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Flying Doctors’ boost Nigeria’s COVID-19 testing

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Red-gloved hands gently dip cotton swabs down nostrils and mouths of people taking turns to stand in front of a tall booth, masks lowered and head tilted backwards. Inside the booth to which the gloves are attached is a COVID-19 sample collector.

Set up by Nigerian health investment firm Flying Doctors in eight of the country’s worst-affected states, the mobile booths, which separate the sample collector from the people being tested, have boosted COVID-19 testing. Between 80 and 100 samples are collected per booth every day, although the number varies among states. Nigeria is conducting an average of 2500–3000 tests daily.

Flying Doctors founder, Dr Ola Brown, explains that at the start of the pandemic, Nigeria had few people trained to take COVID-19 test samples, and collectors would also visit people at homes to take samples, heightening infections risks through exposure.

“It [the sample collection booth] reduces to zero the number of infections on the people conducting the tests. Secondly, it also saves a lot of time compared [with] the people testing having to go to people’s houses to do the tests and thirdly, it saves money because people [are] not having to change their PPE [personal protective equipment]” frequently, says Dr Brown.

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For Dr Walter Kazadi, World Health Organization (WHO) representative in Nigeria, “expanding access to services such as sample collection and diagnostic testing are critical for an effective response.” WHO continues to support Nigeria’s Centre for Disease Control and the national response system by providing resources for training and supplies for sample collection and testing.

The COVID-19 response across Africa has propelled a raft of innovations. Across the continent, innovators have worked to create tools to help public health experts manage challenges ranging from contact tracing and clinical care to local production of equipment and supplies as well as laboratory and testing materials.

Many of the innovations were already existing but have had to be redirected or adapted to COVID-19 response. For example, Zipline, a California-based firm, repurposed its high-speed drones that were in use in both Ghana and Rwanda to deliver medical packages to clinics and hospitals to now identify COVID-19 hotspots and collect samples. In anticipation of new treatments and vaccines that may become available, the company is poised to help with distribution.

In Kenya, to support contact tracing in public transport, a mobile phone-based application, mSafari, was launched in March by its developers in collaboration with the ministries of Health and Transport.

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Most of the innovations are homegrown. The mobile booths in Nigeria are made locally. In all there are 14 booths in Abuja, Kano, Kaduna, Lagos, Ogun, Oyo, Rivers and Zamfara states. Flying Doctors also has transformed one vehicle into a mobile laboratory. In total, the organization has three laboratories. It has trained more than 100 molecular laboratory scientists to carry out COVID-19 testing.

Working with various foundations, the organization has made its testing free to encourage people to turn up. COVID-19 testing in Africa still lags other regions of the world. The World Health Organization Regional Office for Africa recommends 10 tests per 10 000 people per week in the region. Just 12 countries recently surpassed the threshold.

While Africa has recorded relatively fewer COVID-19 infections compared with other regions, the decline in cases seen between July and September has plateaued, with spikes in cases reported in some countries. Dr Brown stressed the criticality of testing and maintenance of vigilance on COVID-19.

“I think [that] one of the things that has really impacted the focus on testing is the fact that not many people have died in Africa compared [with] Europe or America. When people aren’t dying and when people aren’t getting horrifically sick and we’re not seeing those numbers of course it [testing] gets deprioritized especially in a country that has limited resources,” she says.

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“It’s important for everybody to remain vigilant … and continue to really keep our guard up.”

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Health

Fg begins online registration for COVID-19 vaccination {Read details}

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The National Primary Health Care Development Agency has announced that Nigerians can now register for the COVID-19 vaccination through its official website.

The agency on Monday in a tweet explained, “To register for #COVID19 Vaccination, visit our website http://nphcda.gov.ng and click on ‘COVID-19 Vaccination e-registration”.

Nigeria is expected to receive almost four million doses of the vaccine tomorrow courtesy of COVAX, a global initiative backed by the World Health Organisation.

Earlier on Monday, the Minister of State for Health, Dr Olorunnimbe Mamora, noted that frontline health workers would be one of the first set of people to get the vaccine.

“The first will be the frontline health workers because they are facing the battle heavily,” he said.

“They will come first then, secondly, we will look at the elderly – those above 60, 65 years and particularly with comorbidities (people who have existing health conditions such as high blood pressure, diabetes, heart disease – they will also be in that group.

“We will also be looking and the strategic leadership of the country, and then we would be looking at some other people like those at the point of entry, border post managers, and things like that; This will be the order in terms of priority for now.”

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Nigeria to receive about 4m doses of COVID-19 vaccine on Tuesday

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The Nigerian government has confirmed that it will receive the first tranche of the COVID-19 vaccine on Tuesday.

Chairman of the Presidential Task Force (PTF) on COVID-19, Boss Mustapha  disclosed this on Saturday in Abuja, the Nation’s capital. 

Boss Mustapha, who also doubles as the Secretary to the Government of the Federation (SGF), explained that the first shipment of  3,924,000 million doses of covid-19 vaccines is coming from COVAX, a World Health Organization (WHO) backed initiative set up to procure and ensure equitable distribution of vaccines for free among countries across the globe.

