Following the outbreak of the Coronavirus in the Chinese city of Wuhan, the world is grappling with ways of curtailing its spread. SAMSON BENJAMIN in this report examines the measures so far taken by Nigeria to prevent the virus from entering her borders given the nation’s weak public health system
According to the World Health Organisation (WHO), corona viruses are a family of viruses that cause illness ranging from the common cold to more severe diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).
Explaining the origin of the virus, Dr. Chijioke Njoku, a medical microbiologist and consultant infectious disease at the University of Nigeria Teaching Hospital, Enugu, told Blueprint Weekend that “Coronaviruses were originally transmitted between animals and people.” SARS, for instance, he said “was believed to have been transmitted from civet cats to humans while MERS travelled from a type of camel to humans.”
“Several known Coronaviruses are circulating in animals that have not yet infected humans.”
The current scourge of Coronavirus was first reported by a Chinese doctor Li Wenliang. He saw the virus while working at Wuhan Central Hospital on December 30, 2019.
In its daily briefing on the disease, the director-general of WHO, Tedros Adhanom Ghebreyesus, said as at February 5, 2020, the death toll from the Coronavirus outbreak in mainland China had risen to 490 after more deaths were reported in the Hubei Province.
A further 24,324 people on the Chinese mainland have been infected, China’s National Health Commission stated.
“The virus has killed two people outside of mainland China, one in Hong Kong and another in the Philippines and at least 25 countries have confirmed cases,” WHO stated.
On the symptoms of the disease, Dr. Njoku said, “Signs of infection include fever, cough, and shortness of breath and breathing difficulties. In more severe cases, it can lead to pneumonia, SARS, kidney failure and even death. And the incubation period of the Coronavirus remains unknown. Some sources say it could be between 10 and 14 days.”
How it spreads
Similarly, speaking with Blueprint Weekend on how the disease can be contracted, an infectious disease epidemiologist and a consultant in public health medicine, Dr. Istifanus Maikori, said the disease spreads like other infectious diseases.
He said, “The 2019-nCoV coronavirus spreads from person to person in close proximity, similar to other respiratory illnesses, such as the flu. Droplets of bodily fluids such as saliva or mucus from an infected person are dispersed in the air or on surfaces by coughing or sneezing.
“These droplets can come into direct contact with other people or can infect those who pick them up by touching infected surfaces and then their face.
“It is not yet known how long the virus can survive outside a host, but in other viruses, the range is between a few hours or months. The incubation period of the Coronavirus, the length of time before symptoms appear, is between one and 14 days.”
Meanwhile, as the outbreak continues to spread outside China, the new Coronavirus has been declared a global emergency by the WHO. According to Ghebreyesus, “The main reason for this declaration is not what is happening in China, but what is happening in other countries.
“The concern is that it could spread to countries with weaker health systems,” he said.
Similarly, Dr. Maikori told Blueprint Weekend that WHO usually declares a public health emergency of international concern when there is an extraordinary event which constitutes a public health risk to other states through the international spread of disease.
He said, “WHO has previously declared five global public health emergencies: Swine flu, 2009 – The H1N1 virus spread across the world in 2009, with death toll estimates ranging from 123,000 to 575,400. Polio, 2014 – although closer than ever to eradication in 2012, polio numbers rose in 2013.
“Zika, 2016 – The WHO declared Zika a public health emergency in 2016, after the disease spread rapidly through the Americas. Ebola, 2014 and 2019 – The first emergency over the virus lasted from August 2014 to March 2016, as almost 30,000 people were infected and more than 11,000 died in West Africa. A second emergency was declared last year as an outbreak spread in DR Congo.”
Fate of Nigeria, 12 other African nations
Also, WHO on January 31, 2020 identified 13 high-risk African countries for Coronavirus. They are Algeria, Angola, Ivory Coast, DR Congo, Ethiopia, Ghana, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda, and Zambia.
A statement from WHO indicated that the identified African nations had direct links or a high volume of travel to China.
“WHO has identified 13 top priority countries (Algeria, Angola, Cote D’Ivoire, the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Mauritius, Nigeria, South Africa, Tanzania, Uganda and Zambia) which either have direct links or a high volume of travel to China.
