COVID-19 SERIES 20 QUESTIONS & ANSWERS THE FRONTLINE HEROES

Doctors and nurses are seen as life savers who are trained to bring comfort and healing when people are unwell but still, hospitals are not a place people love to visit if they can help it. Aside from providing treatments, medical practitioners also have to counsel their patients and uplift their moods when the patients are consumed by fear and uncertainty. The role of a medical practitioner is not just to operate, give tablets and injections. It goes further than that. Their bedside manners also play a role in the growth of a patient’s recovery pshycoligically, mentally and physically which is very pertinent in the healing process.

In a time of crises like the Corona virus pandemic, these medical practitioners have shown courage, fearlessness and devotion to battle the wave of the virus and flatten its curve. In this edition’s COVID 19 series, EXECUTIVE EDITOR, RUTH OSIME explores the lives of frontliners by drawing attention to their courage and heroism in performing their duties. They are working endlessly to save our lives and most importantly, putting their own lives at risk as they heed to the call of duty!

Through the coronavirus crisis, Nigeria painfully realized how ill-prepared her healthcare system was to fight this virus. But fortunately, they stepped up to the plate by building centers to meet the needs and demands of its citizens under this pandemic. Some buildings were also donated to use as healthcare centers as well, the THISDAY Dome being one of such centers. Naturally, these frontliners are the heroes of today and are greatly admired for their courage and tenacity. Never has their role as frontliners been more appreciated. Going to the battlefront and coming home safe and sound is the prayer the world has for them. Guest correspondents report.

DR. GBADAMOSI ADEFEMI

General Hospital Odan Lagos

Madagascar claims to have found a 1 cure for corona virus which they have apparently tried and tested. What is your take on this product?

I absolutely think it is worth a shot. We should definitely analyze the proposed cure for its efficacy. This cure has been accepted and rejected in several parts of the world. We know that there is no cure for covid-19 and all that is being used is based on trial and error and then seeing a reduction in viral load of an infected patient which is the same thing Madagascar has done. Madagascar claims that at least 55 COVID-19 patients in the country had recovered after treatment with the herbal remedy for the disease. Currently the purported herbal cure for COVID-19 is on its way to Nigeria for clinical analysis of its efficacy by the National Institute for Pharmaceutical Research and Development (NIPRD) and the National Agency for Food and Drug Administration and Control (NAFDAC), as said by the Chairman of the Presidential Task Force on COVID-19, Mr. Boss Mustapha.

Do you have a selection of doctors in

2 certified hospitals for Corona virus treatments specially assigned to treat Covid-19 patients? And if a doctor is known to have an underlining ailment, is he/she exempted from treating patients?

There is training for health workers of different cadre which gives them the necessary tools and information needed to properly handle cases related to covid-19. Also, if a healthcare worker has any issue with working in a hazmat suit, such a person can be exempted for example if it is a case of asthma.

What is your take on the closing down

3 of certain private hospitals because a contacted person entered the premises? Is it logical to do so and if not, what more rational measures should be taken instead of closing it down?

The close down is not a complete shutdown. There will be proper decontamination while hospital activities are suspended usually for about two weeks and if such hospital meets approved standards, it can be reopened. It is completely logical as safety of staff and patients is very important.

Every day, you go to work, are you filled 4 with anxiety? Personally, what steps have you had to take to ensure you protect your family and loved ones from contracting the virus?

No, I am not filled with anxiety. I ensure all precautionary steps are taken and this prevents infection. My family gets up to date information and materials needed to prevent contacting the virus and this for me, is adequate although I have had to stay away from home this period.

The President announced recently that 5 medical insurances are being planned for medical staff who might lose their lives in the call of duty. What other extra steps do you think the government should take to boost the morale of front liners like yourselves?

I believe the government is doing as much as they can with available resources. The most important thing is to ensure front liners in all isolation centers and hospitals are well protected by having necessary protective equipment. Once that is available, work goes on smoothly.

Is it true that taking vitamin D or C and 6 spending more time in the sun can boost your immunity against the virus?

No. There is no such thing as boosted immunity. In actuality, you wouldn’t want to do this. Vitamin supplements aren’t beneficial to you unless you are deficient. The best way to support your immune system is to get enough sleep, exercise, eat a balanced diet and live a healthy life which involves cutting out smoking and alcohol intake.

DRFOLAKEMIEZENWANNE

Eti-Osa Isolation Centre

7 Do you ever harbour the fear of infecting your families and if so, what more stringent measures do you take to doubly ensure they do not catch the virus?

There’s an Infection Prevention and Control (IPC) protocol we employ before we enter and exit the isolation Centre which ideally should ensure that we do not contract the virus if followed religiously but then you can never be too careful. Sometimes the thought comes, and you wonder if you’ve been infected. Because of this potential risk, we are all currently accommodated in isolation from our families just so that we don’t expose them to the virus in case we contract it. Personally, it’s been weeks since I last went home.

