‘…We don’t have adequate human resources to handle another pandemic’
In this piece, BENJAMIN SAMSON seeks the views of experts as the Nigeria centre for disease Control (NCDC) confirms that a new infection has already claimed 25 lives and alerts on the resurgence of Covid-19 pandemic.
The Nigeria Centre for Disease Control (NCDC) on Friday in Abuja via a public health advisory issued a statement confirming the outbreak of a new infection of the nose and throat (otherwise known as diphtheria) that has already claimed 25 lives in Kano state. The Centre went on to state that it responded to “reports of diphtheria cases in Lagos and Kano states and is monitoring the situation in Osun and Yobe states where cases are now being picked up.”
While the Centre is yet to give data on the number of infections and deaths recorded in the country, the Kano state Commissioner for Health, Aminu Tsanyawa, had Thursday confirmed that the outbreak of diphtheria had killed no fewer than 25 people in the state.
But NCDC disclosed that it’s now working with state health ministries and partners to enhance surveillance and response to the outbreak.
It explained that diphtheria is a serious bacterial infection caused by the bacterium called Corynebacterium species that affects the nose, throat and sometimes, the skin of an individual.
It disclosed that people are mostly at risk of contracting the disease are children and adults who have not received any or a single dose of the pentavalent vaccine (a diphtheria toxoid-containing vaccine); people who live in a crowded environment; in areas with poor sanitation and health care workers who are exposed to suspected or confirmed cases of the disease.
The Centre stated further that the disease “spreads easily between people through direct contact with infected people, droplets from coughing or sneezing and contact with contaminated clothing and objects.”
Symptoms
It listed the symptoms of diphtheria to include fever, runny nose, sore throat, cough, red eyes (conjunctivitis) and neck swelling, adding that in severe cases, a thick grey or white patch appears on the tonsils and/or at the back of the throat associated with difficulty breathing.
Prevention
On its prevention, NCDC urged parents to ensure that their children are fully vaccinated against diphtheria with three doses of the pentavalent vaccine as recommended in the childhood immunisation schedule.
It added that health care workers should be vigilant and look out for symptoms of diphtheria, and individuals with signs and symptoms suggestive of diphtheria should isolate themselves and notify the local government area, state disease surveillance officer or the NCDC through its toll-free line (6232).
It also advised that “close contacts with a confirmed case of diphtheria should be closely monitored, given antibiotics prophylaxis and started on diphtheria antitoxin treatment when indicated, while all healthcare workers with higher exposure to cases should be vaccinated against diphtheria.”
Covid-19 resurgence
Also, the NCDC earlier this week confirmed 42 additional Covid-19 infections in the country in two weeks, with Lagos state alone recording 27 cases.
It disclosed this via its official website, adding that Edo, Kano, Nasarawa, Kaduna, Plateau and the Federal Capital Territory contributed the remaining figure. The health agency stated that the new cases brought the country’s total of Covid-19 infections to 266,492. It stated that the cases were recorded between December 31, 2022 and January 13.
This new development has sent shivers down the spines of Nigerians who had heaved a sigh of relief, thinking that the pandemic had been eradicated.
Experts urge action
Medical experts who spoke with Blueprint Weekend have called on the federal and state governments to reintroduce safety measures to stop the virus from spreading.
A virologist, Dr. Nasiru Dogo, said, “Following a resurgence of Covid-19 in China and the detection of the new Omicron sub-variants, BA.5.2 and BF.7, said to be responsible for fuelling local infections in the Asian country, the federal government has to swiftly reintroduce safety measures to forestall the variants from entering Nigeria.
“Covid-19 has so far killed over 6.8 million people worldwide since 2019, disrupted national and global economies, and confounded the accumulated scientific knowledge of humanity. Carelessness should, therefore, not be an option.
“Unfortunately, Nigeria has faltered before. At the outbreak of the coronavirus in 2019, the federal and state authorities failed, despite strident warnings and advice to take effective preemptive measures to keep it out. The result was disastrous. From the first case recorded in February 2020, the Nigerian Centre for Disease Control said that by December 2022, 266,463 cases had been recorded nationwide and 3,155 persons had died. The authorities scrambled to impose lockdowns, restrictions, and safety protocols only after their carelessness had let the virus in. The blunder should not be repeated.
