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COVID-19 cases climb to 22 as FG embargoes international flights

By Lawrence Njoku (Enugu), Chukwuma Muanya, Wole Oyebade, Paul Adunwoke (Lagos), Nkechi Onyedika-Ugoeze, Joke Falaju (Abuja) Ann Godwin (Port Harcourt) Charles Akpeji (Jalingo), Murtala Adewale (Kano)
22 March 2020   |   4:40 am
Yesterday's confirmation of 10 new cases of Coronavirus (COVID-19), which pushed the overall number of positive cases in the country to 22, has sounded the alarm that the country

How Low Attention To Taraba-Cameroon Land Border May Fuel Spread
• FG Gives Conditions For Inter-state Train Services
• Isolation Centres Not Enough
• Nigeria Must Invest In Epidemic Preparedness — Faduyile

Yesterday’s confirmation of 10 new cases of Coronavirus (COVID-19), which pushed the overall number of positive cases in the country to 22, has sounded the alarm that the country could be on the way to facing a dire health crisis in the weeks ahead.

Should that happen, the country’s poor healthcare system could experience shutdown within days making the timely containment of the deadly disease difficult.

Indeed, there are palpable fears that with only five test centres serving the over 200 million Nigerians, and the less than convincing state on many intensive care units in designated and tertiary hospitals, containing the spread of the virus may prove a Herculean task.

Announcing the 10 new cases of coronavirus, (seven in Lagos and three in the Federal Capital Territory (FCT), Abuja, the Health Minister, Osagie Ehanire, said the infection was now in three states – Lagos, Ekiti, and Ogun, as well as the FCT. The three new cases in the FCT (two males and one female) all returned to the country between March 14 and 18. Only one of them has been in self-isolation.

According to Ehanire, all the new cases are Nigerians, adding that all but one of them have travel history to the United Kingdom, The Netherlands, Spain Canada, and France. They all returned one week ago. The 10th is a close contact of a previously confirmed case.

Of the 22 cases, Ehanire, who said Lagos plays host to 16; FCT, 3; Ekiti, 1, and Ogun, 2,” added that two of the patients have been discharged, and that “all cases are clinically stable and receiving adequate care”.

In their warnings that Coronavirus may soon shut down the country’s healthcare system if it is not hurriedly contained, President, Pharmaceutical Society of Nigeria (PSN), Mazi Sam Ohuabunwa, and his counterpart at the Nigerian Medical Association (NMA), Dr. Francis Adedayo Faduyile, told The Guardian, yesterday, that at the rate it was going, the impact of the virus could be catastrophic and endemic on the health sector.

Ohuabunwa said: “Currently the impact is phenomenal, but could potentially become catastrophic. Firstly, we are aware that China and India, Nigeria’s major sources of raw materials, medical equipment and finished pharmaceuticals are currently ‘out of business.’ So, shortages are already occurring and will become increasingly serious as the pandemic subsists. That means that pharmaceutical importers and Manufacturers are already experiencing reduced activity, which may lead to a cutback in operations and manpower redundancies.    
“Secondly, with the increasing scarcity, prices of medicaments, especially those related to managing the infection are inching up and that may fuel inflation and reduce the purchasing power of the ordinary citizens and perhaps, limit their ability to take preventive measures.
“Thirdly, should the shortages persist much longer, there may be a resurgence in the incidence of substandard and falsified medicines. It has long been established that scarcity of medicines is one of the key motivators of fake medicines.
“Fourthly, with increasing cases of Coronavirus infection in the country, our health infrastructure and facilities, which are fragile in normal times, may crack with increased pressure with dire consequences. More so, with limited emergency medicine, and critical care space. Our hope and prayer are that the infection is contained in the urban areas because should they reach our semi-urban and rural areas, the mortality will go out of hand,” he stated.
On his part, Faduyile, told The Guardian: “This is the time to further strengthen Nigeria’s core capacities to respond to public health emergencies. Therefore, the Federal Government and their partners must invest in epidemic preparedness and health safety to promote and protect its people and avert the negative socio-economic impact associated with outbreaks.”

