Concerns Mount over Treatment of COVID-19 Patients by Private Hospitals

• Doctor treating patient dies of pandemic
• Increase contact tracing, flatten the curve, Buhari charges task force
• FG attains 3,000 daily testing capacity, labs increase to 13
• Expands criteria for testing, approval for treatment facility
• Issues guidelines on use of face masks
• Cases rise to 407 with 128 discharged, 12 deaths
• WHO says Trump’s suspension of US aid regrettable

Martins Ifijeh in Lagos, Olawale Ajimotokan and Onyebuchi Ezigbo in Abuja

Treatment of patients suspected of contracting COVID-19 by private hospitals and other undesignated health facilities has sparked concerns about the danger to public health with many people fearing that it might undermine prevailing efforts to contain the spread of the rampaging virus.

President Muhammadu Buhari had signed COVID-19 Regulations No 2 on Monday, extending the lockdown in the Federal Capital Territory (FCT), Lagos and Ogun States, which started on March 30, by another 14 days.

In signing the regulations the president said it was necessary to ramp up the gains of the first 14 days of lockdown, which had achieved its objective of increasing the tracking, testing and treatment of cases and their contacts, admonishing Nigerians to abide by the protocols outlined by the lead agency for the containment of the virus, the Nigeria Centre for Disease Control (NCDC).

The NCDC had established protocols, including that a person with symptoms of COVID-19 should approach it or state health authorities for testing and case management, admonishing citizens not to self-medicate or patronise private health care facilities but rather report to designated isolation centres built for the management of the disease.

Only on Monday, the Minister of Health, Dr. Osagie Ehanire, warned private health providers against the danger of managing COVID-19 patients in their facilities because of what he called “risk of self-infection and cross-infection.”

But THISDAY gathered that the practice of people, particularly very important personalities (VIPs) diagnosed with COVID-19 avoiding designated isolation centres and preferring undesignated private hospitals is on the increase, particularly in Lagos.

“They are endangering the lives of many other Nigerians,” a source told THISDAY last night, warning: “This may jeopardise the efforts of the government to contain the spread of the virus.”

THISDAY learnt that as a result of the pressure from COVID-19 patients who wanted private care, many private clinics and health care centres in Lagos are shutting down to avoid risks to their staff and patients.

Yesterday, the imminent danger of this unwholesome practise to health workers become real when a medical doctor, Dr. Emeka Chugbo, who had contracted the virus from a COVID-19 patient he was managing in his facility, died of the virus at the Lagos University Teaching Hospital (LUTH) in Lagos, which is also not a designated centre for the management of the virus.

The patient Chugbo was treating had died on April 3.
Confirming Chugbo’s death to THISDAY wednesday, the Chief Medical Director, LUTH, Prof. Chris Bode, said the doctor was not a staff of the hospital but was rushed to the facility after he showed severe signs of the disease.

“He was brought in late so there was no much we could do. He was a staff in LUTH years back before he went to join the private sector. We learnt he had COVID-19 patients in his facility that he was treating. He may have been exposed to the virus from there.

“His death has shown what health workers are exposed to in the cause of treating COVID-19 patients. Our hearts are with his family in this trying time. It is a sad development for us.”

Investigation showed that Chugbo did his residency training at the Obstetrics and Gynecology Department in LUTH. He was at the time the Vice President of the Association of Resident Doctors in the hospital. He was also said to have worked at the Lagos State University Teaching Hospital (LASUTH) as a consultant.

Under extant regulations, only designated public facilities can handle COVID-19 cases.

Ehanire, at a press conference in Abuja, last month, said private hospitals should not treat COVID-19 cases because it was highly contagious and risky to their medical personnel and other patients.

He had urged private hospitals to refer any suspected case to the designated centres for diagnosis and treatment.

According to him, besides being highly contagious, private hospitals lack the facilities and laboratory to handle the treatment and could easily infect their staff and patients.

“Private hospital, yes, we know that private hospitals offer 50 to 60 per cent consultation to Nigerians, which is a very powerful factor and very powerful partners in the healthcare system. We know that a good number of patients first of all report to the private centres.

“Most of the private centres don’t have the facilities to treat a highly infectious disease like that and they will definitely not have a laboratory for it. But in that case, we urge private hospitals if they have suspected cases, to refer them for diagnosis. If you can hold him in isolation while getting your result, fine otherwise you can refer them right away to the centres for isolation of suspected cases; get the test done and let the patient be treated in a designated centres,” he had stated.

However, Secretary to the Government of the Federation (SGF) and Chairman, Presidential Task Force on COVID-19, Mr.

Boss Mustapha, said the federal government was considering bringing in some private hospitals to join in combating the virus.

