Doris Obinna, Paul Osuyi, Okey Samson, Linus Oota, Laide Raheem, Noah Ebije, Agaju Madugba, Oluseye Ojo, Desmond Mgboh, Rose Ejembi, Paul Omokuvie, Bamigbola Gbolagunte, Timothy Olanrewaju, Clement Adeyi, Gyang Bere, Tunde Omolehin, and Priscilla Ediare
CORONAVIRUS Disease (COVID-19) according to World Health Organisation (WHO), is a large family of viruses causing illness ranging from the common cold to more severe diseases. These in-clude Middle East Respiratory Syndrome (MERS-Cov) and Severe Acute Respiratory Syndrome (SARS-Cov). A novel coronavirus is a new strain that has not been previously identified in humans:
“Coronaviruses are zoonotic, meaning they are transmitted between animals and people. Detailed investigations found that SARS-Cov was transmitted from civet cats to humans and MERS-Cov from dromedary camels to humans. Sev- eral known coronaviruses are circulating in animals that have not yet infected hu- mans.”
Experts said the virus could cause pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The experts insist- ed that antiviral drugs against flu would not work. Recovery depends on the strength of the immune system. Many of those who have died were already in poor health.
Professor Dimie Ogoina, Consultant, Infectious Disease, Niger Delta University Teaching Hospital (NDUTH), Wilberforce Island, Bayelsa State, however, gave new insight into coronavirus. He told Daily Sun: “Firstly, the virus is new, never previously described. Secondly, it causes a respiratory disease characterised mainly by cough and fever and thirdly, it is contagious, can be transmitted from person to person. Lastly, fortunately it is not as deadly as been perceived. Most will recover; about 3 per cent suffer mortality, especially in persons above 60 or with co morbid disease.
Ogoina is also Chief Medical Director, NDUTH and President, Nigeria Infectious Diseases Society (NIDS), said though Nigeria routinely screens every traveller in major international airports by checking for fever and asking for symptoms such as cough; “unfortunately, it is neither feasible nor evidence base to test everyone for the virus even if they have no symptoms.
“The Ports Health Authority is expected to be extra vigilant. We must all be extra vigilant to avoid close contact with some-one coughing or sneezing. When not possible, first keep a distance and ensure you protect your hand, nose, mouth and eyes from contact with droplets by whatever means possible.”
Transmission of the virus causing coronavirus
Ogoina said coronavirus is not transmitted by inhalation, except under certain procedures undertaken in the hospital settings and on environment to human transmission. Coronavirus could be acquired if infected droplets from coughing and sneezing contaminate surfaces.
He disclosed that when undercooked or raw animals are eaten, it could be transmitted from animal to human: “Although, the virus is thought to originate from bats, the exact animal host responsible for the disease is yet unknown.
“The virus is not exactly airborne by technical definition. It can be contracted from respiratory droplets with close contact with someone infected especially when they cough and sneeze. When these droplets touch the eyes, nose and mouth, then infection is possible. Airborne transmission occurs when infective agents are inhaled. Coronavirus is not transmitted by inha- lation, except under certain procedures undertaken in the hospital setting.
“Coronavirus can be acquired if infected droplets from coughing and sneezing contaminates surfaces. This is what we call fomites. When you touch these fomites and then touch your nose, mouth or eyes, then you can become infected
“There are no evidences that coronavirus could be transmitted from imported goods. Besides, the virus cannot survive in inanimate objects for long especially when exposed to high temperatures common with ferry of some imported goods. With or without coronavirus, it is important we observe personal hygiene, especially hand hygiene.
“Symptoms may not manifest with the first few days, say two to four days after contact. The incubation period for coronavirus is one to 15 days.”
Prevention
Simple soap and water can kill the virus on the hands and on surfaces. Ogoina advised:
“Wear face mask only if you have respiratory symptoms to protect dispersal of your droplets when you cough or sneeze. Wear facemask if you are in the same room or within six feet of some-one suspected to have coronavirus.
“Face masks are to be worn momentarily on contact with a patient. It is not a dress code. You are not expected to touch the front of the facemask, pull it down intermittently to breathe or talk or hang it under your mouth or jaw to pull it over your nose later.
“If you do any of these then you are already exposed if your facemask was contaminated. Do not re-use facemask. For now, there is no evidence to sug- gest that garlic, ginger or hot lemon juice protect against coronavirus.”
State of isolation centres
On the level of preparedness of the country to combat the virus, Ogoina said there are significant gaps in the health system that could complicate issues if the country has more cases, especially in states other than Lagos:
“Most states are not prepared. There is still a window of opportunity for them, especially in the provision of suitable isolation and training of healthcare workers to handle cases. A crisis may occur if states are not proactive
“I am aware that the Lagos State Government has been fully mobilised to respond to the outbreak. The good thing here is that they appear to be tak- ing full ownership at the highest level of political leadership.”
Abia, Nasarawa, Ebonyi set up quarantine centres
Abia State Government has inaugurated committee of the management and prevention of outbreaks in the state. Although, the state has no testing centre for the disease at present, Commissioner for Information, John Okiyi-Kalu, said the state has established an isolation centre where people affected by Covid-19 could be quarantined.
