COVID-19: Doctors raise alarm, lament lack of tests in Kogi, C-River

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As controversy trails non-availability of laboratory testing for COVID-19 cases in Kogi State, suspected cases of the disease are allegedly being seen in hospitals in the state, even as doctors have continued to lament inability to conduct tests.

This is even as the Nigerian Medical Association, NMA, in Cross River State raised alarm over the low rate of testing in the state.

Both Kogi and Cross River are the only states in Nigeria claiming to have no casse of corona-virus in the country.

Chairman, Kogi State branch of the Nigerian Medical Association, NMA, Dr Kabir Zubair, told  Vanguard  in an interview yesterday that the state NMA is not happy about the challenge over testing created by the state government.

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Zubair said despite the increasing numbers of suspected cases, his colleagues could not confirm any of the cases because laboratory tests are not ongoing.

He said: “People are presenting with the symptoms of COVID-19, even though it may not be all the symptoms of the disease but doctors are suspicious of COVID -19, and because we are not able to carry out tests, we could not confirm all the suspicions. Everything ends at the level of suspicion.

“We have been on their neck to see how they will resume the tests but they are not collaborating in any way with NMA.  What the state government has done is that they have been able to procure their own antigen test kits approved by the US Food & Drugs Administration, FDA.

“That is what they said will be used to test any COVID-19 suspected case now, even though the World Health Organisation, WHO, did not recommend the use of test kits of an antigen or antibody. But for now, that is what we have and we will make do with it.”

Resident doctors agitated

Zubair said members of the Association of Resident Doctors, ARD, an affiliate of the NMA, have become agitated and apprehensive in the last few months due to community spread of COVID-19 in Nigeria.

He said suspected cases are being seen, specifically at the Federal Medical Centre, FMC Lokoja  which is also the only functional tertiary health institution in the state.

“As a clinician, standard practice demands that the moment you have clinical suspicion of infectious diseases, the ideal thing is to carry out laboratory confirmation.

“COVID-19 is a highly contagious infectious disease, responsible for the ongoing global pandemic. In Nigeria, new cases are reported daily and community spread is accelerating. This is the reason members of ARD are agitated as testing for COVID-19 has remained a challenge in the state,” he added.

On the level of involvement of the state NMA chapter to the COVID-19 response in the state, he explained that the state government, its health personnel and state epidemiologists were the ones handling the tests.

‘We’re unhappy Kogi is not testing’

Zubair, who frowned on the level of preparedness against the disease in the state, said: “We are not happy that the state is not testing but for the past two to three weeks, we have done the much we think we can do.

“We have reached out to some interest groups to see how the situation can be changed. We have done several publications online on the situation in Kogi. Different health groups like the state Association of Resident Doctors, ARD, have done a lot of publications about the situation in the state. We have also liaised with our national body to see how they can come to our aid.”

He said it was only last night that the state government was able to put up isolation and diagnostic centres with few beds and equipment inside.

“The government is just putting up small arrangements in place. Last week, it opened isolation and diagnostic centre that has few beds and equipment inside. They have also procured Personal Protective Equipment, PPEs. Most of the centres in the state also have PPEs and that is what they are using any time they see suspected cases in the hospitals.

“We have been talking to the state Commissioner for Health, state epidemiologists and other government officials on the need to commence testing and that is the only the way the medical personnel can put their minds at rest.   We are hoping that they will listen to us and do the needful.”

He further debunked reports that more people were dying in the state, saying “there is no sudden increase in deaths. So far, so good. The mortuaries and burial grounds are running normal, no sudden increase in any way.”

According to the state-by-state breakdown of COVID-19 cases by the Nigeria Centre for Disease Control, NCDC, in its situation report for COVID-19 released on May 17, 2020, Kogi State had carried out only one confirmatory test.

Contacted last night on the same issue, Cross River State chairman of Nigerian Medical Association, NMA, Dr. Agam Ayuk, refused to comment but referred Vanguard to the statement the association issued last week, titled “Low number of tests in Cross River unacceptable.”

Low number of tests in Cross River unacceptable — NMA

The statement jointly signed by the chairman, Dr. Agam Ayuk, and secretary, Dr. Ezoke Epoke, read: “The unacceptably low number of persons tested in Cross River State suggests a lack of diligent, expansive and coordinated surveillance response which is the hallmark for effective prevention and containment of COVID-19.