But he added that such private hospitals would be required to seek certification from the Committee of Infectious Disease Experts to be assembled by the Federal Ministry of Health for standardisation and to ensure the safety of frontline staff and other patients.

THISDAY, however, learnt that despite the federal government’s warning, some private hospitals and other undesignated facilities have been treating COVID-19 patients and exposing their staff members and other patients to the danger of contracting the virus.

Cases Rise to 407

Meanwhile confirmed cases of the pandemic rose to 407 with the discovery of 34 new ones in the country yesterday. However, 128 cases have been discharged and twelve deaths have been recorded.
The 34 new cases, according to the NCDC are reported from five states, including Lagos 18, Kano 12, Katsina 2, Niger 1, and Delta 1.

It said a multi-sectoral national emergency operations centre (EOC), activated at Level 3 had continued to coordinate the national response activities

Lagos, Osun, Kaduna, FCT Discharge 32 More Patients

Lagos, Osun and Kaduna States as well as the FCT yesterday discharged 32 more patients.
The Lagos State Government discharged 16 more patients from its isolation centres, bringing to 85 the total number of persons successfully treated for the disease in the state.

The Governor, Mr. Babajide Sanwo-Olu, said the discharged patients comprised 14 males and two females.
He said: “Among the 16 persons are three foreigners, including a Briton, Chinese and a Polish citizen.
“The patients; 14 from the Infectious Disease Hospital in Yaba, and two from the Onikan Isolation Centre, have fully recovered and tested negative twice consecutively to COVID-19.”

FCT discharged nine additional patients from its isolation and treatment centres.
Seven patients were discharged from the University of Abuja Teaching Hospital, (UATH), Gwagwalada, while two were discharged from the National Hospital, Abuja.

The latest figure of discharged patients has brought the number of COVID-19 cases now discharged in FCT to 20.
The remaining ones are clinically stable and responding well to treatment, the FCT authorities said.
The Osun State Government also announced the discharge of six more COVID-19 patients after testing negative twice for the virus following their treatment at the Isolation Centre in Ejigbo.

The Governor, Mr. Adegboyega Oyetola, said via his official Twitter handle, @GboyegaOyetola yesterday that the six patients discharged were among the remaining seven Ivorian returnees.

The patients, who are among the 127 returnees have been discharged to join their families.
A total of 17 out of the 127 returnees had tested positive for the virus while 10 out of them were discharged on Saturday after testing negative twice for the virus.

The release of another six patients yesterday brought to 17, the number of patients that have been managed and discharged in Osun State.

In Kaduna State, one of the six people infected by the virus has been discharged.
The state Commissioner for Health, Dr. Amina Baloni, said in a statement yesterday that the patient had recovered following treatment at the isolation centre in Kaduna.

She said the patient’s recovery ‘’ has been confirmed by two consecutive negative results, the second of which came yesterday, Tuesday, 14 April 2020.’’

FG Attains Testing Capacity of 3,000 Daily

Nigeria now has the capacity to carry out 3,000 COVID-19 tests daily, from 1,500.
This followed the increase in the number of testing laboratories in the country, which now stands at 13.
NCDC Director-General, Dr. Chikwe Ihekweazu, at a press briefing by the Presidential Task Force on COVID-19 yesterday in Abuja, said: “We now have the capacity of testing 3,000 per day. That capacity is not being fully utilised. That is why I focused on Lagos State and the FCT and the efforts they are putting to get more people tested and more samples in.

“The bottleneck now is not the testing, but collecting the samples from the right people and getting it into the lab.

“Ending of today, we are going to publish a testing and diagnostic strategy for the country so that everybody is aware of where we are and where we are going – short and long term. That is, how we are going to introduce the TB facilities (GeneXpert Machines), HIV testing, and how we are going to end up with one lab per state.”

FG Expands Testing Criteria for Pandemic

Also speaking at the briefing, Ehanire explained that the ministry has expanded the testing criteria to include cases with fever and respiratory tract symptoms.

According to him, “To ensure maximum utilisation of our increased testing capacity, the case definition and testing criteria have been expanded to include not only contacts of confirmed COVID-19 cases with fever and respiratory tract symptoms but also all persons with fever and respiratory tract symptoms of unknown cause.
“The advent of community transmission marks the evolution of our initial strictly containment strategy. Risk communication to the public and coordination with the state level COVID-19 response preparedness groups are going to be scaled up.

“There is also an increased drive to detect cases more rapidly, especially in hotspot communities. All persons fitting the case definition are advised to first wear a mask of any type, isolate themselves from friends and family as they call the national emergency number 112, or the NCDC toll-free number 0800 9700 0010, or report to the nearest health facility for referral.”

He added that his ministry’s accreditation committee has produced guidelines to ensure that standards are maintained at all COVID-19 isolation and treatment centres.

