… decry lack of personal protective equipment as cases rise to 214
Plateau nurses, midwives threaten to down tools over lack of PPE
Lagos to pay medical bills of pregnant women, others, impounds 400 vehicles
Oyetunji Abioye, Gbenga Adeniji, Femi Makinde and Sola Shittu
There has been panic among medical workers at the Irrua Specialist Teaching Hospital, Edo State, after two doctors tested positive for coronavirus on Thursday, Sunday PUNCH can report.
It was gathered that the two affected doctors worked at the facility’s Pathology and Obstetrics and Gynecology departments.
A senior medical officer at the hospital, who spoke with one of our correspondents on condition of anonymity, said the two doctors were currently in isolation in their different homes.
The source said the doctors became infected after attending to two patients without protective gear and unknown to them that the patients were carriers of the virus.
ISTH is a World Health Organisation-recognised centre for Lassa fever research and treatment in Africa.
According to the source, the doctors began to exhibit the commonly known symptoms of COVlD-19 after attending to the patients. The tests ran on them however came out positive.
This came as the number of cases in the country rose to 214 on Saturday with five new cases recorded in Bauchi and the Federal Capital Territory.
Bauchi had three while the FCT had two. The number of deaths has risen to four while 25 persons have so far been discharged in Edo and Ekiti states.
Overall, Lagos State, with the highest in the country, has 109 cases; Osun (20 cases); Oyo (nine); Akwa Ibom (five); Ogun (four); Edo (seven); Kaduna (four); Bauchi (six); Enugu (two); Ekiti (two); Rivers (one); Benue (one) and Ondo (one), which was confirmed on Friday evening, and the Federal Capital Territory with 43 cases. As of Saturday night, however, the number of cases across the world had risen to 1,196,049 cases, out of which 246,110 had recovered and 64,542 had died.
Meanwhile, the source said, “The tests were well done. lrrua, as you know, has been at the forefront of combating Lassa fever and is equipped. Sadly, the tests were positive. The victims are resident doctors in their mid-thirties. One of the doctors met with one of the patients 10 days after returning from Lagos where he went to put finishing touches to overseas travel plans.
“We don’t have personal protective equipment; no enough face masks, hand sanitisers and hand gloves. The doctors were doing their normal work. The centre where the two doctors worked was involved in the treatment of coronavirus at lrrua. The two patients infected two doctors in two separate departments in the facility.
“What is clear now to everybody is that the two affected doctors didn’t know that the patients they were talking to and examining were carrying the virus. Most people with the virus were usually asymptomatic at the beginning. There was no prior knowledge of the medical condition of the two patients.
“These two unknown patients must have mixed with others maybe while awaiting consultation and all that. The required social distancing was not enforced. The two doctors went home and probably met with their family members and other patients in their private practice. You see the pattern of spread. It took a while before the situation came to the limelight.
“We usually leave this kind of crisis in the hands of physicians because they are the ones who manage internal medicine and immune status of patients. If it’s mostly respiratory system disease, that is also within their purview.
“It’s only when complications occur and we are not talking about intensive care unit, incubating and putting patients on ventilators that you require the input of an episiologist and intensivist. And at that point, it becomes a multidisciplinary kind of treatment.”
Also, a nurse at the hospital told Sunday PUNCH that though the CMD wasn’t around when the news broke, he had been informed of the development.
The nurse added, “The system doesn’t provide for the safety of doctors and the hazard allowance for an average doctor in Nigeria is N5,000 monthly.”
The nurse said there were fears at the hospital as many nurses had been filing for their annual leave to stay away from the facility. The source added, “Many people have applied for their annual leave but I wouldn’t know if they have been approved. I can’t risk my life working in a facility where there is no PPE. Even a consultant has shut down his outpatient clinic for lack of PPE at the hospital.”
On Friday, President, National Association of Resident Doctors, Dr Aliyu Sokomba, said a doctor at the teaching hospital had tested positive for the coronavirus. He spoke during a live programme in Benin City.
Meanwhile, other reliable sources at the ISTH said there had been panic at the centre since the outbreak of the virus in the state. An official told one of our correspondents on condition of anonymity that nurses were rushing to proceed on their annual leave to avoid the virus.
The official noted that helicopters had been flying in blood samples from various cities for screening at the hospital. The isolation centre for coronavirus patients in the hospital is a building still under construction.
Also, a medical doctor noted that they preferred those who tested positive to stay in isolation in their homes.
Most of the offices visited in the hospital were near empty in compliance with government’s stay at home directive to level one to twelve workers.
Although there was no patient in the isolation centre at the ISTH but a source said there were cases of COVID-19 in the hospital but that the management was trying to manage the information so as not to cause panic.
The source said, “You know if they announce the numbers, there will be panic, even health workers will start running away. Already many have started applying for their annual leave. As I’m talking, we don’t have hand sanitisers. Thank God for the rain that gives water. We don’t have our protective gadgets too, they are in short supply.
