President of the Nigerian Association of Resident Doctors, (NARD) Dr. Aliyu Sokomba has called for an aggressive testing of all health workers in the country as the University College Hospital, UCH chapter chairman of the association, Adedayo Williams tested positive for the coronavirus disease, COVID-19. Sokomba also demanded the provision of Personal Protective Equipment, PPE for all health workers across the country as hospital transmission of the disease is already being experienced. Sokomba who expressed his deep concern and fears on Channels Television breakfast show on Monday noted that all patients across Nigeria are potential COVID-19 patients because community transmission of the disease has been established. According to him, “Patients can come in with their regular ailments without knowing that they are having COVID-19. It was already evident in the University of Ilorin Teaching Hospital, in University of Maiduguri Teaching Hospital, in Aminu Kano University Teaching Hospital, in Irrua Specialist Teaching Hospital, in UCH. Let me give you an example of what happened in the University College Hospital in Ibadan just yesterday. The president of the Association of Resident Doctors there informed us that he tested positive to COVID-19. And this he has gotten simply by interacting with his regular patients. And what’s worse was that he had not demonstrated any symptoms; he just felt like being tested; he got tested and tested positive”.
Sokomba said this underscored the fact that there is need for aggressive testing of almost all healthcare workers to prevent them from further transmitting this disease. “So, this Doctor Adedayo Williams, the president of the NARD, UCH, Ibadan, wouldn’t have known that he’s positive if he had not just insisted that he should be tested. So, this is underscoring the fact that we need to aggressively test all healthcare workers because as they continue to come in contact with patients who seemingly or apparently are very well, and coming to the hospital to seek help for other disease, they (health workers) are also coming in contact with patients that are potential COVID-19 patients. So, there is a need for personal protective equipment to be made available in all hospitals for all health workers because nothing stops any patient coming to the hospital for regular medical care from being positive for COVID-19. And the more these health workers are exposed, the more we are heading for doom because we cannot afford to have a situation where we will be having hospital transmission of this virus”.
Sokomba adduced two reasons for hospital transmission of COVID-19 – lack of adequate testing and inadequate protection off health workers. According to him, adequate testing is not being done because “we have continued to rely on the surveillance case definition which we instituted at the outset of this outbreak sometime nine weeks ago; it’s still the same case definition being used in deciding who is qualified for testing and who is not. I think the case definition needs to be dynamic; there is a need for that to be reviewed at this point”. He explained that the previous case definition which was still being used emphasized travel history which has changed now. “We already have community transmission of this disease so the emphasis on travel history can no longer hold water because people are already spreading this disease in the community. There is a need for us to review who should be tested. There is a need for us to change from passive surveillance that we have been using to an active surveillance where we would go out to the communities, identify people who have this disease”. He said the reason why NARD had been clamouring that healthcare workers be adequately protected was for the sake of other innocent healthcare patients that would be coming to the hospital for their regular healthcare needs.
Accentuating the seriousness of the situation, the NARD President said unlike what is obtainable in communities where one patient could just spread it to two, three people, “if we are having hospital transmission of this disease, we will have a situation where one healthcare worker – a nurse or a doctor – would be spreading this disease to as many as 50 to 100 other patients who probably have come to the hospital to seek care for their regular ailments. And this is already happening in Nigeria so I’m not surprised that we have this already happening in several hospitals”.
Sokomba said there was the need for reorientation that it is not only in isolation and treatment centres that healthcare workers are exposed to COVID-19 patients, positing that all over the country, all hospitals, all patients coming to hospitals, are potential COVID-19 patients and so all healthcare workers should be provided with the PPE and also be tested to ascertain their status.
He said he had written to the leadership of the two arms of the National Assembly, and the chairman of the presidential task force on COVID-19, seeking audience to bring to their attention that the emphasis should not be laid only on persons working in isolation and treatment centres but had gotten no response yet. An apparently frustrated Sokomba stated that “Perhaps someday, we are hoping that we would be given the consideration to at least get an audience to speak our minds”.
The NARD President said he was not surprised that the COVID-19 figures in the country have continued to rise, stating that “As it stands right now, we have not done adequately enough”. He noted that at the outset of this outbreak in Nigeria about nine weeks ago, only over 7,000 people have so far been tested out of which 627 people tested positive to the disease. He observed that “In about the same period, Ghana, our near neighbor had tested about 60,000 people and South Africa has tested about 108,000 people and so, the more people are tested, the more people will be identified; they will be isolated and the spread of the disease will be contained. So, from what we have on ground right now, it’s obvious that we need to do more in testing people”.