He said: “There are three levels of isolation: Isolation 1 is for suspected cases of COVID-19 while awaiting results, this is also used to designate the mandatory quarantine facilities for those returning from abroad with negative results, or those unable to self-isolate at home for 14 days.

“Isolation 2 is for confirmed COVID-19 cases with mild or moderate symptoms, which need little to no clinical management.

“Isolation 3 is for confirmed COVID-19 cases with severe or critical symptoms, which need enhanced clinical management or intensive care.

“In Abuja, for example, the designated Isolation 3 facilities are University of Abuja Teaching Hospital (UATH) and National Hospital, while Isolation 2 centres are located in 4 other places.”

FG Issues Guidelines on Use of Face Masks

The federal government has also issued a health advisory on the use of face masks for the containment of the COVID-19.

Ihekweazu unveiled the guidelines for the use of face masks by members of the public.
He said government recommended face mask to be used in conjunction with other safety measures such as regular hand washing, sanitisers and social distancing.

He said the federal government was making the use of face masks optional for Nigerians, adding that they can use home-made brands or even improvised ones such as clean, dry handkerchief.

He explained that a health condition for use of face mask is that it must be washed after use every day, dried and ironed before reuse.

He said that one should avoid touching the inner part of the mask while putting it on.

Ehanire also gave reasons for the government’s decision not to make the wearing of a face mask or foreign made brands compulsory, saying that it does not want Nigerians to be exploited while scrambling for branded face masks that are not enough.

He said presently some of the countries producing the face masks had shut down their companies due to the impact of the virus.

Also speaking in Abuja after a teleconference with Buhari, Mustapha said the president had enjoined the task force to ramp up contact tracing and flatten the virus curve as soon as possible.

Shippers’ Council May Waive Demurrage on Cargoes

Meanwhile, the Nigerian Shippers’ Council is considering the granting of a waiver on the demurrage to be paid by shipping companies on cargoes that are imported into the country.
The Chairman President Task Force on COVID-19, Mustapha, said yesterday in Abuja that the discussion between the Shippers’ Council and shipping companies also centred on the consideration of the prospects of a partial reduction in the demurrage expected to be paid on the cargo, adding that a decision would soon be reached on that.
He noted that the president in his first declaration allowed that the Lagos Seaport should remain open but be guided by the quarantine processes and protocols that were put in place.
Mustapha also responded to the issue of banks shutting down and not allowing for port operators to carry out the processes of payment of duties, excise and tariffs of port costs.
He said he had a discussion with the Governor of Central Bank of Nigeria (CBN), Mr. Godwin Emefiele, on Tuesday on how to uphold the protocols signed regarding how the banks around the ports would operate during the lockdown without shutting down the economy.
“But I really understand that the Central Bank Governor went further to allow banks to open between the hours of 9 a.m. and- 2 p.m. in Apapa, where most of the transactions in the seaports are located. I believe that we will go back to discuss with him,” he added.

WHO Replies Trump, Says It’s Focused on Saving Lives

The World Health Organisation (WHO) yesterday fired back at Trump, saying it was focused on saving lives and stopping the spread of COVID-19 pandemic.

Reacting to Trump’s freezing of funding to the agency, WHO Director-General, Dr. Tedros Ghebreyesus, said it had done no wrong but only following the creed for which the organisation was established in 1945.

According to him, the organisation was established by nations to protect the highest attainable standard of health as one of the fundamental rights of every human being, without distinction of race, religion, and political belief, economic or social condition

Ghebreyesus said: “That creed remains our vision today.
“There is no time to waste and WHO’s singular focus is on working to serve all people to save lives and stop the COVID-19 pandemic.”

Trump had on Tuesday said he was freezing the funding of WHO, pending a review into the UN health agency’s “role in severely mismanaging and covering up the spread of the coronavirus,” adding: “everybody knows what’s going on there.”

But Ghebreyesus, during a virtual briefing in Geneva, said the US had been a longstanding and generous friend to WHO and hoped the relationship would continue to be so.

“We regret the decision of the President of the United States to order a halt in funding to the World Health Organisation,” he added.

A WHO special envoy also urged critics to focus first on defeating the virus.

“There are one or two countries that seem to be quite concerned about actions that were taken early on in the pandemic … we say to everybody, we plead with everybody, look forward.

“Focus on the epic struggle right now and leave the recriminations until later,” Special Envoy David Nabarro told an online conference.

“If in the process, you decide you want to declare that you’re going to withdraw funding or make other comments about the WHO, remember this is not just the WHO, this is the whole public health community that is involved right now.

“Every single person in the world is a public health worker now, everybody is taking responsibility, everybody is sacrificing, everybody is involved,” he added.