The Minister of State for Health, Dr. Olorunnimbe Mamora has urged citizens especially those who are in doubt of the existence of COVID-19 in the country to at least take extra pre-caution in their daily activities to avoid being a victim of the disease.
The Minister made this counsel at the Presidential Task Force on COVID-19 Press Briefing held on Thursday. He said that as the number of Covid-19 deaths continues to increase in Nigeria, citizens, especially those who are in doubt of the corona virus pandemic should take extra pre-caution in their daily activities.
Dr. Mamora reported that “We had 649 new confirmed cases bringing the total number of cases in the country to 22,020. We have so far successfully treated and discharged 7,613 persons while 542 deaths have been recorded.”
Continuing, the Minister stated that on Tuesday, 23rd June, 2020, an Emergency National Council on Health was held virtually, attended by State Commissioners of Health, Head of Agencies, Directors at the Federal Ministry of Health, Development Partners and other stakeholders in the health sector to review status and align all responses to COVID19 outbreak in States. “The Council approved the Health Sector COVID-19 Pandemic Response Action Plan which was developed by the Federal Ministry of Health in collaboration with the Departments and Agencies to present one response in the health sector delivered in a coordinated and strategic manner.”
The Minister said: “As we learn more about the disease, we continue to evolve response actions. The community transmission has resulted in the high number of confirmed cases with the challenge that in some States, the facilities for case management may become overwhelmed. Bearing in mind the importance of managing cases in facilities, the Federal Ministry of Health through the National Primary HealthCare Development Agency (NPHCDA) has developed a guideline for the establishment of Community Support Centres.”
Dr. Mamora informed that the central objective of the guideline is the establishment of Community Support Centres (CSCs) in selected clusters of Local Government Areas (LGAs) for the management of COVID-19 cases.
According to the Minister, those community support centres would strengthen the capacity of the health system at the community level to respond to the outbreak and result in the reduction of the transmission of COVID-19 within communities in high burden and high density States.
He therefore stated that Nigerians must be reminded daily of the challenges COVID-19 poses to the country and the world, and further reinforce our resolve to tackle the pandemic. “We can reduce case fatality in Nigeria, if non-pharmaceutical interventions are scaled up and we become more proactive in dealing with positive cases. We can scale up testing, tracing, treatment and isolation, with priority on offering more protection to elderly citizens and those with co-morbidities, from the threat of infection”, Dr. Mamora stated.
COVID-19 response in southern Nigeria boosts surveillance of other diseases
In many countries, tackling the COVID-19 pandemic has taken cues from other disease approaches, such as lessons from protecting communities against Ebola. But in Nigeria’s Niger Delta, health workers have found inspiration from guarding against the coronavirus.
They have exploited the rigorous surveillance standard set by the COVID-19 response to keep from losing sight of other priority diseases. Mostly what they have learned is how not to divide their attention.
The unifying surveillance strategy they have enveloped is quickly producing significant and – possibly oddly – uplifting results.
“I recorded my first acute flaccid paralysis case since last year while I was following up on the contact of a confirmed case of COVID-19,” says Sarah Oladimeji, a Diseases and Surveillance Notification Officer in charge of finding cases of preventable and infectious diseases in Oredo Local Government Area of Nigeria’s Edo State.
When COVID-19 crept into the southern Delta region in April, health workers had to learn to overcome their worries and hunkered down to the needed work. The odds seemed stacked against the six states that make up the South-South zone: Akwa Ibom, Bayelsa, Cross River, Delta, Edo and Rivers. COVID-19 cases increased daily while community attitudes towards the virus grew lax. Health workers scrambled to manage the time and resources available to respond to both COVID-19 and other endemic-prone diseases.
One solution government teams and health workers hit upon: bring the aggressive COVID-19 surveillance into the systems used to monitor priority diseases.
Across the Niger Delta, the World Health Organization (WHO) and its partners retrained 3874 surveillance officers who had been mobilized to detect COVID-19 cases in hospitals and communities to also look for acute flaccid paralysis (AFP), polio, meningitis, cholera, neonatal tetanus, yellow fever, measles and more.
After the Government decentralized the COVID-19 response in April, some states began also training religious and community leaders – who are often important decision-makers, influencers and informants – to help find and report suspected COVID-19 and other priority diseases in their communities.
Now, four months into the region’s COVID-19 outbreak, health workers are seeing spectacular efficiency. Detected cases of AFP, for example, increased substantially (doubling and even tripling in one state) between the end of March and end of July as the harmonized surveillance ramped up.
Protecting immunization gains
Keeping eyes on both COVID-19 and other diseases, most of which are vaccine-preventable, is an important but challenging task in the Niger Delta where immunization coverage had been low for years. Located along the Niger River and the Gulf of Guinea, the Niger Delta, or South-South zone, comprises a system of coastal communities that rely on farming and fishing. Waterway systems here are often inadequate and moving around is difficult. In the past, residents in the deepest riverine communities, far from a mainland, had little luck accessing a health centre. Many were discouraged by the distance from taking their children for vaccinations, which led the region to its poor immunization coverage and thus heightened risk of disease outbreaks.
