Covid-19: Are health workers endangered species?



The outbreak of Covid-19 infections in Nigeria has resulted in many deaths, especially among medical doctors and other health workers. In this report SAMSON BENJAMIN examines casualties of the second wave of the pandemic and high rate of deaths among medical workers amidst poor condition of service.

Most nations of the world were yet to recover from the deadly blow of the Covid-19 pandemic when they were hit by the second wave of pandemic, which has continued to sweep the globe infecting millions of people and causing hundreds of thousands of deaths and economic disruption.

Nigeria was not spared of the impact of the pandemic which has caused chaos in developed nations, however, the rate of infections and death among medical and health workers has continued to increase at an alarming rate.

Second wave

The Presidential Task Force (PTF) on Covid-19, in December 2020 said Nigeria had entered the second wave of infections.

The PTF Chairman and Secretary to the Government of the Federation (SGF), Boss Mustapha, who gave the indication, lamented that the country was at risk of not just losing the gains from the hard work since the outbreak of the disease, but also losing precious lives of citizens.

Nigeria, Monday, recorded its highest single-day Covid-19 cases since the first infection was reported in February 2019.

According to the Nigeria Centre for Disease Control (NCDC), the country on Monday recorded 1,204 new confirmed cases of Covid-19, taking the total number of infections to 91,351.

Data on the agency’s website showed that Nigeria recorded its second-highest daily Covid-19 cases on December 18, 2020, with 1,145 people testing positive.

A breakdown of the data showed that 75,699 have recovered from Covid-19 in the country while 1,318 have died of the virus.

The agency said, “On January 4, 2021, 1204 new confirmed cases and seven deaths were recorded in Nigeria.

“Till date, 91351 cases have been confirmed, 75699 cases have been discharged and 1318 deaths have been recorded in 36 states and the Federal Capital Territory (FCT).

“The 1195 new cases are reported from 21 states- Lagos (654), FCT (200), Plateau (60), Kaduna (54), Kano (40), Rivers (30), Edo (28), Nasarawa (25), Kebbi (19), Bauchi (18), Oyo (13), Akwa Ibom (12), Bayelsa(11), Ogun (11), Delta (9), Abia (8), Benue(5), Imo (3), Borno (2), Sokoto (1) and Osun (1).

Working amidst poor conditions

Healthcare workers as first responders to patients are often at risk of exposure to infections, including Covid-19. Although health workers have been advised to use full Personal Protective Equipment (PPE) before attending to patients, many do not have access to this equipment and as a result, many health workers have tested positive for Covid-19 in Nigeria.

According the Minister of Health, Osagie Ehanire, as at June 2, 2020, at least 812 health workers had tested positive for Covid-19.

Also, as of July, over 10,000 health workers in 40 Africa countries had been infected with the Covid-19 virus, the World Health Organisation (WHO) had disclosed.

The exact number of health workers that have been infected in Nigeria could be ascertained as of the time of filing this report, however, the recent loss of 20 medical doctors in one week was an indication of the level of damage the pandemic was wrecking on the profession.

Casualties

The Chairman, Nigeria Medical Association (NMA), FCT Chapter, Enema Amodu, had taken many by surprise when he announced, recently, that at least 20 Nigerian doctors have died from complications arising from coronavirus within one week.

Amodu, who made the disclosure at a press briefing in Abuja, said the deceased health workers included consultants, professors, and some resident doctors.

He said the figures kept increasing daily.

“For those of us in the health sector, we have lost quite a number of colleagues. Across the country, we have lost not less than 20 doctors in the last one week,” he said.

Concerns

The NMA recently said it was disturbed by the death of medical doctors as a result of Covid-19, stating that it would write the federal government on the need to train health workers in infection prevention.

The NMA President, Professor Innocent Ujah, stated this in an interview with journalists in Makurdi while reacting to the death of 20 medical doctors within one week.

Expressing concern about the death of the doctors the NMA president said, “Let me just say that even if it is one doctor that died of Covid-19 in the process of providing service to the nation to prevent death, to us it is sad. No doctor should die providing services for the nation.”

Ujah said the association would write the ministry of health and the PTF to support the training of medical doctors.

He said the medical doctors could have contracted the virus from patients they treated hence the insistence by the NMA that doctors must be trained in disease prevention and control.

He called on government to provide personal protective equipment, running water, soap and gloves for doctors and other health workers.

Nurses, doing the unthinkable – Adeniji

Similarly, the President, National Association of Nigerian Nurses and Midwives, Abdulrafiu Adeniji, while speaking on the need for countries to protect health workers, at all cost, highlighted the vital role of nurses and midwives in the fight against coronavirus.

He said, “It may not seem that there are many reasons for celebration. The world is in the grip of the most severe health crisis of our time. The Covid-19 pandemic is reminding us of the vital roles of nurses and midwives play.

“Every day, nurses are putting themselves at risk to alleviate suffering and save lives. They’re reorganising wards to open more beds for Covid-19 patients, while continuing to provide care for other patients with urgent health needs, including women in labour.

