Thursday, April 2, 2020

Limiting the adverse impact of Corona virus (COVID-19): How Nigeria’s Akwa Ibom State should be responding.


ICMS, Inc Reports
Observations and Policy Advisory Comments
by Tom Okure, PhD

Very recently in the Nigerian news media and floating around the social media, we heard of conflicting news accounts of the number of coronavirus (Covid-19) infection in Nigeria. 

Reported cases by the Nigerian federal government has reached 184 as of April 2, 2020 and the writing of this article. Consequently, the Nigerian government in common with most governments around the world has instituted restrictive movement measures including gradual state lock down measures to stop the spread, beginning with Lagos, Abuja FCT and Osun state. Recent reports by Akwa Ibom State government asserted that reports of two alleged infections in the state was false and the state government though concerned,  took no definitive positive measures at the time to educate the public or restrict movement to control more spread into the population.
Nigeria’s National Primary Health Care Development Agency (NPHCDA) crisis management team meets regularly to support states with harmonized guidelines for Primary Health Care and community based workers
In fact as of March 25, 2020 the state Commissioner of Information, Charles Udoh KSJ, asserted in a public press release on COVID-19 that Akwa Ibom State “has NOT placed a ban on social gatherings including churches, marriage/funeral ceremonies and other celebrations.” However, on April 1, 2020 the situation drastically changed as the Nigeria Center for Disease Control (or NCDC) reported and confirmed 174 active cases of COVID-19 and noted that nine of the affected have been discharged with two deaths. More specifically, the infection breakdown by state according to NCDC was as follows: Lagos -91; Abuja- FTC-35; Osun-14; Oyo-8; Ogun-4; Edo-4; Kaduna-4; Bauchi-3; Enugu-2; Ekiti-2; Rivers-1; Benue-1; Akwa Ibom-5. Suddenly, as the NCDC report indicated, Akwa Ibom State was no more infection free as we were made to believe, but was one of the states with the most infections according to the NCDC.  
For one reason or the other, this information does not appear to be very welcome by the Akwa Ibom State Government. In a recent press release hereby attached to this narrative, the State Commissioner for Health Dr. Dominic Ukpong appears to disagree and take issue with the NCDC data on reported active cases of COVID-19 in the state.  Akwa Ibom State commissioner of health for whatever reasons is upset with the NCDC testing procedures and appears to be rejecting the notion of any infection of COVID-19 in Akwa Ibom
Dr. Dominic Ukpong, 
AKSG Commissioner Ministry of Health
The state government arguments rejecting the NCDC findings include the following:  “We observed a disturbing breach in the test and reporting procedure;…Akwa Ibom State Government only heard about the test results in the news;…The Director General of National Centre for Disease Control (NCDC) was not aware of the reported result announcement;…All 5 reported positive test cases have been contacted and they have showed no COVID-19 symptoms;…While the tests were being processed in NCDC approved test facilities, all suspected cases were held in isolation;….Several sample batches have been previously sent for testing from Akwa Ibom State and they all returned negative results;…Owing to the irregularities observed in the testing and reporting procedure, Health Care Professionals in Akwa Ibom State have called for an immediate reconfirmation test on the 5 reported cases;…The results will be made public, following due process.
The state press release also advises that “Health Care Professionals in Akwa Ibom State have also appealed to the NCDC to ensure that all future tests are conducted following due process in order to maintain continued confidence in the process” and “Residents and citizens are enjoined to remain calm while observing all personal and respiratory hygiene guidelines earlier issued as well as adhere to the social distancing prescriptions.”
Governor Udom Emmanuel of Akwa Ibom State
From the mere reading of the press releases from Akwa Ibom State government over the past two weeks, the state government appears to be asserting its health policy independence and charting its own course of action in regard to the coronavirus pandemic issue that is beginning to spread into the state. One baffling observation of this writer about the arguments of the State Commissioner for Health Dr. Dominic Ukpong, is the fact that he fails to realize that both the NCDC virus tests and the state conducted test may be correct at the time, depending on when the tests were conducted. Tested individuals in many countries including the United States have tested negative at first only to test positive in a follow-up test. Some people are said to be asymptomatic and do not show symptoms of the disease even though they are virus carriers and spreading the virus to others simply by talking with other people and going about their business. That is why everyone is advised to stay home to stop the spread.
NCDC Public Education poster