In Nasarawa State, Chief Medical Director, Dalhatu Araf Specialist Hospital (DASH), Lafia, Dr Hassan Ikramma, revealed: “The state does not have testing machine, but has a perfect isolation centre for suspected people with the virus. It is only Lagos State that has the facilities for testing the coronavirus.
“The state has set up isolation centres in the two hospitals that are well equipped with facilities from National Centre for Disease Control (NCDC).”
Ondo State Governor, Rotimi Akeredolu, said the state has infectious disease hospital in Akure: “The state is in readiness for any eventuality.”
Ebonyi State Government said it set up seven quarantine centres across for prompt treatment of any reported coronavirus case.
Delta, Ekiti, Bauchi intensify surveillance
As one of the five high-risk states for the spread of the dreaded coronavirus, Delta State Government said it has intensified sur- veillance to combat the disease in case of any outbreak.
Commissioner for Health, Dr Mordi On- onye, said precautionary measures have been taken including the testing of persons at strategic places like entrance to the Government House, airport and seaports with a view to isolating any suspected case: “The state has since switched from its watch mode to alert since the first case was recorded in Lagos. In addition, all care givers and management of health institutions have been placed on red alert.
Ekiti State Commissioner for Health, Dr Mojisola Yahaya Kolade, said: “The state is prepared and has put so many measures in place to fight against any outbreak. We have been working since the outbreak of Lassa fever in January.
“We have had several trainings for health workers. The state has also provided us with some protective equipment including aprons, gowns, hand sanitizers, facial masks, gloves and M-95 masks. We have distributed them to all our facilities.
“All prevention and management measures of the coronavirus have been put in place in all the specialist’s, secondary and primary health care facilities.
Bauchi State Government said it has intensified surveillance activities at the Abubakar Tafawa Balewa International Airport, Bauchi. It has also spread surveillance to all motor parks, the Yankari Game Reserves as well as all mining areas. It has strengthened and expanded the current Lassa Emergency Preparedness Response Team (EPR) at the Emergency Operation centre to include coronavirus.
Ogun, Kaduna, Oyo, Benue, others establish EOC
In Ogun State, Governor Dapo Abiodun said the isolation centre at the Olabisi Onabanjo Teaching Hospital (OOTH), Sagamu, would be upgraded to a biosecurity and containment centre, to be the fourth of its kind in Nigeria.
He said the state government has begun to put measures in place to prevent further spread of the virus by establishing an Emergency Operation Centre (EOC) to monitor and curtail the spread of coronavirus in the state.
Commissioner for Health, Dr Tomi Coker, said the centre would be equipped with special computers and manned by trained personnel to gather information about the virus all over the state:
“Also, a mobile application that will help enhance information dissemination among health workers would soon be launched in the state. The Android application christened ‘CommCare’ will serve as one resource for information about case definition. Any suspected case is to be reported to the already activated emergency units across the 20 local government areas of the state.”
Kaduna State government constituted an Emergency Operational Centre (EOC), to respond to any eventuality. Commissioner for Health, Dr Amina Mohammed Baloni, who is the chairman committee of the EOC, said the committee was set up to respond quickly, in the event of an outbreak.
In Oyo State, strategic stakeholders in the preventive and curative health sub-sectors formed a partnership to curtail the spread of COVID-19, with the establishment of some centres to specifically deal with the virus.
Commissioner for Health, Dr Bashir Bello, said the administration is collaborating with the University College Hospital (UCH), Ibadan; 2 Di- vision of the Nigerian Army, and Nigerian Centre for Dis- ease Control (NCDC) for proactive measures to guard against the spread of the coronavirus: “The synergy culminated in the establishment of emergency centres for coronavirus at UCH, Ibadan.”
In Kano State, a facility at Yargaya has been earmarked as an isolation centre. Commissioner for Health, Dr Aminu Ibrahim Tsanyawa, said: “The centre is the only centre for the isolation of patients of communicable diseases in Northern Nigeria.
The centre, which serves as a referral centre, was recently innovated and structurally expanded following the outbreak of the disease.”
Benue State Government said it has stepped up surveillance on coronavirus in all its 23 local government areas. Commis- sioner for Health and Human Services, Dr Sunday Ongbabo, said: “A treatment centre has been established at the Benue State University Teaching Hospital (BSUTH) and a location earmarked to be used as quarantine unit in the event of any outbreak of the disease.
“An Emergency Response Committee on Coronavirus (Covid-19) has been set up. Although no case of coronavirus has been recorded, the EOC and the Emergency Response System (ERS) have been placed on red alert to curtail any of such case.”
Ways out
Ogoina suggested the following measures be taken to ensure the virus is contained in the country. These include, strengthen surveillance at all points of entry; ensure all suspected cases are confirmed promptly; isolate cases promptly and trace all contacts and ensure those treating cases practice infection prevention.
Other measures are, communicate risk to the public, mobilise and engage communities, dispel misinformation and getting functional isolation facilities across the country and qualified personnel to manage cases.
He added: “There are so many things that could help our immune system, especially a good rest, food and water in right quantities and quality. Vitamin C, cod-liver oil, fruits and vegetables have no specific benefit against coronavirus. However, fruits and vegetables are part of a nutritious diet.”