“They’re taking stock of equipment and lending it across units. They’re learning on the job with information that changes daily, even hourly. Nurses are doing the unthinkable.

“Because critical Covid-19 patients are isolated, the last human touch they may feel is that of a nurse’s hand. The kindness of caring for strangers has never been more important. Health workers are on the front lines of the fight against Covid-19, they’re also among the most at risk,” he added.

Poor health sector

In a chat with Blueprint Weekend, an epidemiologist Dr Bright Iyorha said Nigeria was losing so many health workers in the fight against Covid-19 as a result of long years of neglect of the sector.

He said: “The Nigerian health sector has been plagued with inadequacies for decades leaving the upper and middle-class largely distrustful of the system and mostly reliant on medical tourism.

“There is also paucity of medical professionals as a result of brain drain. The NMA President, Professor Innocent Ujah, said about 75,000 Nigerian doctors were registered with the body, but over 33,000 had left the country, leaving behind only about 42,000 to man all health institutions in the country.

“The president also noted that, in rural areas, we have one doctor to 22,000 people, while in towns and cities, we have one doctor to 10,000 Nigerians or one doctor to 12,000 Nigerians, whereas the WHO said for any country to have a balanced ratio, it must have one doctor to 600 persons.

“In the battle against the Covid-19 pandemic, Nigeria like the rest of the world is greatly lacking of the needed personal protective equipment (PPE), which is an essential component in the management of this highly infectious disease.

“So far, she has enjoyed generous PPE donations from well-meaning countries, organisations and individuals and these have contributed to a large extent in the fight against this common global enemy. However, she still desperately needs continued influx of PPE to ensure that health care workers are well protected in rendering their selfless service to humanity.

“Covid-19 being a respiratory disease is often complicated by acute respiratory distress syndrome (ARDS), and in such a case, access to intensive care would prove to be lifesaving. But in such a grossly deprived health care system as in Nigeria, only mass hysteria awaits as the number of confirmed cases of Covid-19 continues to skyrocket with alarming possibilities of cases requiring such advanced health services.”

Health insurance

Similarly, another medical doctor Dr Yemi Edun told Blueprint weekend that failure to implement the insurance packages and allowances approved for medical personnel in the wake of Covid-19 was killing their morale.

“Health insurance is a necessary incentive, even for a medical doctor, not just because it connotes the importance the health care managers confer on the health workers, but also because it serves as an assurance of protection in the event of the unprecedented.

“Nigeria is a nation where doctors courageously manage all forms of infectious diseases as part of their routine daily activities, including the current Covid-19, but are only guaranteed a meagre monthly hazard allowance in the advent of illness or death of a medical doctor while on the job. Whereas, their counterparts in a neighbouring country, Ghana, will be paid US$4322 as health insurance coverage in the occurrence of illness/death of a doctor in the fight against Covid-19, their Nigerians are not sure of any,” he said.

Non payment of allowances

In the same vein, the Medical Superintendent at the Thisday Dome Treatment Centre, Abuja, Dr Molokwu Victor, told journalists on tour of the facilities, Sunday, that all categories of frontline workers had not been paid their allowances since September 2020.

He said, “All the categories of staff are being owed their allowances, but the secretary for health has promised that we should expect something soon. He said the FCT Administration was working on the allowances.”

However, Permanent Secretary, FCT Administration, Adesola Olusade, has assured that the administration was paying attention to the complaints of non-payment of allowances by the health workers at Thisday Dome.

Olusade noted that the Thisday Dome Treatment Centre was just recently transferred to the FCTA by the Federal Ministry of Health.

Patient’s insincerity

Meanwhile, a public health expert Dr. Obi Ebuka told our correspondent that some of the challenges faced by healthcare workers in the frontline of combating the disease were lack of Personal Protective Equipment (PPE) and lack of sincerity from some patients.

He said these were important ‘work tools’ needed at this critical time if the country really wants to defeat the outbreak.

“Since we are having cases all over the country, government and other private health facilities should provide these supplies for their health workers. Whether these health workers are seeing Covid-19 patients or not, because you never can tell who is infected or not.

“And worse still, some of the patients who come into the hospital end up hiding their travel history.”

Ebuka further appealed to patients to restrain from hiding their past medical conditions to ensure the safety of health workers across the country.

He said some doctors contracted the virus as a result of poor knowledge of patient’s medical history and travels.

“To our patients, as you come to the hospitals, please oblige us. Wear your face masks; tell us the truth about your past medical condition. Stop holding any information back,” he said.

Training

Also, the NMA president emphasized the need for raining of young doctors in order to reduce the level casualty.

He said, “Let me plead that we need to be protected by having training among our people. Younger doctors are coming up and Covid-19, we don’t know when it will end or the extent it can go. The only thing we need is infection prevention and control.

“We need to contact the PTF and Ministry of Health to support our training. We need to write a proposal so that we can train doctors and health workers throughout the nation in infection prevention and control.”

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