The world is almost at standstill at the moment, courtesy; coronavirus disease (COVID-19). Most countries are in lockdown, partial or total, grasping desperately to contain the pandemic.
The outbreak of COVID-19 might have been stressful for people. Fear and anxiety about the pandemic have also been overwhelming, causing strong emotions in adults and children. Coping with the challenges of the lockdown that follows is health sapping. Nigerians and the authorities are weighed with the burden of the disease.
The Centres for Disease Control and Prevention (CDC), gave a graphic insight into the burden of the pandemic: “How one responds to the outbreak depends on one’s background, the things that make one different from other people and the community we live in.
“During this infectious disease outbreak, stress can include fear and worry about your own health and the health of your loved ones, changes in sleep or eating patterns, difficulty in sleeping or concentrating and worsening of chronic health problems.”
Chairman, International Institutes of Advanced Research and Training, Chidicon Medical Center, Owerri, Imo State, Prof Philip Njemanze, advised the Federal Government to look inward in coping with COVID-19 challenges. He told Daily Sun: “You don’t listen to what Americans and Chinese and the rest of the world are doing, they will do their own.
“Nigerian doctors know their duty. I expect government to work with our doctors and scientists to come up with national programmes on how to deal with the virus. We have been dealing with things on our own before now. We do not need the World Health Oganisation (WHO) to tell us what to do. We should be able to do things ourselves at this time of crisis.
“You do not cure a disease with a litre drug because the drug will kill the patient first before the disease will. This is exactly what the government is doing. When you shut down the market, of course, people will die of hunger, diseases in the hospital, depression etc. Death is still death whether it is from COVID-19 or from hunger.
“This is very destructive and uninformed. It is a gross human rights violation. It is not a disease prevention strategy, but too much force about nothing. Science does not support it. What the government needs do is, if someone finds herself/himself in place that is unavoidably crowded, like Church, Mosque, banks, workplace, market, bus/rail stations, then a simple barrier, that is, wearing a mask will do. You do not shut down an interface border, which is even against the law of the Federal Republic of Nigeria, you shut down a state border, doing that is declaring a republic.
“You can only cordon off a place, even so, the measures taken are even ineffective. The only option would have been enforcing mass testing, that is, if you have the resources, however, the government does not have it. Also, you can impose a blanket issue. For example, once in a car travelling within and outsides the states, you wear a mask. You cannot impose a state border to be shut down because it is unconstitutional; governors shutting down state borders are doing so in their own peril it is an insurrection.
“Imposing a lockdown, whether in Nigeria or globally is like using politics to fight virus and that is ridiculous. Virus does not obey any political restriction it will transmit anywhere. That is not the correct thing to do you cannot lockdown the country. If you want to restrict, then restrict those who are positive to the virus.
“Do you know that about 70 per cent of Nigerian populace has classified Tuberculosis (TB) right in their lungs? Do we now shut down the country because of TB? It does not make sense. These things are politics enacted and not sensible thing to do.”
However, Director General, Nigeria Centre for Disease Control (NCDC), Dr Chikwe Ihekweazu, held a different view: “Most countries have restricted other proned-countries from entering their countries. As for shipping in and out of Nigeria, we are managing the situation real time.
“In Nigeria, the belief that COVID-19 is only for the rich man is not true, it affects all and sundry. We are increasing communication using different languages/dialects of the people. We are using radio a lot and pigeon English with giggles. We must limit our physical contact with one another.
“I know it is hard to stop what we are used to doing, but it is just temporary. Let us cooperate and take the responsibility. It is not only the task before NCDC but of everyone.”
Njeanze disclosed that someone can remain immune for life if the next pandemic is caused by exactly the same thing: “Though, not always the case, it is usually the mutant viral, any variation in the virus, you are not immune. You are only immune to that identical virus because it is a key-and-lock thing.
“If the key you have, which is your anti-body does not fit the lock which is the antigen, it cannot open it. Then, you can get another infection. That is why it is called COVID-19 because it is a variant. If there is another one now in existence, then it will be COVID-20 or COVID-21 because it is mutant specific.”
Testing of COVID-19
He said: “It is important to note that Nigeria does not have rapid diagnostic test tools in testing COVID-19. No country has it. China only came up with something; the specificity however, is in doubt because COVID-19 is a virus that belongs to a family.
“If you have anything within that family, you might cross react and that cross reaction might give a lot of false positive. Some of the people who said to have COVID-19 really do not have it. They might have had something that was close to COVID-19, which is, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) in the coronavirus family, which is a large family. Those tests are not very specific.”
He warned that government needs to be very careful as there were a lot of people who came into the country during this period. “After the closures of airports, the land borders were open. From reliable source, the Chinese people who have factories in Nigeria that travelled for their new year’s festivals when this outbreak started, and wanted to get back to Nigeria after the celebrations could not get in through the airports.
“What most of them did was to travel to Angola, from there they flew to Ghana and asked their Nigerian drivers to come pick them up from Ghana. Coming through the land border, some of them might have this virus. But let us assume they go on self-quarantine what happens to the Nigerian drivers? This is where the Nigeria case is coming from, they are all imported. It is important that these places are manned thoroughly.
“The internal transmission will be very difficult. It is only very direct physical contact that the virus will be airborne and spread everywhere. This is not possible because the physical constraints of the virus will not allow that.
Ihekweazu also agreed that Nigeria does not have the capacity to do test: “Over there, they have 24 hours power supply. They have trains that connect all cities. We do not have that here we do not have the capacity to march up with those developed economies.
“Here it can be slow with limitations, but we have no alternative. We are working extremely hard, in process engineering. We are improving capacity in upgrading old labs, new labs. We cannot do it overnight but we shall keep pushing because of the level of infrastructure here.
“We have molecular test, and this is not a magic bullet. The process can be slow and frustrating, though government has released some money for us. We shall work with global partners we shall get there. If we must get there, we must work together. If we look for a short-cut for solutions we will end in undesirable end. We are increasing capacity training as well as encourage restrictions of movement.”
Efficacy of chloroquine
Ihekweazu said the NCDC does not have anything personal with clinical trials: “But our goal is to choose from therapeutics available that have gone through clinical trials. We do not regulate clinical trials at all.
“We have some initiatives working with the private sector for Abuja and Lagos to create facilities to manage this scourge, some investments in news and communication through telecoms/broadcast for pro bono. We call on Nigerians to support the responses by providing help and care to health workers. It is a collective responsibility.”
Njemanze also explained: “Chloroquine is an old age drug. We have been using it in clinics for the treatment of malaria. It works in pregnant women very well. Chloroquine is already a trial drug and we are familiar with it. I won’t be surprised if it is giving high efficacy as most people have reported it in France, China and other parts of the world.
“However, you can’t take chloroquine prophylaxis. People who buy and use it are exposing themselves to a serious hazard. There are contraindications in taking chloroquine. If you must, then it must be on prescription. If you do not you will only end up with another disease because of the effect of chloroquine.”
Ihekweazu said the NCDC has three critical scaling. These are scaling diagnosis/testing; scaling treatment and scaling information. He said sending affected persons to different centres depends on the level of the virus in the body.
“The stage at which the person is suffering, some person may need ventilators while others do not. However, we are increasing the level of preparedness to manage all affected persons anywhere they are and rev up what we are doing now. The Minister of Health is working round to stem the tide against escalation. Everyone must be involved.”