COVID-19: Recovered patients can be re-infected, says expert
Olusegun Olaopa, a senior medical doctor at the University College Hospital (UCH), Ibadan, spoke to TOBI AWODIPE on the chances of a COVID-19 re-occurrence in previously discharged patients, increasing community transmission of the virus, heightened anxiety amongst frontline workers and whether the current lockdown in the country is having the desired effect in slowing down the spread of the virus, amongst other issues.
Considering the rapid spread of the Coronavirus, do you feel safe and protected enough, in terms of equipment and tools to work with?
With the level of community spread of this infection, all doctors and nurses in the country have become frontline workers. Unfortunately, patients do not have to show symptoms to transmit this infection and this necessitates that the minimum acceptable protection must be available to work.
Given that, I do not feel safe at work at all. In fact, it appears easier to contract this disease in the hospitals, where patients walk in freely for consultations and are now infecting medical staff, than at an isolation centre.
They say we have protective gear, but I don’t see much evidence of this; what I see are the regular materials we use before the outbreak of this disease. It is even worse now that patients are hiding travel history or history of contact with infected persons, thereby misleading healthcare workers and predisposing them to grave danger.
It is also noteworthy that there is no life insurance cover, to the best of my knowledge, for any healthcare worker in the public sector, despite the clear provisions of the Pension Reform Act in this regard.
There is understandably a lot of fear amongst Nigerians now about the virus. What can you say to assuage concerns?
The situation that we are in is quite precarious. People are justified to be scared at this time, but the challenge imposed on humanity by this virus is not insurmountable. We will overcome it, like we did Ebola in 2014, but the public must understand that it is a collective effort and we all need to play our role in fighting this scourge.
We should also know that with adequate nutrition and preventive methods that are constantly publicised by the government and health bodies, we would overcome sooner than later.
For those who are really scared of the news, they need to stay sane by imbibing the information from government sources alone. The government and other healthcare stakeholders are doing their best to make this nightmare end on time and we need to do our best to support them.
Is there any chance of recurrence in a patient that had tested negative and discharged from the isolation centre?
Yes, there are evidences to this effect in different parts of the world where those who were reported to have recovered are testing positive again. There is a lot to be understood about this disease and what the world health experts are working with are emerging facts emanating from where the diseases is more severe than ours. So, yes, there is a high chance of recurrence in previously recovered patients.
Do you think discharged patients should wait a bit before re-integrating into society?
Strongly so! We must note that a first negative test cannot be interpreted as recovery. There is always the need for a second test and the period in between is also very critical, so they do not go on to infect others that didn’t previously have the virus.
There have been reports that some recovered patients tested positive abroad. Is this possible, even with discharged patients in Nigeria?
Nigerian patients are humans, like other nationalities and people of other cultures, so it is possible. As earlier mentioned, work is going on to unravel many facts, including gene studies and susceptibility issues. I believe going forward, those facts will be documented and published for the world to see.
In the course of doing your job, what are the major challenges you have had to deal with?
Unavailability of Personal Protective Equipment (PPE) mostly. Also, lack of appropriate facilities and welfare package, such as life insurance, hazard allowance and so on.
What can the government do to make your (frontline health workers) job easier?
Generally, the government should equip the hospitals and tighten the gaps in our national health insurance. Our pay package is very poor and we are dangerously understaffed. The government needs to motivate us and decentralise services, so that all level of care are as functional.
With respect to COVID-19, if the government is serious about lockdown, necessary palliative measures and effective distribution of same is extremely critical. Government should provide PPE for medical staff and I have continued to advocate that we must produce our items locally, as we are capable of doing this.
Does it worry you that Nigeria now has cases of community transmission?
I am not surprised, because that is the normal trend for infections of this proportion. What is important is to ensure that the spread is contained as soon as possible. Returnees from overseas brought the infection, mingled with families and friends and before we realised it, the infection spread quickly.
Do you think enough tests are being carried out and enough social distancing still being observed?
We are still not doing enough tests. Nigeria is the most populous country in Africa and it appears we are competing for lowest position in testing.
I, however, think that since the Nigeria Centre for Disease Control (NCDC) is doing its best to expand testing centres across the country and this would change very soon.
Can the use of facemasks and hand gloves help to prevent one from contracting the disease?
Facemasks can help reduce infection to the wearer and reduce spread from a sick person. This, however, depends on the material and type of facemasks. There are guidelines for what you should use and other PPE based on some clinical criteria. Hand gloves also have types, with different level of protection they confer on the wearer.
Do you think the lockdown is having effective in slowing spread of the virus?
Lockdown would have definitely had a strong effect, but we must understand that due to our basic instinct to survive, many citizens are beginning to default on instructions by the government and are still going out daily, putting themselves and others at risk.
If we refuse to stay home, as has been ordered, it would be harder to contain the spread of the virus in quick time.
There have been reports of medical workers contracting the virus. How has this made other healthcare workers apprehensive and have there been any changes to prevent this from recurring?
Doctors and nurses have been the major group of health workers who attend to patients, but there are ward maids, porters and cleaners who are directly involved in physical care of patients. Everyone is apprehensive, but everyone also appears to understand the essentiality of their work, so they are doing it with the highest levels of anxiety.
The first principle with community spread of the virus is to see every patient as a potential COVID-19 carrier and take all necessary precautions to avert eventualities. We do not have as much protective gears as one would expect, so protection is quite limited at the moment, thereby worsening our fears.
Some people claim that one’s blood group play a part in how the virus is contracted and chances of recovery. Is there any truth to these claims?
I am not aware of any such report carried out here in Nigeria.
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