Since 2016, community engagement, better access to health care and increased surveillance have led to rising numbers of vaccinated children. Health workers now attend patients in on-sea treatment centres or travel into the deep-river communities by canoe to provide services.
Navigating the creek communities may be hard but health workers accept that medical care has no boundaries, says Dr Edmund Ogbe, WHO Coordinator for Bayelsa State. Public health commitment and resourcefulness seem to be ingrained characteristics of this region.
Increased detection of measles and yellow fever
To protect their gains in immunization coverage and keep from neglecting other worrisome diseases in these times of COVID-19, the integrated surveillance is making a difference. In March, Bayelsa State recorded nine cases of AFP. But 16 new cases were investigated over the next four months – a 180% increase.
With COVID-19 case findings now meshed with the systems used to detect and report priority diseases, more cases of measles and yellow fever are emerging, too. The reported numbers of both diseases increased considerably between the end of March and the end of July. In a couple states, case detection nearly doubled.
The next step will be to accelerate case search throughout the region. State governments in the South-South zone, supported by WHO, continue to train more surveillance officers and community informants on combining COVID-19 and preventable-disease surveillance. Involving communities by educating them and appointing them as public health informants will help ensure that the combined surveillance continues to be a success, says Dr Olubowale Ekundare Famiyesin, WHO Zonal Coordinator of the Niger Delta.
Early detection of any disease is the goal for health workers in the Delta. “All resources for surveillance at our disposal will be deployed to improve early infectious disease detection and reporting, including COVID-19,” Dr Famiyesin promises.
COVID-19:Oyo trains health workers on decontamination response
The Seyi Makinde -led government in Oyo state on Tuesday trained no fewer than 77 environmental health officers on containment and decontamination response initiative to prevent the spread of coronavirus (COVID-19) in the state.
Also, each team had been provided with a revolving N500,000 seed grant for the purchase of chemicals and logistics.
The state’s Team Lead of the Containment and Decontamination Project, Prof. Olanike Adeyemo who disclosed this during a training programme on COVID-19 Decontamination Response Network held at the University of Ibadan ahead of the commencement of the initiative, also noted that the initiative would focus on the next phase in the containment of COVID-19 in the state.
The training had in attendance representatives of environmental health officers in all the 33 local government areas which had been divided into seven zones.
According to Prof. Adeyemo, “COVID-19 has spread beyond Ibadan and what that means is that the government has to be responsive to do what is right.
“You can imagine if there is an incidence in Ibarapa and another one in Iseyin, it would be very difficult for the state containment team to cover all.
“So what the government is doing is to decentralise the containment efforts.
“Containment is not all about decontamination, it is a lot of things, so this is embedded in the local government system. Every local government has an environmental health unit.
“These are the people that are being trained because they are on the staff of the Oyo State government already to be able to take up this task as frontliners,” she added.
Speaking further, she stressed the need for self policing, disclosing that compliance form had been made available to report violators of COVID-19 guidelines.
Reacting to the high rate of COVID-19 cases in the state, Adeyemo explained that there was the need to work more on compliance to reduce infections.
‘If you look at the mortality rate and you look at Oyo State and compare it with Edo state that is behind us and you compare the mortality, definitely they are under reporting in those states.
“I think Oyo State is doing more testing and we are reporting a closer to accurate number and that is why we are high there.
“But when you compare the mortality rate for people behind Oyo State on the NCDC list of confirmed cases then you will see that their mortality is higher.
“And it is just science, the more the cases the more likely people will die. So it’s easy to extrapolate that those states that have very high mortality but low numbers of confirmed cases are under reporting”, she continued.
Also commenting, Mr Mojeed Mogbonjubola, the Deputy Chief of Staff to the Governor, informed that the decentralisation of containment was the initiative of the administration.
“It is quite unfortunate that the pandemic is spreading really wide and we couldn’t contain it in Ibadan.
“What His Excellency is trying to do in conjunction with the University of Ibadan is to extend the committee’s team to other regions of the state.
“This is about a call to service. Like I always advise people it is a privilege for everybody to be part of this and it is something that will stay with us for a very long time.
“Since there is no vaccine to control the virus the only way is to contain it and decontaminate affected zones,” he submitted.
Remarking, the Personal Assistant to Governor Makinde, Alhaji Akeem Azeez urged residents to own their actions as well as their safety since the virus had spread all over the state.
Mr Tunde Adeyanju, the Permanent Secretary in the Ministry of Local Government and Chieftaincy Affairs, averred that there was the need for a very good response in view of the rate of infections in the state.
A technical expert in the team, Prof. Victoria Adetunji, however urged participants to adhere strictly to precautions in handling the decontamination equipment while engaging in evaluation of their activities.
Use of RDT kits for COVID-19 test is illegal in Lagos – Commissioner
The Lagos State Commissioner for Health, Professor Akin Abayomi has reiterated that the use of Rapid Diagnostic Test (RDT) Kits for COVID-19 testing in Lagos remains illegal until the State can validate that the kits actually work.
