BY IMAOBONG DEM

Akwa Ibom state has experienced an unsettling increase in its corona virus Infection rate since the start of the 2^nd wave of the Pandemic in Nigeria.

From just scores of confirmed cases by the Nigeria Centre for Disease Control (NCDC) to over 1000 confirmed cases with close to 1000  active cases, the numbers continue to rise. Of these numbers, so far, over 700 persons have been discharged following recovery from the infection and more persons will recover to create more bed spaces for further admissions of infected and sick persons.

Following the increase in infections, the state incident Management Committee (IMC) expressed worry that the 300 bed spaces at the Isolation centre in Ituk Mbang General hospital is now filled to capacity, as well as other facilities. These include the Ibom Specialist hospital, the University of Uyo Teaching Hospital’s Covid19 Isolation unit which also  accommodates those sickened by corona virus also known as Covid19. The test outcomes for the state captured in the NCDC daily report on incidence of the disease shows scores of new cases.

Akwa Ibom’s Commissioner for Health, Professor AUGUSTINE UMOH speaking on Inspiration 105.9FM, when he appeared as guest on ‘Sharing Life Issues’; Ibibio Version, early February, said the infection rate was increasing due to community transmission of the virus. Professor UMOH said the message on the need for every resident of the state to take responsibility for their health was profound and instructive enough for all to take heed.

“I think we should break it down to the individual, that is, when the individual complies, that the community complies, that the state or local government complies, that the state complies. So we have to break it down and make it not really on a large scale of how will the state do it? The state will only do it when that individual in the state complies with the non-pharmaceutical interventions. There is no holiday from preventing the transmission of this virus” ….Prof. Oyewale Tomori.

RESTRATEGIZING TO TACKLE 2^ND WAVE OF COVID19.

With the start of the 2^nd wave of the disease, and identification of the new variant of the virus, AkwaIbom’s State epidemiologist DR NTIENSE UMOETTE says it has been pertinent to take sample collection from communities to test at the molecular (PCR) Laboratory in the state which was established during the first wave of the pandemic. 

Speaking in an exclusive Interview with Inspiration FM, Nigeria’s renowned Virologist, Professor OYEWALE TOMORI indicates that seeing an increase in AkwaIbom’s Covid19 infections reflects that there has been an augmentation in testing.

“It’s good news to hear that Akwa Ibom is going down to testing more people. Like 60 to 80 percent of people will not feel symptoms when they get infected, the only way to know if they are infected is by testing but the sad part of it is that, even though they are not showing symptoms, they are still able to transmit infection so that’s why it’s more important to test more people to know who exactly has the thing so that you can isolate the person and prevent that person from spreading around…… so then you see for the second and third time, Akwa Ibom is doing the right thing”.

Akwa Ibom’s Incident Management Committee at the start of 2021 during its meeting agreed on a review to the coronavirus safety guidelines. In a statement signed by the Incident Manager EMMANUEL EKUWEM, the committee agreed to intensify contact tracing, re-energize the state IMC Incident and community engagement strategies.

On this list were reactivation of monitoring teams for strict enforcement compliance, immediate reactivation of COVID19 protocol enforcement by security agencies which still seem farfetched, as a large number of residents are not complying with the non-pharmaceutical interventions, chief of which is the use of facemasks.

To drive the re-strategy, the state’s ministry of information believes daily highlights using media platforms like radio, television, and social media to broadcast the infection rate reported by the NCDC will resonate with residents.

Commissioner for Information INI EMEMOBONG who speaks of this approach notes ; “What we’ve done is to re-energise the risk communication and community engagement strategy to ensure that we communicate in better ways, simpler ways, more concise and concrete ways that will get information to the lowest of our people.

He also emphasized on the up scaling of testing in the state ; “ we’ve also intensified testing, if you check, testing results are now published daily in collaboration with the Ministry of Health and Ministry of Information, so that people can understand, that also shows you the intensification of testing that has gone on. We’ve even gone to the point where ministries are testing. We’ve tested cohorts, we’ve tested the NYSC members when they came. So when you look at the intensification of testing, its giving results to and immediately people are positive, we get through to them and the treatment pillar is activated immediately”.

“We must make risk communication a community driven programme, we must adopt community driven strategies for disseminating information about Covid19 and encouraging people to keep up  with these strategies. It is easy to activate a community based risk communication team, we can leverage the town hall setting, church settings, market groups, have groups of trained persons that will drive the process. It is about community engagement that will help us take the risk communication and promote the use of the non pharmaceutical interventions”…Dr Casmir Ifeanyi.  

CONTROVERSIES WITH COVID19.

A disturbing trend with the outbreak of COVID19 in Nigeria has been the doubt in some quarters that the COVID19 prevalence in the country is real. We have seen a sitting Governor, the number one Citizen in Kogi state YAHAYA BELLO who had insisted that the disease did not exist in his state until confirmation of cases there. A look at the state’s column on the NCDC website shows that there are only 5 confirmed cases, zero case in admission, 3 persons discharged and 2 cases of fatality as at February 22, 2021. Governor  BELLO’s stance echoes with a number of Akwa Ibom citizens; team Covid19 is fake. 

