Doctor under the aegis of the Nigerian Medical Association (NMA) have provided reasons why Nigerians should prepare for worst-case scenario on the COVID-19 fight.

President NMA, Dr. Francis Adedayo Faduyile, on Saturday, told journalists that after reviewing the policies, programmes and activities implemented so far in the management of COVID-19 outbreak in Nigeria, the Association has made some observations and proffered solutions.

Also on Saturday, Lagos State Governor, Mr. Babajide Sanwo-Olu, threatened that the state government will not hesitate to review the terms of the easing of the lockdown, if residents and businesses continue to flout the rules.

Sanwo-olu said: “Five days into this gradual easing, we can look back and pronounce a verdict on the general level of compliance in major sectors of our economy. We have seen our manufacturing and construction companies gradually ease back into operation.

“In terms of non-compliance, the list is regrettably much longer. On the first day of this new phase of eased lockdown, the compliance level for commercial transport sector operations was regrettably very low. The reports about mask usage in public places have also not been encouraging. This is simply unacceptable.

“Let me reiterate that the success of this gradual easing of the lockdown is dependent upon the compliance of each and every one of us.

Faduyile said though the Nigerian Centre for Disease Control and Prevention (NCDC) (Establishment) Act 2018 empowers the NCDC to lead the national response in disease outbreaks and public health emergencies, and to coordinate diverse kinds of feedback thereof, the Centre has been unable to discharge these functions in some states of the Federation.

“Aside threats and in some instances, prevention from collecting and testing samples of suspected cases of COVID-19, the pronouncements of some political leaders constitute outright interference in NCDC’s coordination of case treatment for effectiveness and learning lessons,” he said. “The NMA vehemently decries the stance of Governments of Kogi and Cross River states to NCDC’s advisory. While it would be welcome news for a ‘no-positive-case’ status in any state or FCT, every state must ensure that it is following the testing guideline issued by NCDC. That way, no cases are missed, as that would seriously imperil the whole national response to controlling COVID-19 pandemic.”

The body, therefore, appealed to the Federal Government to direct through the Presidential Task Force (PTF) an investigation into the claims of the two state governments in the interest of safeguarding Nigeria’s public health, and to recommend appropriate remedial intervention (s), if necessary to the President.

On challenges with testing: specimen collection, transport, and inadequate testing kits and testing centres, the NMA President said the Association review revealed verifiable difficulties in collecting samples, transporting them in the proper media and dearth of test kits by the coordinating authorities.

He said this development was coming a few days after being told of the markedly increased capacity of 50,000 samples per day in 21 laboratories to ramp up testing nationwide.

The body blamed this on poor coordination, poor planning, poor forecasting and slow response to developments. “This depressing development saddens NMA because it will wipe away the efforts made so far by the Government, PTF and Nigerians in the public reaction against COVID-19 pandemic. The Association places the responsibility on the PTF and NCDC to find the fastest workable solutions to fix this challenge, including incorporating the approved private sector laboratories that already have established specimen pick up and transport modalities,” he said.

Expressing dismay over inadequate supply of PPEs to doctors and other health workers, the Association said it had directed its members and other healthcare workers in the country to avoid attending to suspected or confirmed cases of COVD-19, if they do not wear the appropriate PPE in the interest of the personnel, their families and the wider society.

Faduyile said the PTF must direct the FMOH and NCDC and other employers of doctors and health workers to make arrangements for the provision of an adequate supply of PPEs at the point and time of need in the campaign against COVID-19. He said the out of stock is preventable and that NMA opts for the local production of PPEs in a nation where textile materials are not in short supply.

Faduyile said the Association recently expressed misgivings about the premature easing of the lockdown, as the numbers of infected persons are still rising, just like the death toll from COVID-19.

The NMA President said this spike is clear evidence that the peak has not been reached, not to talk of ‘flattening the curve.’ Noting that the NMA was not oblivious of the socio-political and economic implications of continued lockdown, and the attendant hunger and acute deprivation in the population, he said the Association maintained the firm view that the solution is not to loosen the lockdown prematurely.

Faduyile said, instead, the solution lies in a more robust and widened palliatives’ policy and its practical and urgent implementation. He said public education and awareness campaign about COVID-19 must go beyond the state capitals to the rural areas. He said the NMA proffered that government uses the period of the lockdown to increase capacity and capability of doctors and health workers, and ramp up population testing, which is the only reliable barometer to predict community transmission and prevalence.

Faduyile, however, said when there is evidence that the infection has peaked, and the curve is flattening, the NMA recommends a phased and slow approach to the loosening of the lockdown, as experience from other climes demonstrates that such approach is the best practice.

While welcoming the special risk allowance and insurance for healthcare workers, the NMA strongly demands that there should be no further delay in commencement of the payment of the announced sums or contemplation of effective date of implementation, as it was of common knowledge when COVID-19 became a public health emergency in Nigeria.

On infectious Diseases Control Bill 2020, Faduyile said the NMA appreciates the sense of urgency and purpose of the House of Representatives in enacting strong legislation to fill the void in the existing ones.

He urged broader consultation with relevant stakeholders to have a law that will be implementable and not in conflict with the Constitution. “The public outcry against specific provisions of the Bill is one of the hallmarks of democracy. NMA welcomes the resolve of the House to subject the Bill to a Public Hearing. We further urge the withdrawal of the Bill entirely and redrafting to remove any existing and future doubts in the people.” (The Guardian)

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