“There was a case of a lady from Ondo State who came to visit her boyfriend in Ekpoma. She was admitted for pneumonia. After two or three days, we noticed that the symptoms the girl was exhibiting were not for ordinary pneumonia. We had to take her blood sample and at the end of the test she came out positive. It is possible that the majority of the patients in that ward were infected and the people she had contact with could also have been infected and there was no contact tracing.”
Our source further stated that all the cases of COVID-19 were being handled by the Lassa fever unit because they had not created a unit or isolation place for them.
“Yes, there have been cases but as a worker here we cannot say it out because they will say one is going against the ethics. So it is what they give to the media that will be reported,” the source added.
On why the doctors and nurses were scared, our source said they had genuine reasons because they were also afraid for their safety.
The source said, “Take for example, when I came to work today, the face mask was scarce and no hand sanitiser and the face mask is key. I can do without hand sanitiser.
“For washing of hands, I can use methylated spirits and I can use morning fresh but the face mask, when you go close to a patient to take the body temperature or blood pressure, they will breathe directly on your face.
“You cannot take your face away because you are attending to a patient. Also, you need to have face-to-face contact with them and because I don’t have the face mask I have to isolate myself. That is the truth.”
The source said what many of them were doing now in many of the hospitals around was to improvise the face mask by using toilet paper.
Another source in the hospital said there were palpable fears because the hospital could not continue to keep the COVID-19 patients with Lassa fever patients.
“That will only complicate issues,” the source said. “I saw the second-in-command to the CMD going round the uncompleted building yesterday, trying to see what they could do because of the danger involved in keeping them with Lassa fever patients.
“I hope the government will send some of the billions of naira they said they are spending on this coronavirus to us to complete the building.
“The United States has mopped up all the ventilators and so you can hardly find ventilators to buy at this time. Let all our senators go and enjoy their abandoned constituency projects now. I think this is good for us anyway, maybe we will learn our lesson.”
Tension in UBTH as two tested positive for COVID-19
Meanwhile, tension mounted among health workers at the University of Benin Teaching Hospital on Saturday after two patients who earlier tested negative for the COVID-19 were declared positive after further tests were conducted.
The development came as the Nigeria Centre for Disease Control on Friday confirmed the death of two patients of coronavirus in Edo and Lagos states.
The Association of Resident Doctors in UBTH in its message to its members expressed dismay that the earlier results of the two suspected cases previously declared negative turned out to be positive after further tests were carried out.
The message, which was signed by the Chairman of the Resident doctors, Dr Etinosa Imagbenikaro, partly read, “Whilst the exco cannot fully ascertain at this time what may have led to this, it has become imperative at this point to inform our members on the sudden turn of events.
“We expect management to issue a statement on the way forward, as this cuts across all members of staff that have been involved in the management of these patients.”
It, however, urged members to remain calm as always, continue to maintain high suspicion and ensure standard precautions for all patients.
Similarly, an internal memo signed by UBTH Chief Medical Director, Darlington Obaseki, said contacts tracing had commenced for all staff members who had direct contact with the patient.
He added, “Terminal disinfection has been mandated for all the places the patient was managed. The patient has continued to improve clinically, vital signs remain stable and his SPO2 has ranged between 92 to 94 per cent.
“Management enjoins everyone to remain calm and continue to observe the necessary standard precautions.”
Hospital denies COVID-19 cases
When contacted, the Head of Public Relations unit of the Irrua Specialist Teaching Hospital, Mr Odijie Ohue, denied that two doctors tested positive for COVID-19 in the centre.
Ohue, however, said he was not in a position to speak on the matter and directed our correspondent to the Chief Medical Director of the hospital, Professor Sylvanus Okogbenin, who was out of the state.
He said, “However if you want any information, I think you should call the Chief Medical Director of Irrua Specialist Teaching Hospital Professor Sylvanus Okogbenin. I am not in a position to make any statement on it.
Calls to Okogbenin’s mobile indicated it was switched off. Response to a text message to the mobile was being awaited as of 11:30pm on Saturday.
However, a top official of the hospital, who spoke on condition of anonymity, confirmed the development.
He said, “You know, they (the doctors) have been taking exams in the UK Embassy and each time they come we always tell them to go into isolation. Anybody that comes from Lagos or UK, we do that to them but this one came in three weeks ago, he is one of our resident doctors and he got flu so we advised him to go for the test and it was positive. He went to the British Embassy, he had passed his exam and had written to resign his appointment, he was supposed to have moved to the UK. He went there to go and do some biometrics and others so he must have contracted it from there. The other person was negative but we still tell him to go into isolation and observe the compulsory 14 days’ isolation.”
The source also confirmed that the CMD was in Abuja to train people in how to handle COVID-19.
