By Chris Onuoha
Governor Hope Uzodinma, on March 20, inaugurated Imo State Task Force on COVID-19, with mandate to activate all health platforms to check the disease.
In this chat, member of the Imo State Task Force, Dr. Success Prosper Ohayagha, speaks on activities and the efforts to check the pandemic in the state. Excerpts:
Coronavirus has not subsided in Imo. What you have just noticed from the quietness at the Task Force office is a phase of the curve that has ended. That was when people were confused to ask ‘what kind of virus is this?’ It was not a new virus, but a comeback of coronavirus that has existed in the past with mutated strength; that is more related to the respiratory system. The name changed from ‘Endcovid’ – that is novel COVID -19 to SARS Cov-2.
As a result, the country went into lockdown with measures to contain it. What happened at this stage was that, people took heed to the advice we gave, by way of staying at home, hand washing, physical distancing, wearing face mask and others. We saw that the statistics that was actually going up started going down.
At this point, the economy had to open, because if you lock down for too long, the state may experience unrest caused by hunger and business failure similar to the #EndSARS protests. As the economy starts to open up, the curve obviously shoots up and we have to go into the next phase of battling it. Now, this next phase, mind you, it was one body controlling the whole thing; nationally, the Presidential Task Force (PTF) and the state inaugurated Task Force.
What we did at this stage was to assign responsibilities to different ministries in Imo to handle. By this, we mean giving relevant ministries like education to handle schools, commerce and industries to take care of markets and commercial activities, transport ministry and others to take care of their various sectors. Health and its component agencies undertook the primary and related areas of health in the management of the COVID-19 cases. Everything was domesticated according to each ministerial responsibility.
Now, it is very natural to think that since people are not exhibiting severe symptoms and serious cases as it was predicted from the beginning, doubts set in. Some people insinuated that there is no coronavirus while some think, it was just a mere mythology; something that was brought to scare us. This resulted to people flouting the lay down rules.
Transporters carry more passengers, churches filled to brim with no physical distancing and observation of other rules. It is apt to note that there is something called the ‘W – Curve.’ The first phase slid down, but now it is coming up in W-Curve. When a disease makes a second return, it is not with the same strength as before. Now, we have more mutated strength coming up. Some days ago, England initiated another lockdown because it is going up. One of the states in US has already imposed a lockdown. US has recorded over a hundred thousand deaths. If you check the wave globally, if we don’t start now to put things in order, we might be caught unawares.
Task Force mandate
In Imo State, government was barely one month before the virus struck. As of that time, the government did not even have a cabinet. Only the SGF, Chief of Staff and Attorney General were in office, no Commissioners. But in his wisdom, Gov Uzodinma assembled technocrats, a think-tank group called the Task Force to handle the emerging virus.
They never thought of building isolation centers but rather thought of strengthening existing institutions such as hospitals and other medical facilities in the State. The mandate was to utilise any available fund meant to build new facility, to strengthen an existing institution. As a result of that, we have to look at viable institutions such as the Federal Medical Centre, the Woddi Centre and other facilities available. We also had the Imo State University Teaching Hospital isolation centre. However, whether federal, state or local government, coronavirus is a disease attack everybody.
So, we had one straight response. There was no dichotomy between the federal and state government. The Federal Medical Centre was handy for use, as they had handled similar tropical diseases in the past. That was how we started. Secondly, we thought about risk in communication and noticed that until people understand the magnitude of the disease, we would not go far. That, however, explored mass media options, introducing algorithms, jingles and press releases every week concerning the disease.
You should also bear in mind that when it came, we hadn’t any case in Imo. You may ask what we did differently. We closed our borders. Viruses don’t move, but human beings move it. Notwithstanding, human beings will always cut corners despite measures. But in our case, we had a good relationship with traditional rulers, town unions asking them to report any person returning from outside the state.
These were our initial measures before the rising cases in Imo. By then, we were also ready medically because during the period between the initial stages to when it rose, we studied what other people were doing to curtail it. Our next strategy was strong surveillance and monitoring team. We embarked on contact tracing both directly and indirectly for anyone that have tested positive to the virus.