This writer asserts that this is no time in Nigeria to play politics or a blaming game. This is a very difficult and dangerous time for the whole world which includes Africa, Nigeria and yes Akwa Ibom State. There is no known cure or vaccination for this virus at the moment. Nigeria is just beginning to experience the spread and the economic impact of this pandemic. People are dying and more will die, Nigerians are afraid, the economy is suffering and is on the edge, ventilators and masks are scares and in short supply, our hospitals are not prepared and lack the capability of handling this type of emergency and Nigerian medical staff are already over stretched and stressed.
Ikot Ekpene Local Government Corona
Virus Educational campaign poster
The coronavirus (or Covid-19) for a majority of infected people typically causes moderate and minor symptoms, for example fever and cough that are resolved between two to three weeks. The virus has affected all races, groups and socioeconomic classes of people around the world including the rich, the ruling class, the youth, women and men alike. Nevertheless, one thing appears to be obvious as data around the world are being analyzed; in a majority of cases of the virus infection, the incubation period of the virus is about two weeks or even more. The elderly appear to be especially more adversely impacted especially those with existing health problems such as diabetes, high blood pressure, heart problems etc. The COVID-19 virus causes more severe sickness among the sickly and elderly, which results in pneumonia in most cases and even death.
As a policy recommendation, this writer advises that everything officially announced and reported on this deadly virus in Nigeria and Akwa Ibom State should be Data Informed and not based on any personal sentiments or party politics. This is no time for ego shielding or arrogance pedaling by high level appointed government officials who may find their egos trampled upon by the terrible truth of this dangerous virus. What we need is level hotheadedness among our federal and state policy makers who should work round the clock and cooperate to educate themselves on the status of the infection nationally and worldwide in order to better inform and to educate the public. In this regard, it is imperative that cooperation between the Akwa Ibom State Ministry of Health and the National Centre for Disease Control (NCDC) be enhanced immediately.  
Ikot Ekpene local government chairman Mr. Unyime Etim
begins a public education campaign to educate residents
Government front-line doctors, researchers and medical staff both at the state and federal level should be given adequate financial and moral support to do their tests and medical advisory jobs without political interference. Those who have ideas and wish to make suggestions should be encouraged and be allowed to air their views on government implementation policies and procedures to combat this pandemic spread without fear. In short, all meaningful professional and public input on state and local government policy in Akwa Ibom State should be tolerated and entertained.  
Lessons learned from the experiences of other countries like China, Japan, South Korea, Italy, Spain, United States, United Kingdom, Egypt, South Africa etc. tackling the spread, control and prevention of the corona virus should be carefully catalogued, analyzed and used to generate predictive models and the predictive models adapted to the Nigerian unique situation.
Our African and Nigerian society is a loving and communal environment where we have open markets and shopping bazaars; we like to merriment, enjoy parties and religious gatherings etc., where we constantly hug each other and shake hands. These situations must be curtailed and even temporally restricted to prevent the virus spread. 
Ikot Ekpene distributes sanitizers and masks to residents 
The virus is real and deadly and the slogan “Stay at Home to Help Save Lives” is a real and a proven preventive measure that is working for all countries and should gladly be welcome by all Akwa Ibom residents and voluntarily abided by. 
The federal government and the state and local governments should work together to fight and contain the virus by all means including experimenting with traditional herbal medicines or remedies like the Chinese are doing. Information is needed especially at the local and village level to educate our villagers, youth and elderly. Village chiefs should be actively involved to help spread the news in the states local government’s areas using announcement mediums such as identified family heads of households and village announcers to inform the people. No one can predict when the pandemic will end or whether this is going to be a cyclical/annual event like influencer that may occur annually. Potential permanent change in human behavior worldwide may be needed to combat this pandemic. The world has changed and may have changed permanently. We need to be proactive in supporting our universities and research institutions nationally. Some Nigerian medical epidemiology scientists have asserted that they have long known about corona virus and have discovered and known about the virus structure long before now. There are many more dangerous viruses this writer understands and even malaria viruses lurking in the environment background waiting to manifest as epidemics.

