COVID-19: How insufficient facilities may ruin Nigeria’s containment efforts

By Sola Ogundipe and Chioma Obinna

Even before Nigeria recorded its first case of the coronavirus disease (COVID-19), there had been outcry nationwide over what was widely perceived as the country’s ‘unpreparedness’ towards containment of the dreaded respiratory disease.

Many Nigerians expressed reservations about government’s claims of readiness to find, isolate, test and treat every coronavirus case in order to break the transmission chain of the disease.

The Federal Ministry of Health, FMOH, and the Nigeria Centre for Disease Control, NCDC, have since been under fire.

Currently, Nigeria is among African countries significantly affected by the COVID-19 pandemic.  Just last week, within 48 hours, the country recorded 15 new cases. On  Monday, 23rd March, Nigeria had recorded a total of 36 cases and one death – a 67- year- old man.

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Critical health watchers are expressing fears that this number may increase in the coming days. For them, their fears have been confirmed by the skyrocketing imported COVID-19 cases in the face of Nigeria’s weak health system.

However, the World Health Organisation, WHO, had earlier urged African countries to “wake up”  to the increasing threat and to “prepare for the worst and prepare today.”  The WHO had also listed Nigeria as one of the 13 African countries most at risk of the pandemic.

Amidst these concerns raised by WHO, Nigeria still lacks sufficient number of laboratories and isolation centres needed for a pandemic of this nature.

As at the time of filing this report, Nigeria parades an abysmal five designated coronavirus laboratories to cater for over 200 million population.

The laboratories, unfortunately, vare located in 4 states across the 36 states including the Federal Capital Territory, FCT, Abuja.

The centres are the NCDC National Reference Laboratory, Abuja, FCT; Irrua Specialist Teaching Hospital, Edo state; the Virology Laboratory of the Lagos University Teaching Hospital, LUTH; the Nigeria Institute for Medical Research, NIMR, and the African Centre of Excellence for Genomics of Infectious Disease, Ede, in Osun state.

There are also worries that with the number of people screened so far, Nigeria may be failing in the WHO  recommendation that testing should be made available for all that need it.

Good Health Weekly can authoritatively report that the  NCDC  isolation centre located in Gwagwalada, Abuja, University of Abuja Teaching Hospital is currently undergoing construction.

Further investigation showed that the newly built Accident and Emergency, A&E, wing of the hospital which was financed by the hospital through its Internal Generated Revenue, IGR, and offered to NCDC and the federal government as a temporary isolation centre, is seriously begging for expansion.

Currently, the wing is not appropriately equipped to tackle the spread of the virus. A reliable source told Good Health Weekly, that the health institution has received little or no support from the government. Today, only Lagos state has a functional isolation centre.

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In Ekiti state, the state government had converted an eight-bedded facility into an isolation centre. Health watchers say such a facility cannot cope in the event of a surge in COVID-19 cases.

Also in Oyo state where a case has just been confirmed as at the time of filing this report, findings show that there was no sign of preparedness by the state government.

At the University College Hospital, UCH, there is only a 4-bedded isolation centre with an empty chlorine tank, non-functional monitoring device, no water etc even though reports say the state government has directed that funds should be made available to equip the place.

At the 2 Division, Nigerian Army, Odogbo in Ibadan where the state also claimed to have another isolation centre, there were no test kits and medical consumables were inadequate with low staff strength.

Confirming the state of alleged isolation facilities in Oyo, the State Chairman of the Nigerian Union of Journalists, NUJ  Mr Demola Babalola described the situation in Oyo as unpleasant.

According to him, the government-designated centres for infectious disease control which would double as Emergency Operation Centre in Olodo area of the city was still a ghost land.

Last week, the Governors Forum announced that they were going to build isolation centres in every state of the nation, however, the situation in most states is not cheering.

As for the few isolation centres that are fairly habitable, findings by Good Health Weekly revealed that they need expansion, equipment such as ventilators and increase in healthcare personnel, anaesthetists, and intensivists among others.

According to a Public Health Consultant and Medical Scientist/researcher, Dr Casmir Ifeanyi, Nigeria is failing in testing.

“There are no test centres in the South-South, North West and North East zones of the country. All the available test centres are concentrated in the South West, North Central and South-South zones. Ifeanyi, who is National PRO of the Association of Medical Laboratory Scientists of Nigeria, AMLSN, called for the adoption of global standards.

“In the passing years, I have made appeals to the Governor of Enugu State, to set up a public health reference laboratory in his state. I have led a team to the Governor and he sent the Deputy Governor to interface with us. These were the issues we raised with him, but two or three years down the line,  he has not done anything about it.  The state keeps having a record of Lassa fever, now it has a record of coronavirus.

“The same thing is applicable to Ebonyi state which is also endemic for Lassa fever. We also made overtures to the Governor of the state directly and through the media that a reference laboratory is put in place because these states are vulnerable.

“The same thing applies to other states in the South West, particularly  Ondo State that is at the  border with Edo State that is also endemic  for Lassa fever.”

“The states in the South East are not ready for COVID-19 and nothing can be further than that.   They are ill-prepared.   The highest hospital in Enugu is the Federal   University Teaching Hospital and the state-owned Enugu State Teaching Hospital. If you take a tour of the hospital, you will not in any way pass it for a Teaching Hospital. I don’t know what the state government is doing to relocate that hospital to a proper place where it can function as a teaching hospital.    I also think that the capacities of the laboratories in the two hospitals I have mentioned are nothing to write home about.”

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Ifeanyi said strengthening and expansion of COVID-19 laboratory diagnostic capacity should be uppermost as part of the response and preparedness measures put in place by the Federal government against the pandemic in Nigeria.

“In this particular time that we are bedevilled with this outbreak, what we need to do is to develop an emergency crack medical laboratory workforce.   We need the NCDC to go beyond training their staff to begin to engage medical lab practitioners and medical laboratory scientists in Teaching Hospitals and FMCs and train them on how to carry out work now in the lab and how to  carry out the diagnosis of this disease.”

For the President of the Common Wealth Medical Association, CMA, Dr Osahon Enabulele,  expressed hope that after successful management of the pandemic, government at all levels would henceforth give top priority to the rebuilding and strengthening of Nigeria’s weak health system, through sustained political commitment, provision of the necessary

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