No need for second lockdown – Odikpo, physician
•Why private hospitals are rejecting non-coronavirus patients
By Charles Kumolu, Deputy Editor
Founder of First City Diagnosis and former governorship aspirant in Delta State, Dr. Iyke Odikpo, in this interview, urges government to prioritise production of simple test kits to stop rejection of non-COVID cases by private hospitals. He also advises against second lockdown, saying government should device home-grown solutions to rising number of infections.
Reports are indicating that people are dying owing to rejection by hospitals on suspicion of having COVID-19. As someone who runs a flourishing medical facility, what can you say about that?
The issue of testing should be taken seriously. Testing is very important to know the status of people. Government should reach out to Senegal to know how it developed simple test kits. If the kits are available in Nigeria, hospitals would use them in knowing the status of people before they admit them. We have immunologists and research centres in Nigeria that can develop the kits. Why is government not looking in that direction?
If the simple test kits are developed and made available to every health facility, doctors and other medical practitioners would no longer be afraid to admit patients. Someone told me that in UNIBEN the oxygen concentration for COVID-19 cases is below certain levels, which is a practical analysis from what they have seen. With that in mind, any patient that comes, pulse oximetry is carried out to know whether his case is COVID-19 related or not. Without knowing the status of a patient, the doctor who admits the patient ignorantly for treatment would die. So the man has to be careful.
Even the hospitals that had tried treating COVID-19 patients had been shut down. In Kano today, a lot of medical personnel are being infected probably because they treated patients ignorantly. Testing for COVID-19 should be a precondition for any private medical facility to admit any sick person. For me, I screen patients on phone to know their symptoms. In doing so, I know who to see, who not to see and who to see with caution. In December 2019, I encountered a patient from Wuhan, China, in my facility and I managed the patient.
Thinking back now, I realised that it was COVID-19 that I dealt with but was lucky not to be infected. Maybe I had strong immunity that saved me from being infected. Most people get it and remain asymptomatic while some get it and exhibit mild symptoms. I have discovered different categories of infections. Some contract it without knowing, some would contract it and would manifest symptoms like common cold and mild fever, some would be averagely ill and those who would be severely sick. The last category might recover or die.
If people, who are in the practice of medicine, have what it takes to identify COVID-19 cases, they would freely treat patients. But when they do not have the test kits, they are running a risk because when they die, that is the end. That is why I was not surprised to read that many medical personnel are running away from hospitals in Kano. I don’t blame them.
Tomorrow would be one week since the lockdown was relaxed and the rate of daily infections is now higher. Beyond the measures being taken now, what should government do in the face of this new level of infection?
We just have to continue with social distancing. Government should prioritise continuous education of the populace because a lot of them are still ignorant. The hospitals must be taught what to do in terms of the acquisition of PPE and usage. Hospitals should treat every case as a COVID-19 case until proven otherwise.
We should devise simple test tools just the way Senegal did. Nigeria should devise similar tools and make them available to all hospitals. If that is done, any patient that comes in, the saliva and necessary samples should be taken and tested. If the person is COVID-19 positive, he should be referred to NCDC and if he is negative, the person should be treated by the private hospital. Any private hospital that is allowed to manage COVID-19 cases, must take extra precaution.
We just have to learn how to deal with COVID-19 because locking down again would amount to running away from the problem. I have seen suspected COVID-19 cases in my hospital and I referred them to IDH Yaba.
One of them even ran away and called me a few days after to say that he didn’t go to Yaba because he believed he didn’t have COVID-19. This is a society where people hide their illness and such a practice is a risk to private hospitals. Locking down people who hide their illness is dangerous because even when they have COVID-19, they may not even disclose their status.
They would prefer to hide in their houses with the ailment. Therefore, what is required is massive testing. We must have a peculiar way of dealing with COVID-19 in Nigeria and not the general way. If Madagascar could be making money from their COVID-19 mixture, what is stopping us from telling our herbal people to look at what Madagascar did and analyse it so that we can develop ours? I just feel the mentality of copy and paste from the West has affected us so much.
Government talked about the possibility of a second lockdown…
I am opposed to lockdown because it would be counter-productive in our society. Lockdown works for the man who lives in Ikoyi and Victoria Island. Lockdown can’t work for people who live in slums where many people live in one room. Locking down the poor people would not help in this kind of society. Another workable measure should be devised for the poor.
It was surprising that despite being a medical doctor, you called for the relaxation of the lockdown imposed by the Federal Government to contain the spread of COVID-19. What informed your position?
I was concerned about the negative economic effects, especially on poor people. A greater number of persons in Nigeria are daily workers and if you ask them to stay at home without working, the negative effect on them would be more severe than the effect of coronavirus. As of when the lockdown was imposed, coronavirus was imported and had not gotten to the community level. I felt that those that should have been isolated and locked down were the elites who brought the virus into the country. As of the time government announced the lockdown, Lasa fever had more mortality rate in the country than coronavirus. That was why as a medical doctor, I felt that lockdown was not the right response.
My position as a medical doctor is that you don’t run away from disease, you learn to deal with it. Coronavirus is a viral infection with less than five percent mortality rate. It has shown that those badly affected are people with diabetes, High Blood Pressure and the obese.
What the viral infection does is that it compromises the immune system, making the human body unable to deal with issues the way it should. If we had started searching for a solution just as Madagascar did, maybe we should have had a solution now. I didn’t see anything wrong with us looking inwards and trying to see whether we would get an answer to the problem. My worry which I had expressed to those in authority was that I felt we were not doing enough internally to get a solution to the problem.
The Nigeria Centre for Disease Control, NCDC, said 90 percent of those infected recover without treatment. All they are doing are symptomatic treatments. If any of them develops fever, the person would be treated. If he develops body pains, it would be managed and in the process, the body builds immunity that fights the virus. Once a greater number of the population develops immunity, we would live it. Coronavirus is not going to leave us. Even in China where it originated, new cases are emerging but they have learnt how to manage it.
Are you saying that Nigeria should target herd immunity?
Most flu outbreaks are seasonal. They come and go. Coronavirus would become seasonal. Let’s not expect that it would disappear entirely. There would be a period when it would spring up after which it subsides. When many persons get used to it by being infected and getting immune, it would no longer be a nuisance as it is or something that took the world by storm.
You said Nigeria isn’t looking inwards. What do you think the authorities should do locally to get a homegrown solution?
The first thing should be proper education of the people. There should be massive sensitisation of the populace. If the masses are told what to do and they comply with it, the rate of infection would be nothing to bother about. If a man is educated on an issue, he would know what to do to help himself.
Now that isolation centres are becoming overwhelmed by the number of infections, what is needed to properly educate the people?
Among other measures, authorities should tell people to practice steam inhalation because heat kills the virus. Steam helps in expelling mucus. It is not everybody who has coronavirus that would die. Many people who have it are not in critical condition. If that is the case, those who are not in critical condition should be taught how to manage the disease. If the right thing is done, infected persons would not get to the stage of severe infection. Nigerians easily get adapted to changes. For instance, they have embraced the wearing of face masks without being compelled.
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