According to him, with no vaccine or treatment, the most effective way to stop COVID-19’s spread was to limit person-to-person transmission by identifying infected individuals as quickly as possible, and isolating them for treatment before they infect others, adding that this strategy worked against the Severe Acute Respiratory Syndrome (SARS) epidemic in 2003.

He urged the Federal Government to strictly enforce the international standard routine screening of every traveller at the country’s major international airports and seaports.

Dearth Of Treatment Facilities
Abuja hosts two vital facilities as far as the fight against COVID-19 is concerned. But a fortnight ago, Ehanire told newsmen that the isolation centre at Gwagwalada would be ready in April, adding that funds approved for the Nigeria Centre for Disease Control, NCDC, had been disbursed to improve the Isolation Centre in Abuja with the contractor asked to fast-track the upgrade of the facility.

However, when The Guardian visited the isolation unit at the National Hospital, Abuja on Friday, the hospital’s Public Relations Officer (PRO), Dr. Tayo Hasstrup, said that the hospital had completed the renovation and upgrading of the unit. 

The unit has an elevator dedicated to it though which only patients access the centre while the neat-looking air-conditioned rooms are all en-suite and equipped with oxygen panels. 

Also, the isolation unit is equipped with high-tech security gadgets, while the movement of persons around it is highly restricted.

The Chief Medical Director of the hospital, who also heads the government CMD’s Committee Team on COVID-19, Dr. Jaff Momoh, told The Guardian that even though the National Hospital is not an isolation hospital, it has put in place five rooms, which are all en-suite to serve as isolation unit if the arises. 

Momoh explained that each patient is entitled to his own room, his own care facilities, including a ventilator, adding that the hospital has the personal protective equipment that would be used by the personnel. 

According to him, about 15 nurses, five doctors and other personnel have been trained and deployed to man the unit while general training will be organised for all the staff of the hospital. 

Kano In Need Of Intensive Care Upgrade
IF Kano State records positive cases of COVID-19, it may be a daunting task to manage them in the state as the major tertiary health facility there, the Aminu Kano Teaching Hospital (AKTH) appears to be in need of basic facilities in its intensive care unit.

The AKTH’s ICU presently has only five respirators, one critical life support machine, among other facilities, and responding to the needs of a reasonable number of COVID-19 patients would completely ground the facility. All three suspected cases of COVID-19 in Kano State tested negative.

But a senior medical officer in the hospital, who prefers to remain anonymous said the hospital possesses the manpower required to manage the viral disease, adding that the Federal Government must, however, make resources available to it.

“You see for any facility to manage such a viral disease, such a facility has to be enlisted by the Federal Ministry of Health, which will also provide all the facilities needed to manage the disease.

“Apart from AKTH, no facility in the North has the capacity to test and manage Coronavirus. And it is not as if the management is rocket science. At AKTH, we have well-trained doctors and medical officers, who can offer their expertise, but in this kind of situation, you need government intervention.”

Wear And Tear At UPTH ICU
EQUIPMENT at the ICU of the University of Port Harcourt Teaching Hospital (UPTH), which came stream during the administration of President Olusegun Obasanjo has experienced some form of wear and tear, while some are no longer functional due to poor maintenance culture. Some have become totally obsolete.

When The Guardian visited the facility, yesterday, it was discovered that the patient monitor is no longer functional.

Findings also revealed that the unit is in dire need of ventilators, respirators, and a central monitor.

According to top management staff in the unit who craved anonymity, “When the ICU commenced operations in 2005, it was circuited in a way that all patients were connected to the central monitor. So, everything about patients were displayed on the central monitor and that enhanced service delivery because the nurse or doctor could take up a patient and do whatever he wants. But such is no longer functional today because the equipment is not working again, and it has affected the speed of work at the ICU.”

Dr. Opusunji Tamuno, a consultant paediatrician said the government needs to equip the facility with ventilators and respirators etc. so that any case of COVID-19 would be successfully managed.

No Test Centre In Rivers
ON why the state does not have a disease control centre and COVID-19 testing centre, the Director, Public Health and Disease Control, Golden Owhonda, said it is not the number of testing centres established in a state that matters, but how much effort is being put in place to contain the virus.