“To ensure rapid detection of the novel coronavirus, it is important to have laboratories which can test samples and WHO is supporting countries to improve their testing capacity. Since this is a new virus, there are currently only two referral laboratories in the African region which have the reagents needed to conduct such tests.
“However, reagent kits are being shipped to more than 20 other countries in the region, so diagnostic capacity is expected to increase over the coming days. Active screening at airports has been established in a majority of these countries and while they will be WHO first areas of focus, the organization will support all countries in the region in their preparation efforts,” the WHO said in a statement.
“It is critical that countries step up their readiness and in particular put in place effective screening mechanisms at airports and other major points of entry to ensure that the first cases are detected quickly,” the WHO Regional Director for Africa, Dr. Matshidiso Moeti, said further.
However, in a chat with this reporter, the head of Research and Knowledge Management of the Nigeria Centre for Disease Control (NCDC), Dr. Chinwe Lucia Ochu, said Nigeria had put enough measures in place to tackle outbreak of the disease in Nigeria, adding that “there is collaboration between China and the Nigerian government, especially through screening of incoming travellers.”
She said, “The NCDC is well-positioned to handle any case of Coronavirus that comes into the country. We are better prepared to manage Coronavirus if it comes to Nigeria than we were during the Ebola outbreak. Our system has been tested by other infectious diseases over time, and lessons learnt from theses outbreaks has further strengthened our capacity.
“We are working closely with the Federal Ministry of Health Port Health Services to screen passengers at airports. We are confident that the Ports Health’s Service Division in the Federal Ministry of Health of Nigeria will be able to detect these cases on time.
“We are coordinating a multi-sectoral group in collaboration with the Federal Ministry of Health of Nigeria Ports Health Service and partners to monitor the Coronavirus outbreak in parts of the world and developing preparedness measures.”
Similarly, the NCDC Head of Response Division, Dr. Olaolu Aderinola, said, “No case of Coronavirus has been detected in Nigeria. We are working closely with the Federal Ministry of Health Port Health Services to screen incoming travelers at airports and seaports. As information on the novel Coronavirus is rapidly unfolding, the world is working together on this.
“Symptoms of Coronavirus include coughing, sneezing, breathing difficulties. Our message to Nigerians is to report immediately to the nearest health facility if you notice any of these symptoms. Health care workers should adhere to standard precautions at all times to ensure they protect themselves and that preparedness measures for the novel Coronavirus is a collective responsibility.
“The fatality rate from the novel Coronavirus outbreak in parts of the world is very low. There has been no case of Coronavirus recorded in Nigeria. No travel restriction has been placed by WHO. Our advice to Nigerians is to limit contact with animals if you must visit China and ensure good personal hygiene at all times.”
In its reaction, the federal government on January 31, 2020, formulated an inter-ministerial and inter-sectoral preparedness and rapid response strategy against the Coronavirus epidemic.
It also approved N71 million as preventive cost against a possible outbreak of the virus and subsequently directed that operators of all ports of entry into the country be on alert and screen all passengers at the seaports, international airports, and land borders.
Blueprint Weekend learned that the strategy was to enable all relevant ministries, agencies, institutions, organisations and development partners to move for quick intervention against any Coronavirus symptoms traced to any individual or group coming into the country.
The Minister of Health, Dr. Osagie Ehanire, disclosed this to newsmen after meeting with heads of various government institutions for a collaborative engagement against the dreaded virus in Abuja. He advised Nigerians and residents to be cautious and calm about the novel coronavirus.
He said, “Travellers from China should be isolated, at least two weeks as the symptoms delay before manifestation. We have to review national strategies and plans and assign roles especially testing capacities in Abuja and abroad.
“Where a case is suspected, the affected traveler should be made to step aside and, the travel history be checked. Surveillance should be enhanced in Port Harcourt, Enugu, Lagos, and Kano airports.”
Institutions involved in the strategy meeting include: the Nigeria Immigration Service (NIS), Nigeria Ports Authority (NPA), Nigeria Customs Service (NCS), Nigeria Civil Aviation Authority (NCAA), National Emergency Management Agency (NEMA), commissioners of states and representatives of the United States Agency for International Development (USAID) and World Health Organisation (WHO).
Also, the NCDC disclosed that isolation facilities for the virus would be sited in the Federal Capital Territory (FCT) and seven states across the country.