Abayomi stated this at a news briefing on COVID-19Lagos Response, explaining that RDT kits have a very high risk of giving false positive or negative results which could be traumatising for citizens.
“In the event that a false-positive result is given, a potentially negative person will be subjected to trauma, isolation and treatment like a positive patient. And in the event that a false negative is given, a potentially positive person is allowed to continue to roam freely in the community regardless of his positive status and as a result, the use of RDT kits is illegal until Lagos State can validate RDT kits that actually work”, he insisted.
The Commissioner explained that the State Government had considered the use of Rapid Diagnostic Test (RDT) Kits as part of the strategies to expand its testing capacity but noted, however, that none of the RDT kits submitted for validation passed the required test.
“In order to expand our testing capacity, we considered the use of RDT Kits and to facilitate the quick validation of the RDT Kits and reduce the barrier of entry for proposed manufacturers and suppliers of RDT Kits, Mr. Governor paid the validation fees for the RDT kits. However, upon review of several RDT kits that were submitted for validation, we can report that none of the RDT kits passed the validation exercise”, Abayomi disclosed.
While noting that the World Health Organisation (WHO) has not declared any RDT kit useful for public use, Abayomi stated that it is also illegal for private health facilities to test or manage COVID-19 cases without proper accreditation and validation by the regulatory authorities.
“It has come to our attention that several laboratories and health facilities are testing and managing COVID patients without proper accreditation and validation by the regulatory authorities. Two laboratories were sealed as a result of this. We will continue to closely monitor all facilities that partake in these illegal activities and endanger the lives of all residents of Lagos State and instigate punitive measures to ensure they desist from such activities”, the Commissioner said.
Disclosing that only seven private laboratories were already accredited by the State government, he maintained that the second phase of accreditation and validation of laboratories will be conducted when the demand arises.
Abayomi added that the State Government has also only accredited three private facilities and is currently in the process of accrediting more, including general practitioners and small clinics, that are interested in partaking in the soon to be launched community-based and home-based care program.
“It is important to reiterate that the COVID-19 pandemic is a public health emergency and the Lagos State Government has adopted a central planning approach to managing its response”, he stated.
Assuring that plans are in top gear by the State government to scale up sample collection at the 20 LGAs to include the 37 LCDAs in order to improve the efficiency of sample collection in the community, Prof. Abayomi disclosed that residents will have access to free oxygen therapy at some of the centres, if required, while arrangements will be made to transfer such a person to a COVID-19 Centre.
Abayomi hinted that the State government will in the next couple days transition to the next phase of the COVID-19 response, which he referred to as the community-based care.
“Under the community-based care arrangement, we provide the opportunity for mild-to-moderate cases being managed and isolated at home in situations where this is allowed. However, our critical-to-severe cases will be continually managed in our COVID-19 isolation centres, where they will have the opportunity of the best treatment available”, the Commissioner assured.
Stating that a date for the commencement of home-based care will be formally announced soon, Abayomi observed that vulnerable, elderly and severe-to-critically ill patients will be managed at the isolation centres to ensure that they receive the best possible care available.
Giving epidemiology statistics on COVID-19 cases in Lagos State, the Commissioner said that over 56,276 COVID-19 tests have been conducted so far while the total number of positive cases stands at 13,543, pointing out that of the 2,476 COVID-19 patients admitted so far, 2,075 have been discharged to reunite with society after recovery.
Abayomi added that no fewer than 9,066 confirmed COVID-19 cases monitored in the communities by the COVID-19Lagos response teams have either recovered or are positively responding to treatments, noting that 192 COVID-19 related deaths have been recorded in Lagos.
He disclosed that Eti-Osa Local Government has the highest number of confirmed COVID-19 cases with Eti-Osa, Alimosho, Kosofe, Ikeja and Oshodi accounting for 60% of the total COVID-19 cases in Lagos State.
Commenting on the COVID-19 Lagos community engagement, the Commissioner for Information and Strategy, Mr. Gbenga Omotoso, emphasised the need for citizens to wear face masks correctly, especially in public places to curtail the spread of the virus.
Omotoso reaffirmed the State government’s commitment to securing the lives of citizens, disclosing that necessary precautions and guidelines stipulated by professionals will be taken before schools and religious centres reopen while the government will not take any risks with public health issues.
“Some of the reports we are getting that people do not want to wear face masks are not too good. What we are dealing with is a very dangerous enemy that has no remedy anywhere in the world. Humanity is just trying to curtail this terrible situation”, Omotoso said.
He maintained that the proper use of face marks will reduce the possibility of an infection and urged citizens to take responsibility for proper use of face masks, saying they do not need to wait for enforcement before adhering to directives on the use of face masks.
“I assure you that schools and religious institutions will be opened as soon as the go-ahead is given. We have to wait for the professionals so that we do not put ourselves in trouble. The State remains committed to securing lives and property of Lagosiapractitioners
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