UNTH Announces Readiness
THE University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu prides itself as a medical facility with some of the best facilities in Africa, with an ICU that is “very effective and responsive, and which has continued to perform open-heart surgeries, brain surgeries and other complex cases.”

As the country battles the COVID-19 scourge, officials at the hospital’s ICU say they are ready and prepared to undertake cases if called upon to do so since experts there have handled complex issues and have continued to excel in them.

Speaking to The Guardian on the development and the country’s readiness to handle the medical emergency, a Development Economist, Dr. Chiwuike Uba, stated that the COVID-19 pandemic had once again exposed Nigeria’s unpreparedness to handle emergencies; especially, medical emergencies.

“This clearly is a reflection of our resort to ad hoc and interventionist approaches to resolving fundamental problems. Given what the country witnessed during the Ebola epidemic and the recurring Lassa fever episodes, it is very disheartening to note that all Nigeria has at the moment for testing of Coronavirus is only a few centres. Unfortunately, the available diagnostic centres are not evenly cited for efficiency and effectiveness,” he said.

According to him, “ the distance between the centres from the catchment states, in addition to posing reputational risks, presents even a worse medical risk to the people. Let me rephrase this. The distance exposes the sample and the medical personnel (including people along the roads leading to diagnostic centre) to risks. They may contract the disease while taking the sample for confirmation. Furthermore, the inherent distance may delay treatment and even subject the suspected carrier to inhuman treatment.” 

Isolation Centres A Joke
Commenting on the state of isolation centres in the country, President of the Guild of Medical Directors, Prof. Femi Dokun-Babalola told The Guardian, “This is a joke; the government is not serious and does not actually appreciate the severity of this condition. Governments, both federal and state did not prepare for this until the cases started appearing. Even now, many states have earmarked cockroach and mosquito-infested places for the patients. This is the reason the first case in Nigeria (the Italian) almost absconded.” 

According to him, the government should urgently locate proper hospitals that are fully equipped and comfortable so that patients do not feel abandoned and isolated. We need isolation centres that can be up-scaled to intensive care units as the need arises.
“The government currently does not know how many people are infected, carriers of the virus or asymptomatic. The government does not know how many intensive care beds are available, fully equipped and manned; the government does not know the capacity and capability of its own hospitals, and it does not have any idea of trained infectious disease experts in the country; where they are; and what they can offer. The government does not also have any projection or plan for the numbers of possible sick patients if this virus takes hold in Nigeria. The government is not serious,” he added. 
Meanwhile, some Nigerian officials at the country’s border with Cameroon in Taraba State are bothered at the scant attention paid some border posts, while airports and seaports are receiving immense attention.

Citing the way resources and energy are being expended on airports and land borders like Badagry in Lagos State, and Idiroko in Ogun State, they complained that such was not the case in their areas.

Wondering “if these ignored border posts are not part of Nigeria,” a port health personnel said, “could you believe that we bought these hand gloves we are wearing with our money?”

The Guardian findings showed that various villages in five local government councils of the state share common boundaries with Cameroon, which has a higher number of positive cases than Nigeria.

SHORTLY after the country’s COVID-19 cases jumped to 22, the Federal Government, yesterday, directed the closure of the Murtala Muhammed International Airport in Lagos, and the Nnamdi Azikiwe International Airport, Abuja, as part of fresh measures to contain the rampaging disease.

The two busiest airports shall be temporarily shut to all commercial international commercial flights.
A statement by the Director-General of Nigerian Civil Aviation Authority (NCAA), Captain Musa Nuhu, stated that the shutdown shall last till April 23, 2020.

Nuhu said the new measure was in addition to the closure of Mallam Aminu Kano International Airport, Kano, Enugu International Airport and the Port-Harcourt International Airport.
ON its part, the Nigeria Railway Cooperation (NRC), yesterday, rescinded its decisions to suspend train services due to COVID-19.

Earlier in the day, it had announced the suspension of train services to curtail the spread of the virus, but in a statement signed by its Public Relations Officer, Yakub Mahmood, the outfit said the board and management reviewed its earlier decision and decided to provide passenger train services with some conditionalities.

The conditions include passengers providing their full names, addresses, dates of birth, and means of identity.

NRC urged all passengers to cooperate with any other measures put in place to protect Nigerians from the virus.