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ESCALATING CASES: Mistakes that threw Nigeria into turmoil — Experts

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Nigeria in handcuffs: The DISCOs and the spirit of NEPA
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…Say containment efforts slow, suggest total lockdown

By Chioma Obinna

As state governments continue with adhoc measures, some medical experts in Nigeria have described the containment efforts of the Federal Government as slow and unproductive.

To this end, they demanded a total lockdown of the country to avoid escalation.

They specifically lamented that many critical health experts are lacking, adding that there are no purposely built isolation centres across the nation.

Speaking, National Chairman and College Vice President, West African College of Physicians, Prof. Abel  Onunu,  said the current Covid-19 infection crisis in Nigeria is self- inflicted.

He said: “Africa had enough warnings about the dangers but did not act with the decisiveness required to prevent importation of the disease into our nation.

“In Nigeria, we have failed in preventing importation of the virus into our country.  We are in the phase of containment now, how successful that is done will determine what we are going to see in the next stage of the epidemic. We are not in a very comfortable position considering the poor state of our health care system and infrastructure.”

Key strategies

On his part, President, Nigerian Medical Association, NMA, Dr. Francis Faduyile, observed that certain key strategies have been largely absent or sub-optimally implemented in the ongoing efforts to contain the spread of Coronavirus.

He said the severe inadequacy of critical care facilities like purposely-built Care Units (ICU), in Nigerian hospitals, is making matters worse in the containment efforts. According to him, ICUs with Ventilators/artificial respirators make the difference between life and death in complications from Covid-19.

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“It is scary that the dearth of these facilities is the same in all the 36 States and the FCT. Given these inadequacies,  NMA, therefore, calls for immediate commencement of supervised self-isolation in any manner that will protect public health,” he added.

Supervised isolation

Faduyile said immediate commencement of supervised self- isolation would ensure that returnees from the countries with high prevalence will adhere to instructions and confine themselves to a location to protect members of the public.

He called on the federal government to immediately commence a strategic partnership with the states and their relevant organisations on day to day basis. The NMA boss said the weakest link in the chain can rubbish every effort of the stronger parts.

In addition, he urged state governments not to relent on the excuse that there are no confirmed cases of COVID-19 in their states.  Continuing, he stressed the need for uniformity in implementing the lockdown orders on non-essential services.

Total closure

Corroborating his position, President of Commonwealth Medical Association, Dr. Osahon Enabulele, called for total closure of all entry points into Nigeria. He further urged government to urgently deploy more facilities and resources to combat the pandemic.

Enabulele, who recently toured some isolation centres in Lagos and Abuja, to ascertain the state of preparedness, called for effective reduction of mass gathering. He said the total closure became necessary considering the increasing number of imported cases in the country.

Enabulele explained that:”There is a need for government to go beyond partial closures, by extending the closure to every point of entry into Nigeria. I want to urge government to quickly consider this so that the cases already in the country can be effectively managed. Every effort needs to be made to get government to enforce a total shut down of the points of entry into the country, especially as a fragile healthcare system like that of Nigeria may find it difficult to cope with the kind of explosive situation that occurred in China and Europe.

‘’There is an urgent need to improve the capacity of the few Isolation centres through the deployment of more health personnel, resources and equipment, empowerment of  few healthcare personnel currently on the ground, through the provision of adequate and appropriate Personal Protective Equipment (PPEs) and incentives. This is to improve the effectiveness and efficiency of the Isolation centres, as well as boost the morale of health workers, particularly those already in the field combating the dreaded pandemic.’’

Unbundle

He also called for the expansion and equipping of the isolation centres, public health institutions, including the Primary Health Care facilities.  ‘’A nationally mobilised citizenry is crucial and has helped other countries in addressing the scourge.

‘’From the evidence on the ground, the NCDC seems already overburdened. There is, therefore, the need to consider unbundling the NCDC to enable the agency to attend to the practical realities in the field more responsively.

‘’I see no reason Nigeria should have only four public diagnostic reference laboratories to cater to its over 200 million population. Why shouldn’t each of the federal teaching hospitals and federal medical centres have the diagnostic capacity for managing cases of Covid-19 and other infectious diseases?’’ he queried.

Volunteers

On his part,  Medical Guild Chairman, Dr. Olujimi Sodipo, who also decried the delay in closing the country’s borders called for a total lockdown of Lagos State. According to Sodipo the most difficult aspect of the containment is contact tracing, adding that since the numbers are growing there is need for government to ask for more volunteers.

Noting that shortage of experts may hamper management of patients if the number increases, he said rather than  indiscriminate posting of medical doctors from other general hospitals to the Infectious Disease Hospital, IDH, there is a need to get volunteers.

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