rises further if you include patients who were infected in hospitals and clinics.
At present, Wuhan's hospitals show many signs of being overwhelmed. All the 14 patients in an infectious disease ward at Wuhan Union Hospital were healthcare workers at the hospital itself, state-owned CGTN said in a recent video segment.
Halting the spread of disease depends crucially on the quality of disease prevention in hospitals, and there the evidence is decidedly mixed.
"The Chinese health care system is riddled with long wait lists, shortages, and poor equipment because of funding constraints," Bingwei Sun of Jiangsu University wrote in a 2016 article in the American Journal of Infection Control. "Hospital wards have become breeding grounds for microbial pathogens, with increased risk of infection."