Laments increase in infant and maternal mortality
.Issues new case management guidelines
.Keeps mum on how it obtains samples from Kogi
.FCT reopens worship religious houses
By Omeiza Ajayi
ABUJA: The Federal Government has kicked against the diversion of antiretroviral drugs which are currently being used for the treatment of Covid-19.
While it lamented the steady rise in infant and maternal mortality as a result of the fixation on the Covid-19 pandemic, it urged hospitals to continue to render services to Nigerians rather than turning them back because of Covid-19.
This was as the Nigeria Centre for Disease Control NCDC issued a new case management guidelines regarding the quick discharge of Covid-19 patients.
The NCDC however declined to answer queries regarding how it obtained samples from Kogi which it tested and recorded three positive cases for the state.
These were disclosed Thursday in Abuja during the daily briefing of the Presidential Taskforce PTF on Covid-19.
Speaking on the impact of Covid-19 on the nation’s health services both in terms of the quality and access to care, National Coordinator of the Taskforce, Dr Sani Aliyu said the focus on the Pandemic has led to a rise in mortality caused by other factors.
He said; “As a result of the Covid-19 pandemic, the whole world has engaged in an unprecedented response against this virus and the disease, and quiet rightly too. However, as a result of this, we are seeing a situation where health services are not concentrating on other health conditions. If anything, the emergence of Covid-19 has led to the detriment, in terms of care, for other essential health services and these negative impacts include reduction in health services that could arise from disruptions in medical supply chain or the availability of human and financial resources and also in a decline in people accessing healthcare simply because of fear of getting infected by Covid-19.
“We have also seen reduced access to healthcare for diagnosis of other conditions and the most vulnerable population like children, the elderly and those with underlying illnesses such as diabetes. As I have said in the past, if you have fever today in Nigeria, it is far more likely that it is going to be due to malaria than due to the Covid-19 infection and people need to be able to access care.
“We have been observing a steady rise in maternal and child mortality as a result of disrupted essential services. We have also seen life saving maternal, newborn and child health services, routine vaccinations, access to carry for chronic conditions such as HIV and other treatments not being delivered in our hospitals. We are also seeing diversion of certain products like second line HIV drugs, for instance, Lopinavir/Ritonavir that is being used for HIV treatment, that is currently being used for Covid-19 infections. As mentioned by the NCDC, we are asking health institutions to make sure that they have proper assessment processes for people presenting with possible Covid-19. They must have holding and screening areas so that their staff can protect themselves and at the same time be able to deliver care. Hospitals are there to look after patients. Hospitals are not there to turn patients back. People should not be allowed to suffer or die because of Covid-19 infection. We must not allow preventable deaths to occur in our communities simply because of Covid-19 or because we are afraid of it. The PTF will continue to protect the health and safety of our health workers both in the public and private sector. We are appealing to the private sector facilities to make sure they have adequate PPEs to protect their staff”, he added.
New Case Mgt Guide
Director General of the NCDC, Dr Chikwe also announced new case management guidelines for Covid-19.
He said; “Last week I mentioned that we were working on a new case management guidelines and we have now published the third version of our new case management guidelines. There have been new sciences emerging about the duration of the infectivity of individual patients which led to the WHO issuing new management guidelines of course adapting them to local circumstances.
“The key thing is that the management of Covid-19 remains primarily supportive. We do not have any treatment so far that has any proven impact on morbidity. So, the five general areas of management are supportive management of the symptoms the individual has, managing whatever pre-existing conditions, supplemental oxygen therapy to different extent, treatment of bacterial infections and ensuring that patients are well nourished and well hydrated.