“I can assure you that the vaccines are coming and they are coming very quickly barring any change in the delivery plan that has been released to us by UNICEF,” the SGF said, exactly one year after the virus was reported in the West African nation.

The SGF continued , “We believe that our vaccines should depart India on the 1st of March, 2021 at 10:30 pm and arrive in Abuja on the 2nd of March by 11:10 am.”

The Minister of Health, Dr Osagie Ehanire had earlier confirmed that Nigeria will be getting the COVAX vaccine in March, and explained that the Federal Government is targeting to vaccinate 70 percent of the population. 

“We have been told to open an account with Afreximbank under the African Union; we have done that already successfully because we are going to pay for that part of the vaccine. The COVAX vaccine is free, at no cost to us, it is made from donations,” the minister had explained during a briefing with journalists

“We want to immunise about 60 to 70% of our population. If COVAX immunises 20, then we have about 40 to 50 to immunise within the next two years”,  he said

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Why the US has the highest COVID-19 death toll

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The United States crossed the grim milestone of 500,000 deaths from COVID-19 on Monday, a year since announcing its first known death from the virus on February 29, 2020 in the Seattle area.

Why does the world’s leading power have the highest death toll and what lessons are American health specialists learning from the past year?

Here, infectious disease experts Joseph Masci and Michele Halpern provide answers to some of the key questions.

Masci, 70, is one of the leaders of Elmhurst Hospital in Queens, which was at the heart of New York’s epidemic.

Halpern is a specialist at the Montefiore hospital group in New Rochelle, a New York suburb where the epidemic arrived in force in February 2020.

– Why has the United States been hit so hard? –

Prior to this pandemic, the United States observed coronaviruses “from a distance,” explained Masci.

“There was SARS in Canada but very little or none in this country. There was no MERS here at all,” he said.

“There was a lot of preparation made for Ebola coming to the United States, and it never really did.

“Suddenly this (coronavirus) was a problem where the United States was the epicenter.”

Masci said it was difficult to compare the United States with other countries.

“I think smaller countries that had structured health care services had a good chance of bringing things into play quickly.

“In a country like ours, with 50 independent states, and a huge landmass, with largely a private hospital system, it is always going to be difficult to get everybody on board with one particular set of strategies,” he explained.

Masci added that Donald Trump’s administration had a “haphazard approach”, which did not help.

“The fact that hospitals were competing with each other to get personal protective equipment didn’t make sense. They had to centralize all of that very quickly and they didn’t.

“It was a struggle to try to deal with those obstacles that were put up,” he said.

Masci and Halpern rue that mask-wearing was politicized.

“It’s purely a health care issue,” said Masci, adding that it is going to be difficult for the federal government to “reframe” that message.

Halpern insists that people should not see mask-wearing as “infringing” on their freedom.

“There are other things we do routinely that you could say infringe our liberties like wearing a seatbelt or running through a red light,” she said.

According to the Johns Hopkins University tally, another 1,297 virus-related deaths were reported on Monday in the United States.

– What are the main lessons to be learned from the crisis? –

For Masci, the most important lesson was to learn how to reconfigure hospitals to make them able to cope with a sudden influx of patients.

“Now… instead of 12 hot ICU beds, you have to have 150. Where do you get them? Who do you staff on with? So now we’ve learned this lesson.” he said.

Masci said the group of public hospitals of which Elmhurst is a part found strategies to distribute the burden among NYC’s 11 public hospitals by transferring patients very quickly.

“We’ve turned from one hospital with 500 beds, to 11 hospitals with about 5,000 beds. It’s worked very nicely.”

More generally, Halpern says the pandemic has made everyone realize that “hospitals need resources.”

“You have to invest in research, but you also have to invest in hospitals, in nursing homes. They have to have enough staff, they have to have the equipment that they need and the personnel has to be happy,” she added.

The epidemic has also sharply exposed inequalities, not just in health care but also in housing, with Black and Latino communities dying in disproportionately high numbers.

“We have to look at housing, and how it can be better suited to handling future epidemics. There are others coming,” said Masci.

– Will we still be wearing masks in December? –

Vaccines are rolling out but health experts are cautious due to uncertainties surrounding the British and South African variants of the virus.

Masci says that if the variant strains don’t turn into a huge problem and once we’ve reached the point where 70-80 percent of the population is vaccinated then “there’s a good chance” we won’t wear masks anymore.

“(But) suppose these variant strains do take hold, become more of a problem, are vaccine resistant, and we’re all closing schools and putting masks and locking down again in a few months, (then) it’s a lot harder to say by December, ‘We’ll be out of the woods.’”

Halpern says it’s reassuring that the second wave was largely controlled, in New York at least.

“I have hopes that the vaccines will be effective and will tamper future waves. But it’s hard to be sure whether our vaccines will be effective in the longer term, or on new variants. I don’t think anyone knows that.

“So we have to be prepared that we’re in this for a while,” she said.

In the long term, Masci says countries must not “fall into the trap” of forgetting about the pandemic once it has passed.

“It is unnerving to think that this came without warning. It’s caused so much restructuring of everything.

“We have to have a more meticulous global search for new pathogens because we’re living in a time now where there is no, ‘Something is happening in Asia and it’s not going to happen in America.’”

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