Most people are gravely afraid of this 8 virus. They see it as a death sentence and worse still, a stigma which is very unfair to its victims. Due to this, many people, even with all the awareness being created, live in denial and as such, there have been more deaths that could have been avoided if attended to early enough. Now, when patients come, how do you assuage their fears? Do you have to sometime counsel them to make them deal with the virus better mentally and emotionally?

We recognize the psychological effect of being isolated for COVID-19 on patients and how it affects their mental, social, and emotional wellbeing, and so apart from the work we do as healthcare workers in allaying their fears, we also have therapists that speak with them and help them. There are also information brochures we give them on admission that provide all they need to know about the virus, so a lot of them are well informed.

Understandably, there’s a lot of anxiety out there because this is a relatively new virus and we are yet to completely understand it but it is important to mention at this point, that it is wrong to stigmatize people that have COVID-19 as this leads to people hiding the illness and prevents them from seeking healthcare immediately. It is also pertinent to note that People that have COVID eventually RECOVER and at that point are not able to infect others. COVID-19 is not a death sentence as about 80% of cases have mild to moderate symptoms.

How logical is it to lift a lockdown

9 when the curve has not flattened? Considering social distancing is not well observed in certain areas, will the virus not automatically spike up as has been reported in some countries that have done so?

It does not make any logical sense for the lockdown to be lifted seeing that we are still on the climb but then, the government obviously made this decision for economic reasons and has tried to put measures in place for a successful ease of the lockdown. However, it is sad to see how social distancing and all other measures put in place are being flouted by citizens which will inevitably lead to a surge in the number of cases.

Obviously there is great research being 10 done in an attempt to create a vaccine to cure this virus. What are the phases needed to be done before a vaccine can be approved?

After the approval from the FDA, the clinical trials of a vaccine occur in about three phases and can typically take up to 18 months or more before the vaccine will be developed, tested, and mass produced. This is because the safety is evaluated,

and the side effects and adverse reactions are taken into consideration. For now, our best bet remains maintaining current levels or a slow rise in levels of infection by the use of face masks (correctly) and social distancing so that our isolation centers are not overwhelmed.

A group of Chinese doctors recently 11 came to Nigeria. How do you as a doctor feel about that?

Our doctors are putting in great work and a lot of sacrifice into the fight against COVID. We’ve employed a case management system that works and has led to successful recovery rates and also minimal infection of frontline healthcare workers. In view of this, l don’t think it was necessary to bring in the doctors from China. I’m yet to see how the entry of the Chinese doctors has positively impacted our treatment protocol.

DR GBOLAHAN DIYA

Mainland Hospital Yaba

People, especially Africans are warm 12 natured and love to embrace and hug each other as an expression of love. After a while of living with fear and social distancing, these old habits might return. Do you think this is more likely to happen especially after a vaccine has been found? Would people become less afraid of the virus or do you believe social distancing will still remain regardless?

So, in my opinion, we’ve really not observed the physical/social distancing appropriately from the onset. The old habits are returning already with people learning more about the virus and its relatively low mortality. I’m not sure the vaccine will affect anything anytime soon because it’s still in the trial stages and nothing is confirmed, plus I see many Nigerians refusing it because of all we’ve heard and read on social media spaces and a major question on the lips of many remains “Why not try the vaccine in countries with worse numbers and mortality”? There are still some who don’t believe in the virus even in the developed countries.

Social distancing where commercial buses and markets are still full plus the way people living in the slums co-habit isn’t actually social distancing. So, we will just continue living the way we’ve been with minimal social distancing.

Is it also true that the virus cannot

13 spread as much as it has done in international shores because of our climate? So, is it safe to assume we might not be hit as bad in terms of recorded cases? Personally, what steps have you had to take to ensure you protect your family and loved ones from contracting the virus?

The virus has defied all those myths obviously with the rate of spread here and even in Northern Nigeria. For now, the weather doesn’t affect its spread. It’ll be very wrong to assume we won’t be hit as bad in terms of recorded cases. If we test enough, we’d get similar numbers. I’m pretty sure many have contracted it and gotten better. Because statistics shows that about 80% will present with mild or no symptoms.

So, Lagos state government did well in protecting our families. All frontline workers with direct contact with patients have been housed away from their family members. I only see family members through video calls. And I keep educating them about any updates on the disease to help keep them safe as much as possible.

Do you believe enough people are

14 being tested enough to give us a relatively accurate figure of infected cases or might the numbers be far worse than projected?

The government itself has said several times that we aren’t testing enough. I think by the time we get optimal with our testing, most people would have contracted it and gotten better. So, we won’t have the scary figures being projected.