Conclusion

The lesson here from the spread of COVID-19 into Nigeria is that we have to be vigilant and be proactive against the further spread of the virus. Proactive measures like a two to three weeks lockdown of the state of Akwa Ibom may be needed and while unpleasant will slow the virus spread so that it does not fully engross and paralyze our communities. 
This writer observes and applauds the state and local governments in Akwa Ibom for beginning an active community educational and awareness program. The state should buy large quantities of masks for distribution to the public. Control and treatment centers should be planned, dedicated and equipped to accommodate a large in flock of infected patients. Preventive measures should also include actual testing of residents to determine who is infected, with the understanding that even people determined to be initially negative as witnessed in Akwa Ibom State may be false negative and asymptomatic and may be positive in later tests.
______________________
AKWA IBOM STATE COVID 19 UPDATE 3.0
PRESS RELEASE




Sequel to the news report about the positive testing of 5 hitherto suspected cases of COVID -19 in Akwa Ibom state, we wish to state as follows, that;
1. We observed a disturbing breach in the test and reporting procedure.
2. Akwa Ibom State Government only heard about the test results in the news.
3. The Director General of National Centre for Disease Control (NCDC) was not aware of the reported result announcement.
4. All 5 reported positive test cases have been contacted and they have showed no COVID-19 symptoms.
5. While the tests were being processed in NCDC approved test facilities, all suspected cases were held in isolation.
6. Several sample batches have been previously sent for testing from Akwa Ibom State and they all returned negative results.
7. Owing to the irregularities observed in the testing and reporting procedure, Health Care Professionals in Akwa Ibom State have called for an immediate reconfirmation test on the 5 reported cases.
8. The results will be made public; following due process.
9. Health Care Professionals in Akwa Ibom State have also appealed to the NCDC to ensure that all future tests are conducted following due process in order to maintain continued confidence in the process. 
10. Residents and citizens are enjoined to remain calm while observing all personal and respiratory hygiene guidelines earlier issued as well as adhere to the social distancing prescriptions.
11. The Enforcement Committee of the Quarantine and Restriction of Movement Regulations 2020 have been mandated to see to the full operation of the provisions of the regulations.
12. The Incident Management committee will continue to meet on a daily basis to review and analyze the situation while updates will be provided as and when due.
Together, we can stop the spread of this pandemic.
Let’s be safe; let’s stay safe. 
Signed:
Dr. Dominic Ukpong
Hon. Commissioner
Ministry of Health

Valuable Links:

  1. GOVERNMENT OF AKWA IBOM STATE PRESS RELEASE: NO BAN ON SOCIAL GATHERINGS
  2. Coronavirus: Akwa Ibom questions NCDC’s announcements, demands second tests
  3. Nigeria Centre for Disease Control

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All rights reserved by Tom Okure, Ph.D President and CEO of Inter-Continental Mgt. Systems, Inc (or ICMS, Inc). The information included in this article may not be used, reproduced, transmitted, rewritten or redistributed without the prior written permission of ICMS, Inc. The author Dr. Tom Okure is President of ICMS, Inc, a multifaceted business and management consulting firm with its head office in Albany, New York. Dr. Okure is a writer, author, business/management consultant, public policy advisor and commentator and a change advocate.

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