A statement on its website read in part, “NCDC is currently preparing treatment and isolation facilities in the Federal Capital Territory and seven other priority states in Nigeria. They are Lagos, Akwa Ibom, Rivers, Enugu, Delta, Cross River, and Kano states.”
On the risk of the virus berthing in Nigeria, the Centre stated that, “The risk assessment conducted by WHO places the country at High Risk, meaning that there is a high chance of an infected person (traveller) coming into Nigeria. Till date, there is no confirmed case of the novel Coronavirus in Nigeria.
“The Nigerian government is closely monitoring the ongoing novel coronavirus 2019 outbreak which originated in Wuhan, China. A multi-sectoral Coronavirus Preparedness Group has been established at the NCDC. The Coronavirus Preparedness Group meets daily to carry out regular epidemic intelligence gathering.
“The Port Health Services Division of the Department of Public Health has heightened screening at the ports of entry, especially for travellers with a travel history to China. The NCDC has established a standard case definition for novel coronavirus and circulated it to State Ministries of Health, health facilities and all relevant stakeholders to guide detection and response.”
The Centre also reiterated that the National Reference Laboratory had the capacity to diagnose the virus while warning health officials to call 07032864444 for sample transportation and related advice if they had a case that corresponded with the case-definition.
WHO supports FG’s efforts
In his contribution, the Officer-in-Charge of WHO in Nigeria, Dr Clement Peter, said the agency is supporting federal government’s effort at scaling up preparations in handling coronavirus.
Peter told the News Agency of Nigeria (NAN) in Abuja that the agency had been working with NCDC to provide reagents for testing the virus.
“I am happy to say that WHO is working with NCDC. But globally, we need to move to countries to provide reagents. What we called primers is because the test can be done anywhere in Nigeria.
“These primers are very important; other partners are also bringing some reagents into the country. If we have suspected case, we can confirm through primers. But how do you rule out if it coronavirus or not? It is good to have a good case definition, like who do you suspect?
“So, that when you take samples, you narrow it to those that you have suspected and not taken everyone. On the issue of capacity, at least to treat is very important. I think in Lagos and Abuja; there are some discussions to have isolation capacity.
“That was in the beginning, but with the declaration of coronavirus as a global health emergency, we need to scale up in terms of preparedness. That means, we need to have more facilities available to be used as centres.
“We have five states that are considered high risk, with five points of entry, which are Enugu, Lagos, Rivers, Kano and the FCT. We need to have the capacity to diagnose because with the declaration of global public health emergency.
“WHO does not restrict movement and trade, it has to continue because that affects the economy. People might come from China to Nigeria; so we need to be on the alert.”
Peter also said the agency had been working with NCDC since the case was first reported, given the linkage between Nigeria and China citizens.
“A lot of Nigerians are in China and a lot of Chinese are in Nigeria or coming into Nigeria; this means in terms of risk, it is high and anything can happen.
“Secondly, from the presentation of the diseases, there are many unknown things about the virus, it presents as a mild illness, common cold and difficulty in breathing and death.”
Meanwhile, advising Nigerians on the precautionary measures to be taken in case there is an outbreak of the disease in Nigeria, Dr. Njoku said, “In terms of self-protection and containing the virus, it is important to wash your hands frequently and thoroughly with soap; cover your face with a tissue or your elbow when coughing or sneezing; visit a doctor if you have symptoms; and avoid direct contact with live animals.”
Stigmatising infected persons
The federal government has assured Nigerians that it is well prepared to combat the deadly Coronavirus in the country.
The Secretary to the Government of the Federation (SGF), Mr. Boss Mustapha, who disclosed on February 5 at a one-day sensitisation programme on the Spread of Coronavirus and Lassa fever, said rumours of the spread of the disease should be avoided.
“We have been informed by the Nigerian Centre for Disease Control that they have set up their response centers and that they are mounting surveillance. Medical personnel have also been put on standby to attend to any emerging issues.
“What we are doing today is the responsibility of management to create awareness within our work force. The issue of stigmatisation should be reduced to the barest minimum. No fiction, no rumours, science and facts are what we want to deal with,” he said.
Mustapha, represented by the permanent secretary, General Services Office, Mr. Olusegun Adekunle, the SGF urged Nigerians to take the precautionary measures seriously to remain safe.
He urged Nigerians not to stigmatise the Chinese in the country.
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