The Front Line of COVID-19 War

THE HORIZON BY KAYODE KOMOLAFE

Shuffling through posts on the Coronavirus Disease (COVID-19) one often finds some useful pieces of information buried in an avalanche of fake news, hate speech and other genres of mischief.

A recent instructive material is a video of health professionals of the Belfast Health and Social Care Trust of Northern Island in United Kingdom. In the highly emotive video, respiratory consultants, nurses and other professionals took turn to make a stay-at -home appeal to the public.
One of the doctors pungently warns that COVID-19 “is not a rehearsal.”

As the capacity of the otherwise developed healthcare system of the UK is being severely challenged by the burgeoning figures of COVID-19 patients, professionals in the healthcare team “beg” members of the public to “play your part” of staying at home so as “to save lives” during the “greatest medical crisis of our life time.”

Another respiratory nurse puts it like this: “doctors and nurses have died; we need to stay healthy so we can help you. You can help save our lives. So, stay at home…”
The moral of the story is this: these health professionals have made the war against COVID-19 their own. They are appealing to their public to help them in winning the war by staying at home thereby reducing the number of people who could die from the disease.

There is a hidden irony in the prosecution of the war against coronavirus. In one breath, governments across the world are gearing up to enforce stay-at-home orders (when moral appeals fail); in another breadth doctors, pharmacists, nurses, physiotherapists, technologists and other members of the medical team are called upon to be on duty in the hospitals to provide care for COVID-19 patients.

Members of the medical staff cannot work from home.
Medical professionals on retirement are being recalled to bridge the manpower deficit. The system is not only overburdened in terms of the number of available ventilators and other items of equipment, the human beings who operate the system are overstressed.
It is time policymakers and the people alike acknowledged the heroism of the medical personnel working in almost impossible conditions especially in the countries mostly ridden by the public health crisis.

These are the front line soldiers and generals in this global war against coronavirus and the disease that it spurs, COVID-19.
They deserve a salute!
The Chinese hero doctor, Li Wenliang, who first raised an alarm about the virus, has since died in the course of the pandemic. The report on his death has acknowledged his “bravery” and “sacrifice.” The 34-year old eye doctor contracted the disease while treating an infected patient. Other doctors should not be exposed to such grave risks unduly as it happened to Dr. Li.
As more is known in the epidemiology of COVID-19, new challenges are introduced into the clinical management of the crisis. The World Health Organisation (WHO) is reportedly considering “airborne precautions.”

To paraphrase the Roman general, Publius Renatus, if you want peace (good public health), prepare for war (putting and end to the COVID-19 pandemic). Those who would be the front line fighters in the Nigerian sector of the war should be well equipped with the appropriate weapons.
The health worker becomes more exposed to the virus when facilities become overwhelmed with the exponential growth in the rate at which patients seek medical attention. There have been reported cases of hospitals completely out of masks, shields, gloves and other gears.

Members of the public are being told to stay at home. But when health workers leave home to provide care for COVID-19 patients in the hospitals, they should not be made to look like lambs going to the slaughter’s slab. The health care giver should be adequately protected so that he could give an efficient care to the COVID-19 patients.
According to a new study, experts believe that coronavirus could survive in the air in some situations. Few months ago, it was said that the virus could only be transmitted in droplets from sneezing and coughing . Social distancing and other precautionary measures could prevent such transmissions by droplets. Now depending on factors such as heat and humidity, the virus could be airborne to wreak havoc on its victims. So, the medical staff needs to be protected because of the newly discovered risks.
Although the war is global, the prosecution is, of course, local.

Every country is virtually left to its own devices in the circumstance.
So how battle ready is Nigeria? The trend in the spread of COVID-19 in the last few days especially should make Nigeria wake up to the possibility of a public health emergency of monumental proportions. Even the screening at the airport was reportedly handled in a sloppy manner. A cavalier attitude has been noticeable in some official and non-official quarters in dealing with the crisis. Preparedness is the word. But it is dangerously lacking. The system should be firmly put on alert. If relatively highly developed healthcare systems of Italy and Spain could be so exposed as grossly inadequate in the face of the COVID-19 storm, it is hardly imaginable how Nigeria could cope if the crisis gets worse. Indications in the last few days seem to suggest that the capacity to tackle the magnitude of the crises of Italy and Spain is absent here in Nigeria. If the disease is said to be airborne, are there enough and appropriate masks for medical staff?

A painful memory of the risk before healthcare providers fighting an epidemic is that of Dr. Stella Ameyo Adadevoh. Her heroism, (which by the way has not been sufficiently acknowledged by Nigeria), was that of seizing the moment in 2014 to prevent the spread of the Ebola virus beyond containment. She ensured that the index case, Patrick Sawyer, a Liberian, was quarantined in Lagos. The man was on his way to attend an international conference in Calabar. The Ebola crisis was not as devastating on Nigeria as it was on the poor West African countries of Liberia, Sierra-Leone and Guinea. Sadly, Dr. Adadevoh died in the process of saving Nigeria as she herself got infected with the virus. Her story should bring home again to policymakers the enormous risks that medical staff in Nigerian hospitals face as the nation prepares to fight the COVID-19 from its own corner.

This moment of crisis provides another test for the capacity of the healthcare delivery system as an important segment of the social sector. The capacity of the facilities and the welfare of the medical staff should ordinarily be the focus of the investments in the sector. This is what this crisis has proved in other countries.
The COVID-19 catastrophe is making governments across the world to rethink some assumptions about public health as well as the preparedness for tackling epidemics, and in this tragic case, a pandemic. With all the sophisticated gadgets and technology that the world powers have acquired for both constructive and destructive purposes, this crisis has proved again that you still need human efforts to get problems solved partly using simple methods. The time-honoured methods include washing hands and staying at home. That is why human development should always be at the centre of all development efforts. Humanity will always assert itself despite the massive erosion.
In Nigeria, the neglect of the social sector is significantly manifest in the poor attention paid to the welfare of those expected to sustain the system as medical personnel. When doctors, nurses and other medical staff go strike, it is not perceived by the society itself as something unusual, much less an emergency. Despite the abysmally poor doctor-patient ratio, Nigerian doctors and nurses emigrate to more developed climes. Yet, policymakers do not seem to think anything is amiss about that negative trend.

It is a paradox in this society that even in normal times those whose job it is to save lives are hardly appreciated and respected.
This societal attitude should change. Meanwhile, whatever strategy being put in place by the Nigerian taskforce on COVID-19 should include ensuring adequate protection and welfare the medical staff who would provide the care sorely needed by the patients.

Apart from providing the Personal Protective Equipment (PPE), all the WHO protocols should be strictly adhered to in this country. The medical staff should not be overworked. In some countries, retired medical personnel are being recalled to meet the extraordinary needs of the emergency situation. The isolation centres should be made more humane and decent so that it could attract suspected cases. The staff of the Nigeria Centre for Disease Control (NCDC) would be encouraged to move swiftly in taking patients for isolation only if they are well kitted with protective gears.
In other words, those who would be in the front line of the battle against COVID-19 should be given the appropriate weapons. They should not be equipped with toy guns and paper shields when they need AK 47 and bombs to confront the enemy.

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