“In practical terms, one of the major changes that has happened is the discharge criteria. The two critical groups of patients are symptomatic patients any asymptomatic patients. For symptomatic patients, they may now be discharged at least 10 days after symptoms onset and at least three days without symptoms. If you are symptomatic, you can be discharged if you have had three days without symptoms in addition to at least 10 days of symptoms. Of course if your symptoms last for longer, we will wait for a while, managing and supporting you. If you are asymptomatic, you can be discharged 14 days after your first positive test. So, we no longer have to wait for a negative test to discharge. You can be discharged 14 days after your first positive with confidence that you can go home, that you are no longer infective and you are not at risk or putting anyone else at risk. Change is difficult, even though we have published these results, many physicians are still hesitating to use them but we can assure everyone managing cases that 10 days is what the evidence says, but we have added four days to make it a neat two weeks for people to implement discharge for asymptomatic patients.
“In the same vein, we have also removed antivirals from our treatment guidelines. The trials for Chloroquine and Hydroxychloroquine will go on. We have no problem with that but we are asking that we restrict the use of these medicines to those trial settings and not use them casually around the country”, Iheakwazu added.
Chairman of the Taskforce and Secretary to the Government of the Federation SGF, Mr Boss Mustapha said the PTF has continued to observe the take-off of Phase two and implementation of the additional guidelines nationwide.
He said; “State oversight of this phase of the response is very critical. The response needs to be decentralized to the LGA level, identifying high burden LGAs and ensuring mapping of adequate support to rapidly trace, test and treat cases.
“States need to drive aggressive campaigns to engage communities to address behavior change and debunk misconceptions and stigma. Traditional and religious institutions have a role to play in sensitizing communities about COVID 19.
“As we approach the weekend, we remind the public to be aware of the guidelines set for restricted opening of places of worship. National guidelines have been shared with the states and we expect that protocols will be agreed with religious leaders. Compliance is important to avoid unwanted consequences that put the lives of people at risk of contracting COVID19. We urge utmost caution at all times.
“We have received reports about citizens refusing to help with contact tracing as well as going into isolation after testing positive. It is in the interest of everybody that contacts are traced to slow down the spread. It is also in our interest to go into isolation facilities for close monitoring. Several fatalities have been recorded due to change in the condition of patients while staying outside the isolation facilities. Our appeal is that if agents of the state get in touch with you regarding testing, contact tracing activities, please cooperate
“Also, let’s be prepared to be quarantined and to monitor our health for onset of symptoms because we need to break the chain of transmission and prevent the further spread of COVID-19 in our dear country”.
Moves to slow down infection of Health workers
“Earlier in the week we raised the red flag and enumerated our efforts to cut down the rate of infection among medical workers. The NCDC is stepping up training on infection, prevention and control to slow this emerging situation down. We need our health workers to be healthy and available. As always, we remain very proud of you all”.
Minister of Health, Dr Osagie Ehanire disclosed that the National Primary Healthcare Development Agency is discussing options and guidelines of supervised out-of-hospital isolation and care with some States, which is either home-based care or based in communal space, like school dormitories, since schools are presently closed down.
On test kits, he said; “To comment on various test kits said to be in use in Nigeria, especially antibody-based test kits, it is important to advise that only four of the kits have been evaluated by the Medical Laboratory Science Council of Nigeria and all four failed the validation tests. No antigen test kits has yet been evaluated. This means that results obtained from these tests are not tenable for diagnostics, being deficient in sensitivity and specificity and are likely to give false results and mislead people. The NCDC certified laboratories in Nigeria use WHO recognized PCR testing methods which give reliable result. Though expensive, this option is right and we have 30 laboratories deployed, to establish at least one laboratory in every state”.
The Federal Capital Territory FCT Administration on its part has adopted the guidelines issued by the PTF on the reopening of worship centres.
Consequently, worship centres are to resume service henceforth but must follow all protocols as announced by the PTF.
FCT minister, Malam Muhammad Musa Bello in a statement said woshippers must ensure social distancing of two metres and also adopt all non-pharmaceutical measures against Covid-19.
He advised those above 55 years and others with underlying health challenges to worship at home.