“We appeal for an expansion of the surveillance unit with provision of  more field staff, utility vehicles, ICT/technical support to enable this vital unit carry out the critical role of early case finding for testing and isolation of confirmed cases to limit community transmission.

“As of May 21, 2020, information available to us has it that seven out of the eight samples collected so far are from the University of Calabar Teaching Hospital, Calabar, UCTH.   Many questions are begging for answers.

“Is it only UCTH that has patients that meet the criteria for sample collection? What happened to patients who may have visited the various primary health care facilities, general hospitals and private hospitals across the state that may have satisfied the criteria for testing?”

“Very worrisome is the fact that most members of the medical community are currently expressing concerns if the samples collected are the samples sent to NCDC. We call on the state COVID-19 task force to create a transparent system for tracking of samples from the point of collection to testing centre to restore confidence on the eventual results reported.”

Delayed response

The association claimed it had received several reports of delayed response by the State Surveillance and Epidemiology unit to calls for suspected patient review and sample collection.

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“We call for rapid response and urgent transportation of samples within 24hours of the collection with daily situation report (SITREP) made available to the public to avoid fake news and allay fears and anxiety. The quick response time has become more imperative due to the rising number of deaths from suspected cases in the state, the most recent being a health worker.”

Cross River NMA further faulted the implementation of the compulsory use of face masks as claimed by the state government in the state, alleging that the enforcement of the policy was only in the Calabar.

It added that while the state government conti-nued to receive accolades across Nigeria, there is need for continuous and aggressive engagement and buy-in of various unions and associations like the market, automobile dealers and road transport unions to activate their internal mechanisms to enforce government policies.

We’re prepared for COVID-19 in Kogi —Commissioner

Reacting to NMA’s stance yesterday, Kogi State Government said it is prepared to curtail the disease and had made adequate provision for the safety of the medical personnel.

State Commissioner for Health, Dr. Haruna Saka, who reacted  in Lokoja, said: “This is to call for calm and allay all fears that the public may have, for Kogi State remains committed to fighting COVID-19, a global pandemic, irrespective of reservations we may have over its handling in Nigeria.

“It is also important that we dismiss the notion that we are not inclined towards testing for the virus. What then will be the use of procuring over 5,000 test kits worth several tens of  millions of Naira? We have never been known in the past to be complacent with the lives of our people and we will not be found wanting at such a critical time, this we can assure all Kogites.

“The public should be rest assured that Alhaji Yahaya Bello, Executive Governor of Kogi State, will continue to place health as a priority. Despite the pandemic and dwindling fortunes of all states in the country, construction and equipp-ing of health facilities worth billions of naira are ongoing across the state in the three senatorial districts. This is a pointer to the fact that we intend to revamp the health sector.

“Everyone can attest to the fact that the rot in the health sector has been exposed by coronavirus across the country. It is, therefore, our resolve to make sure that eventually, people will have access to quality and affordable health care services that they can be proud of.”

NMA never said what people are alleging, says C-River govt

Also reacting last night, Cross River State Commissioner for Health, Dr Beta Edu, debunked insinuations that the state is not conducting enough tests.

She also said NMA never alleged what was being spread in the media as content of its press statement.

“Cross River State NMA never made such allegations, neither did it raise concerns about patients showing symptoms of COVID-19 in the state.

“If you have seen the press release, kindly read it again; NMA never said anything like that. That is my response,” she said.

On the issue of testing, the commissioner had earlier stated: “It is not compulsory or a must that Cross River must record a COVID-19 case; the pressure for us to have a case is really getting out of hand.

“We only received 50 sample collection kits from the Federal Government to use for a population of about 4.5million people, yet we have been able to use the highest index in testing all suspected cases.

“People have come forward with text messages they received asking them to claim that they are COVID-19 positive and they will be paid for that.

“Every state in Nigeria must not have it, Cross River is peculiar, we started campaign and regular sensitization early, even before any case was recorded in Africa and Nigeria . We sensitized our people about Lassa fever and COVID-19 as early as January.

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“We started the rule on face masks that has now been adopted nationally. We started our emergency response before any other state, we closed our international borders before any other state, and we also started screening visitors at our airports on time.

“Lesotho is in Southern Africa, surrounded by countries with cases yet they have not recorded any one case. Czech is in Europe yet their story is different, why is Cross River being criticized and castigated?

“Instead of so much castigation, we should be approached by the government to understand what we are doing differently and our modus operandi and what we are doing differently.’’

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