“The global community is once more on edge over the discovery of the new sub-variants in China, the same country from where the first outbreak began. Though they have not been officially designated by the WHO as variants of concern, many countries have been responding accordingly with strict epidemiological control measures, including restriction of travelers who have been to China, increased vaccination, and enforcement of health protocols at entry points and among the local population.
“In Nigeria, public health safety measures have been lifted since the dwindling of cases reported from the last wave that resulted from the discovery of the Omicron variant. Though the NCDC says that the BA5.2 and BF.7 have not been officially discovered in Nigeria, nothing should be taken for granted. All necessary measures should be taken to prevent their entry.”
Similarly, a Professor of Public Health/Community Medicine, Adebisi Salau, urged the federal government to increase surveillance to stop the fresh spread of the Covid-19 pandemic in the country.
Salau described the surge of Covid-19 in China as “unfortunate,” even as he reminded Nigerians that the Coronavirus has not completely gone.
“At the airports, seaports and land borders, security, border, and health officials should be on alert. There should be zero-tolerance for the unpreparedness, indiscretion and nonchalance that facilitated the entrance in February 2020 of an infected foreigner from Italy, who did not go through preventive protocols at the Lagos airport and sucked Nigeria into the pandemic.
“First, there should be flight bans. At least 14 countries have imposed travel restrictions and tests on in-bound travellers from China. In Africa, Morocco and Ghana imposed outright bans. India’s travel constraints regime is extended to travellers from Hong Kong, Japan, South Korea, and Thailand. More are imposing similar restrictions following China’s removal of Covid-19 restrictions on its population and the expected influx of Chinese tourists and businessmen.
“Prevention strategies need to be reinvigorated. Covid-19 protocols at entry points should be tightened. The Port Health Services, the NCDC, and the Federal Ministry of Health should ensure that all in-bound travellers are tested. Temporary imposition of flight restrictions should be imposed,” he said.
FG’s stance
However, the federal government has insisted that it would not impose Covid-19 restrictions on China despite the rising infections in the East Asia country.
The Coordinator and Technical Head of the Presidential Steering Committee on Covid-19, Dr. Muktar Muhammad, who stated this in Abuja, however, said the government has raised the surveillance level in the country.
Muhammad said countries imposing restrictions on China are doing so without a scientific basis as available data shows that cases are increasing worldwide.
He said, “For us, what we are doing now is to try to raise our surveillance level to be able to understand what kind of viruses are coming in, to continue to do our genomic sequencing to identify the variants that are coming into Nigeria so that we will have credible intelligence on what we need to do.
“We believe what is happening is not more than a seasonal increase in upper respiratory tract infections, including Covid-19, and we are monitoring the various variants circulating in the world.”
Enlightenment key
Likewise, a public affairs analyst, Punshak Mallo, in a chat with our reporter recommended that the government at all levels should engage opinion moulders to educate the people on the need to embrace safety protocols including vaccination.
He said: “Relevant public enlightenment agencies at the federal, state, and local government levels, religious leaders, CSOs, market and community leaders, should collaborate for public advocacy.
“Nigerians should be educated to adhere to safety protocols to protect their own health. Enforcement of social distancing, wearing of face masks at public places, regular washing of hands and use of hand sanitisers are essential, especially as the electoral season is on. The government should impose strong sanctions on violators of safety protocols.
“Opinion moulders should be engaged by the government at all levels to campaign for vaccination and emphasise its safety. The National Primary Health Care Development Agency disclosed that only 63.66 million Nigerians have been vaccinated in the over 200 million-strong population.
“This is depressingly low and cannot provide the required herd immunity until it reaches at least 70 per cent of the adult population. Testing should be intensified to detect more clandestine cases. Wearing a mask has no side effects. It only saves lives.
“Vaccine racketeering and profiteering by corrupt officials, as well as the issuance of fake Covid-19 test certificates by government-accredited centres must be stopped. Vaccination is very important. Experts say if they spread faster than the Delta variant, BA.5.2 and BF.7 will require vaccines and travel restrictions to restrain them. It is estimated that by the end of the year, enough vaccines will have been manufactured to vaccinate the whole world.