It has been said that some people 15 might have had little or no symptoms and the virus can even leave bodies untreated. For who fall into this category, what can they take at home to further ensure they rid themselves of the virus completely?

Generally, viruses are self-limiting and most leave untreated. For those with mild symptoms, I’d advise that they try to get tested first of all, so it can help the country know how bad we got hit and help better contact tracing in case they have people around them that it could not be mild on. Because being with mild symptoms or none at all doesn’t mean someone can’t transmit the disease. But generally, Vitamins would do to help boost the immune system and standard dose of paracetamol for any fever.

People should ensure they get tested to reduce the spread.

How long should it take to know

16 whether or not you are out of the woods just in case you have or think you got a mild dose of the virus? What key things do you look out for to know if it has left your system?

Like I said earlier, I’d advise anyone with symptoms to get tested. There are different criteria to be sure one is clear of the virus. Very important is two negative PCR results 48 hours apart. There are other criteria also I can’t fully discuss here. You can refer to the NCDC guidelines for discharging a patient for that.

But usually, the symptoms will disappear, and the person will have a feeling of a better state of health. No fever reduced or no cough, no chest pain, no breathlessness, no body pains and gradual return of sense of smell and taste if it was lost. Basically, it’s individualized.

DR AWOFESO KEMI

Onikan Isolation Centre

How can you tell the difference between 17 having the flu, malaria, cough and the Corona virus? Though similar in symptoms, what differentiates them from the virus? Personally, what steps have you had to take to ensure you protect your family and loved ones from contracting the virus?

It is true some of these diseases mentioned present with similar symptoms like fever, headache, generalized aches and pains, fatigue, etc. The most common distinctive symptoms of covid-19 are; dry cough and shortness of breath or difficulty in breathing, diarrhea, loss of smell and taste.

Some of the patients with covid-19 may have a history of contact with infected person(s) or a history of travel to countries with cases of covid-19. Some of these patients may be asymptomatic despite being highly contagious.

Another difference is seen in complications. With flu, complications are less likely to occur because of immunity built up over time, whereas, in covid-19, severe respiratory complications may come on extremely quickly.

Education is key!!! I always emphasize on the importance of practicing hand and respiratory hygiene at all times, as well as, maintaining at least 2-meter distance between themselves and others even while wearing a face mask.

Having been described as flu like, does 18 this mean that like the flu, if you have had the virus before you can have it again?

As the covid-19 outbreak continues to evolve, there remains a lot of uncertainty. There is currently no evidence that people who have recovered from covid-19 and have antibodies are protected from a second infection, but experts say that patients who test positive again after recovery are not cases of

re-infection but are cases where lingering infection was not detected by tests for a period of time, that is, a positive test after recovery could be detecting the residual viral RNA that has remained in the body but not in high enough amounts to cause disease.

Aside from the academics and practice 19 of Medicine, we know Doctors are psychologically trained to handle ailments of any sorts. Apparently there is also an oath all Doctors have to swear by before they become medical practitioners. What is this oath called and what does it represent or mean?

It is called the Hippocratic oath.

It is the oath of ethics and obligation taken by a physician at the commencement of his/her medical practice. Over time, the medical community has changed this oath to accommodate the shifts in Medicine and our society, but the core values remain the same.

In the oath, the physician pledges to prescribe only beneficial treatments according to his/her abilities and judgement; to refrain from causing harm or hurt; to live an exemplary personal and professional life by embracing teamwork when in doubt and also to respect the privacy of patients.

Although medical Doctors rarely

20 encourage the herbal medicinal approach, we have heard of various conditions like the turmeric/ginger/ lemon/honey where you boil in water and inhale the vapor. We have also heard about placing onions on your chest overnight to expunge the impurities inside your body. What is your take on remedies like this?

Dozens of possible vaccines are in various stages of development around the world. Some have begun clinical trials; however, certain things cannot be rushed. Even when researchers find a vaccine that works against covid-19, it could take 12-18 months before it’s ready for the public.

I think herbal remedies can and should only be embraced when there is scientific evidence proving that these remedies can be used in treating the illness, as well as establishing their efficacy and safety through rigorous clinical trials.

It’s important to understand that although many herbal, dietary supplements and some prescription drugs come from natural sources, “natural” doesn’t always mean it’s a safer or better option for your health. Also, caution must be taken against misinformation, especially on social media about the effectiveness of certain remedies. Many plants and substances are being proposed without the minimum requirements and evidence of quality, safety and efficacy. The use of products to treat covid-19, which have not been critically investigated can put people in danger, giving a false sense of security and distracting them from hand hygiene and physical distancing which are important in covid-19 prevention and may also increase self-medication and the risk to patient safety.