Plateau health workers threaten strike over lack of protection equipment
Nurses and midwives in Plateau State under the aegis of the National Association of Nigeria Nurses And Midwives have threatened to withdraw their services if the state government fails to protect them from the coronavirus pandemic
The health workers who addressed a press conference in Jos, the state capital, on Saturday accused the state government of exposing them to the risk of the virus by not providing them with personal protection equipment .
The Chairman, NANNAM, Plateau State, Mrs Briskila Dabit, said, “Everyone knows about the danger of COVID-19 and it will be unfair on the side of government to expose our members to the virus without personal protection equipment.
“We have decided to down tools in all health centres, including hospitals and isolation centres if the state government will not provide our members with the desired protection equipment”
“We need protection if we must serve our fellow citizens as patriots.
“As an association, we are aware of the shortage of PPE in our hospitals and isolation centres. Consequently, we have directed our members not to attend to any patient with a suspected case of coronavirus without PPE, “ Dabit declared.
But the Director of Press and Public Affairs, Government House, Dr Macham Makut, who described the nurses’ threat to withdraw their services as unfortunate, explained that the state government had already purchased about 400 units of personal protection equipment for distribution and is also in the process of producing more locally.
Health workers on the front line face huge risk of contagion, death
As the coronavirus pandemic rages on, it has somewhat reminded the world of the key importance of a category of people – the health workers, who have been on the front line since the disease broke out in late December 2019.
The United Nations has described the health workers as soldiers protecting the people from a common enemy: coronavirus.
According to Chinese health officials and the World Health Organisation, over 3,000 health care workers in China alone have been infected with COVID-19. Of those workers, 14 had reportedly died, among them Doctor Li Wenliang, who was silenced by the government after publicising news of the outbreak.
In Italy, more than 11,000 medical personnel were said to have been infected while 73 doctors had died, according to the country’s Institutes of Health and the Association of Doctors.
Spain’s health workers were also said to have been contracting the COVID-19 virus at a faster rate than any other country, with around 15 per cent of its almost 125,000 total cases being doctors, nurses and other medical staff.
In Egypt, 15 medics – three doctors and 12 nurses – were reported to have tested positive for the virus while in the United Kingdom, two nurses in their 30s had died during the week after contracting the virus.
The UN had said doctors, nurses, carers and paramedics around the world were facing an unprecedented workload in overstretched health facilities, and with no end in sight.
In sub-Saharan Africa, which includes Nigeria, the UN said pressure on the health care workforce would intensify in the coming months.
Lagos declares free treatment, deliveries during lockdown
Lagos State Governor, Mr Babajide Sanwo-Olu, on Saturday announced free treatment for patients with emergency cases as well as deliveries for pregnant women throughout the month of April at the state’s general hospitals.
The governor, who announced this at a press briefing, added that drugs would be given free of charge to patients on emergency cases during the lockdown.
He explained that the state decided to add these to its welfare packages for the people to make life easier for them throughout the lockdown period.
Urging Lagos residents to continue to obey the movement restriction order by the Federal Government, the governor said about 400 vehicles of those who flouted the directive had been impounded.
He warned those flouting the directive to stop, saying the directive on restriction of movement was to curb the spread of the coronavirus pandemic which had killed over 60,000 persons across the world.
Alluding to Saturday PUNCH’s exclusive story that a renal patient died of coronavirus at the Lagos State University Teaching Hospital on Friday, the governor said the patient had some underlying ailments and died before the result of his coronavirus test came out.
Sanwo-Olu stated that while the state recorded the first death, another coronavirus patient had been discharged.
The governor said the state had started to review the process of distributing food relief package, which was introduced at the beginning of the restriction, noting that the programme had made positive difference in the lives of the targetted beneficiaries.
He said, “Concerning our stimulus package, we have since returned to the drawing board for us to look at what has gone wrong and what we need to improve on in that exercise.
“I want to use this opportunity to further announce additional ameliorating measures to complement our welfare and food stimulus package.
“The Lagos State Government will for the duration of this lockdown and throughout the month of April take full responsibility for medical bills of all patients who fall under the following categories and they present themselves at all our secondary health facilities (27 general hospitals and maternal and child health facilities) in the state.
“Emergency casualty cases including registration, laboratory tests, surgeries will be treated free of charge. Maternity cases, all pregnant women that have to do delivery in this month of April either cesarean or normal delivery will also be attended to free of charge. All admissions in this period will also be covered and treated free of charge in the month of April.
“What this means is that patients that fall within the above categories that will need to access our hospitals will be treated free.”
Asked whether there would be extension of the lockdown, Sanwo-Olu said, “We are in the period of national emergency and the ongoing restriction was declared by the President. If there’s need for an extension, the federal authorities will decide on that based on the outcome of the ongoing measures.”
Sanwo-Olu said although the free treatment and deliveries would increase to the burden of the medical workers, he added that they had assured him they would rise to the challenge.