On 31 December 2019, health authorities in China reported to the World Health Organization (WHO) a cluster of viral pneumonia cases of unknown cause in Wuhan, Hubei and an investigation was launched in early January 2020. On 30 January, the WHO declared the outbreak a Public Health Emergency of International Concern (PHEIC)7,818 cases confirmed globally, affecting 19 countries in five WHO regions.
Nigeria, like many other countries began making preparations for possible outbreak of the disease in the country. Meanwhile, many Nigerians including some health workers believed it’s a foreign ailment amid claims that the virus could not infect black Africans. Well, the death of Abba Kyari, President Buharis Chief of Staff was a timely reminder of what Nigeria is about to experience. As a pharmacist at Mainland Infectious Diseases Hospital (IDH), Yaba Lagos, I was anxious about the new reality. The hospital is known to have a government owned isolation center which was essential to the containment of the Ebola virus six years earlier. Hence, seminars were organized to train staffs on how to handle the new situation and on the proper use of personal protective equipment (PPE).
As expected, a new sign board was mounted around mid-February towards the main gate of the hospital with the notes “Caution: Highly infectious environment”. Barely a week after, the hospital opened its doors to the first coronavirus case in the country on the 27th of February, 2020. The index case spurred a number changes in the hospital services.
When there are no disease outbreaks, the hospital is a center for the management of Human Immunodeficiency Virus and Tuberculosis, however due to the advent of COVID-19, the traditional in-patients were discharged and transferred to other facilities, while the out-patients were referred to designated community pharmacies for their drug refill. This was a calculated step to prevent the spread of coronavirus to other patients.
Despite the lesser interaction of pharmacists with COVID-19 patients, the hospital pharmacy still placed a new signpost in the department Have you washed your hands today?. Also, we welcome more supplies of Lopinavir/ritonavir (Alluvia®), a second line antiretroviral drug used in the management of people living with HIV/AIDs but now deployed for coronavirus patients.
The above experiences cemented my belief as well as other staffs of the hospital that the pandemic is real in Nigeria as it is in other climes. However, several factors have made the average Nigerian doubt the presence of the disease in the country. The emergence of videos showing people in isolation centers dancing and partying raises questions as to the fatality of the virus unlike how it was portrayed in the media. Nevertheless, this does not mean that patients in isolation centers are not infected. Not until early June when the Nigeria Centre for Disease Control (NCDC) released a new guideline for the admission and treatment of coronavirus patients, both symptomatic and asymptomatic patients were admitted to the hospital from the onset of the pandemic in Nigeria. The government have decided not to release videos of symptomatic and intensive care unit (ICU) patients based on patients confidentiality. No one saw the late Chief of Staff in the media, until his sudden death.
For asymptomatic patients however, it is traumatic to be literally imprisoned for days within the four walls of a hospital. This may explain why videos of dancing patients emerged, which was recorded on Easter holidays.
Another factor that downplay the severity of the pandemic in the country is the spread of fake news. A tweet by Kemi Olunloyo claimed that President Buhari is very sick and a makeshift ICU was being set up for him. But this turned out to be false, as Mr Buhari was never positive for the virus. The spread of fake news means the already over-burdened NCDC have to combat two pandemics at a time: the virus and fake news. A review by the Centre for Democracy and Development suggested that purveyors of fake news have sought to incite panic and panic buying, proffer fake cures, undermine medical advice, promote hate speech and promote polarization along political lines.
Moreover, one major factor that makes Nigerians doubt COVID-19 is the selective nature of who dies from the virus and who survives. For several weeks after Nigeria recorded its index case, the rate of the spread of the virus was significantly low and there were no deaths recorded. This makes some people to wrongly conclude that coronavirus is a scam-demic in the country. A number of states governors also caught the virus but all of them recovered.
There is no doubt that some political leaders have seek to take advantage of the situation, but nonetheless, the virus is real in Nigeria. We should be aware that research is still ongoing on the nature of this virus. On June 8, 2020, the WHO released a new guideline that asymptomatic carriers of the virus will rarely transmit the virus to others, this is a backdrop from earlier guidelines of human-to-human transmission that necessitates the call for social distancing. The WHO later back down on this conclusion.
In mid-April, members from our department went for COVID-19 screening just like other frontline workers in IDH. Out of four people that went for the test, two came out positive. These pharmacists were otherwise healthy but have to go into isolation. But, for most of us, we chose not to go for the test as we had no symptom that necessitates it.
Furthermore, a number of events and instances have established the presence of COVID-19 in Nigeria. As mentioned earlier, the death of Mr Presidents CoS due to coronavirus clearly demonstrates that the virus is here and can kill just about anybody. Senator Buruji Kashamu was at IDH and was reportedly managed successfully only to give up the ghost at First Cardiology Consultants, Ikoyi after IDH discharged him.The death of Senator Abiola Ajimobi and Senator Bayo Osinowo is still fresh in our memories.
Also, the pharmacy department of IDH attended only to prescriptions for COVID-19 patients for more than five months until August when the traditional patients are allowed to return while the remaining COVID-19 patients are managed in the newly built CA-COVID centre. (COALITION AGAINST COVID 19)
In conclusion, instead of doubting COVID-19 in Nigeria, continue to thank God Almighty for helping us manage its emergence in the country. Surely, the families and friends of those corpse deposited on a daily basis to the IDH mortuary will never doubt the reality of coronavirus in Nigeria.
OJOMO Qudus Abiola is a young pharmacist undergoing National Youth Service at Mainland Hospital, Yaba, Lagos.