We never used force to achieve this; rather we applied diplomacy and psychological reframing of the mind. Already people had developed the mindset that isolation centers are death traps for even healthy people. Honestly, Imo government was proactive enough to tackle the situation headlong from onset. The state gave us a five-star hospitality facility, “Woddi” for an isolation centre. The environment including others facilities erased this negative perception about isolation centers being a place of fear and death sentence.
At that point, people in Imo State willingly submitted themselves for test. We also managed cases from outside the State. At a point, a high profile case from another state was brought to us for care, and we responded with success. The news attracted more influential personalities with such case to trust our capabilities.
There was a social challenge; hunger. Economy was down, things were at a standstill and people felt it is better to succumb to corona virus than die of hunger. There was so much grumbling in all sectors of the economy by transporters, traders, artisans, hoteliers and others who depended solely on daily income for living. Listening to their cries, we had to use diplomacy to sensitise them to apply all safety measures to keep safe.
Secondly, the Healthcare workers’ welfare came to bear. These personnel started to demand for special allowances to function. However, their jobs were very essential but we considered that coronavirus is not different from other similar diseases that came up or existed such as Lassa fever, tuberculosis, or even Ebola.
We had to appeal to them to consider that the disease is everybody’s burden including their family members. We also had challenges from the security agents who at the point of enforcing compliance, made it difficult for the healthcare workers to do their job. Some of them did not understand the magnitude of the situation, but we had to dialogue and appeal to them to understand. Another major challenge is choice of drugs.
Most virus cases, once they hit the immune system and you don’t develop the symptom, which is the period the inflammatory system is high, you will survive. But within this period, one or two conditions can bring down your immune system. Pregnancy is one of such. We had a case where a pregnant woman, tested positive, who delivered twin baby could not survive, but the children lives. Pregnancy brings down your immune system naturally. A critical situation in this case is when a person is induced with anesthetic drug for operation that weakens the system.
When we started, there was paucity of fund. Remember I told you that the government was barely one month old when this corona virus struck. The Task Force was a Think-tank group who were doing much of the technical aspect of the fight. There was not much of fund-involving programmes. Areas that really required fund involvement were communications and logistics which the government responded adequately. Even in the paucity of funds, his Excellency was very responsive. This contributed to the success we recorded so far in the first phase of the pandemic fight.
What we did differently
This, according to my initial response on border control was one of the measures we adopted for effective control. But nonetheless, security check at some of the border points became porous. At one point, a truck conveying huge number of people was stopped at a checkpoint.
Instead of asking the driver to return back to its exit point, the vehicle and its human contents were detained for some days. While we conduct tests on them, 26, out of the 92 persons who were in the truck tested positive. And while waiting for the test to come out, border security has asked them to return home.
This is a breach of the security system at some state borders. However, the recorded number of positive cases from such situation accounts for the recorded cases in the State. For the fact that they were not treated in the state, this accounts to our number shot up.
Glimpse into new phase
The first phase was filled with so many activities that got us prepared. Talking about the second phase, it is a very critical period. This phase have what we call ‘super spreaders.’ The EndSARS protest that just ended was a super spreader too.
A lot of people with or without facemasks congregated for 14 days chanting together, protesting, and that is one major way to spread the virus. Another super spreader is the Christmas period. When people come back home to be with their loved ones, lot of partying, hugging and eating together will occur. It will be very difficult to control physical distancing. At this point, I am making it clear to Imo citizens and the general public that if it not necessary for you to travel, ‘please don’t go.’
People should put on face mask all time. If you are going to protect your face, use a face mask. It is best to use sunshade to protect your eyes with nose and mouth mask than use transparent face shield. The shield only protect your eyes and do not adequately protect the critical areas of transmit, which are nose and mouth.
So, my earnest advice is to use mask than to use shield. This is not a fashion show. It is a matter of protecting life. Alcohol base sanitizers is still a good option, but the best advice is ‘stay at home’ and do not go out if not necessary. I don’t see adherence to lay down measures as a lock down in disguise. Obviously, you can’t disguise death.
If this is the only thing that will make you stay alive, do it. The irony of the yuletide situation is that ‘if you don’t go to your village to celebrate the Christmas, will anything happen? If the answer is yes, then you take the risk but must adhere to safety measures. But if it is for familiar fun, then, you are at risk of either spreading or contacting the virus.