“More funds need to be injected into the weak health system. The government must resolve all pending grey areas and negotiations with the medical sector unions and other health sector associations to forestall work stoppages and curb the exodus of medical professionals from the country.”
Nigerians react
However, a cross-section of Nigerians who spoke with our reporters have expressed worry over the federal government’s refusal to place travel restrictions on in-bound passengers from China in the country.
According to them, Nigeria does not have adequate human resources to handle another pandemic as a result of the massive emigration of health workers to other countries.
A civil servant, Philip Tyooda, asked the government to make plans to protect its citizens from a resurgence of Covid-19.
“We need to act now because we don’t even have enough doctors to handle the current challenges we have in the health sector. If we now have a major pandemic, it will only worsen the situation because what we have at hand now, we don’t even have enough medical personnel to take care of them and that is why you have an increase in waiting time in the hospital and rescheduling of surgeries.
“Anybody coming from China must come with a negative Covid-19 test, they must be screened and they must guard their contacts and maintain vigilance and after they come with a negative test, they must repeat the test after a week. If we don’t do that, we are going to be in trouble,” he said.
Likewise, a bolt driver, Uyo Achenyi, urged the government to restrict travellers from China to avoid resurgence in the country. He said he was concerned that the government is yet to impose restrictions on travellers from China.
“Prevention is better than cure and that is the more reason the government needs to act on preventing any case from China. They should not think of whatever they gain from China but think of the ultimate thing, which is life.
“The government should be proactive and not wait until we have cases before placing restrictions.
“The world is a global village and we are closely connected. I am worried because we don’t have the human capacity to cope with any pandemic at this time and people have gone back to their normal activities; people need to be very cautious again,” he said.
WHO’s update, admonitions
Meanwhile, the World Health Organisation (WHO) has recommended the use of facemasks by the public in specific situations. It issued the update given the current spread of Covid-19 globally.
The agency notes that masks are recommended following recent exposure to Covid-19, when someone has or suspects they have Covid-19, when someone is at high risk of severe Covid-19, and for anyone in a crowded, enclosed, or poorly ventilated space.
In a new release by the WHO, it said, “Previously, the WHO recommendations were based on the epidemiological situation.
“Similar to previous recommendations, WHO advises that there are other instances when a mask may be suggested, based on a risk assessment. Factors to consider include the local epidemiological trends or rising hospitalization levels, levels of vaccination coverage and immunity in the community, and the setting people find themselves in.”
The WHO also advised that a Covid-19 patient could be discharged from isolation early if they tested negative on an antigen-based rapid test.
“Without testing, for patients with symptoms, the new guidelines suggest 10 days of isolation from the date of symptom onset. Previously, WHO advised that patients be discharged 10 days after symptom onset, plus at least three additional days since their symptoms had resolved.
“For those who test positive for Covid-19 but do not have any signs or symptoms, WHO now suggests five days of isolation in the absence of testing, compared to 10 days previously.
“Isolation of people with Covid-19 is an important step in preventing others from being infected. This can be done at home or at a dedicated facility, such as a hospital or clinic,” it noted.
The evidence considered by the organisation showed that people without symptoms were much less likely to transmit the virus than those with symptoms.
“Although of very low certainty, evidence also showed that people with symptoms discharged at day five following symptom onset risked infecting three times more people than those discharged at day 10.”
The WHO also extended its strong recommendation for the use of nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’).
It, however, said pregnant or breastfeeding women with non-severe Covid-19 should consult with their doctors to determine whether they should take the drug, due to the ‘likely benefits’ and a lack of adverse events having been reported.
“Nirmatrelvir-ritonavir was first recommended by WHO in April 2022. WHO strongly recommends its use in mild or moderate Covid-19 patients who are at high risk of hospitalisation. In December 2022, the first generic producer of the drug was prequalified by WHO.
“WHO also reviewed the evidence on two other medicines, sotrovimab, and casirivimab-imdevimab, and maintains strong recommendations against their use for treating Covid-19. These monoclonal antibody medicines lack or have diminished activity against the current circulating virus variants.
“There are currently six proven treatment options for patients with Covid-19, three that prevent hospitalisation in high-risk persons and three that save lives in those with severe or critical disease. Except for corticosteroids, access to other drugs remains unsatisfactory globally,” the UN body stated.