Akwa Ibom’s state epidemiologist, Dr NTIENSE UMOETTE attributes beliefs by some residents in the state to the asymptomatic nature of some Covid19 cases where infected persons do not show symptoms and cannot relate to the realness of the disease.

Again the Virologist, Professor TOMORI says to curtail the spread of the disease in the state, individual compliance to the Covid19 protocols and guidelines become apt. “I think we should break it down to the individual, that is, when the individual complies, that the community complies, that the state or local government complies, that the state complies. So we have to break it down and make it not really on a large scale of how will the state do it? The state will only do it when that individual in the state complies with the non-pharmaceutical interventions. There is no holiday from preventing the transmission of this virus”.                                                                    

Of immense concern to Professor TOMORI are states with low COVID19 cases, a situation he says is not realistic, considering that Nigeria is witnessing community transmission.

Another state with low statistics of Infection is Cross River state. With reference to the NCDC dash board again, roughly 267 cases have been confirmed, 32 persons noted to be on admission with 223 persons recovering following treatment.

A visit to Calabar by Inspiration FM’s health correspondent in February shows that residents have indeed gone subtle on the use of facemasks. Very few persons could be seen using a mask in areas including the Federal housing estate, Essien Town, other locations around the Murtala Mohammed High way.

Commissioner for Health DR BETA EDU in an exclusive interview with Correspondent IMA DEM says residents of the state have let their guards down at the moment. “A lot of people lost their guards and we don’t have up to that 9 in 10 wearing masks maybe 4 in 10 or 5 in 10 are using masks right now in cross river state but we’ve continued to encourage them”.

Dr EDU stated that its low infection rate can be attributed to early initiation of the non-pharmaceutical interventions, particularly the timely compliance of residents to the use of face masks during the outbreak of the disease in the country. She added that the immunity of residents in the state seem to be also high because of a campaign for Neglected Tropical diseases. “We are also looking at other things that happened around this period that could have given Cross-Riverians that high level of immunity. Finally, we are also looking at the role of a particular drug even though that drug has not been approved for use for covid-19 but Cross River state has had 4 campaigns in that last two years even last year January we had a campaign, that’s January-February and in December we had another campaign on NTD’s, Neglected Tropical diseases. We had a campaign for this Neglected Tropical Diseases and especially in the rural areas, we gave everybody the drugs, we are presently carrying out a research, an operational research to say that could low numbers also be associated with that? We have not proven it yet, we are not saying so yet, we are only carrying out a research”.

Dr BETA EDU further commented on the remarks made by some experts that Cross river was not testing enough hence the reason it’s number of confirmed cases are low. She speaks on the state’s capacity to test for covid19:                “We have over 5,000 cases that have been tested so far and we still have 267 cases confirmed, so do the ratio and compare the number of testing done against the number of positives recorded, it will tell you that its really on the low in cross river state. It’s simple science, its data, so it shows you that truly the number of cases we have in cross river state is really really very low”.

She explains further insisting; “Right now we have three different labs that are testing. The navy reference hospital is testing, the IDH that’s the Lawrence Henshaw memorial hospital is testing and the university of Calabar teaching hospital is testing. So in Cross River state we have four labs that are testing for covid-19, how much more capacity will you need to be able to detect more cases ” ?

WORDS OF ADVICE FOR STATE GOVERNMENTS                                               

A Molecular Epidemiologist based in Abuja, Dr CASMIR IFEANYI who also expresses concerns over how averse citizens are towards complying with the Covid19 protocols and guidelines says the non-pharmaceutical interventions can help reduce the infection rate.

He advises the Akwa Ibom state Government, and other state governments to invest in risk communication amongst other solutions he specifies can cut back the spread of the virus.

According to him; “People see it as something in the interim and so long as you see it as something for the Interim, the likelihood of your not internalizing it and making it a part of your way of life will be quite high and if that happens, the reluctance will be high. The level of investment we need to make is not about going on air , it is not about putting it on television channels, that is good but that is not sufficient. 

We must make risk communication a community driven programme, we must adopt community driven strategies for disseminating information about Covid19 and encouraging people to keep up  with these strategies. It is easy to activate a community based risk communication team, we can leverage the town hall setting, church settings, market groups, have groups of trained persons that will drive the process. It is about community engagement that will help us take the risk communication and promote the use of the non pharmaceutical interventions”.    

On more solutions that can be adopted after he took time to express his commendations for steps taken by the Akwa Ibom state Government to build an isolation and treatment centre as well as a providing a PCR laboratory , Dr  Ifeanyi added; “Can Governor UDOM EMMANUEL activate another Laboratory, and I know he can. The Governor should increase the number of testing facilities within his state. He has a world class Molecular Laboratory now, let him establish a second one, if possible, of the 3 senatorial zones can we have one of such Laboratories, it may be smaller, where as the existing one will be like the coordinating laboratory. ”The Governor also needs to set up surveillance teams that can visit markets, churches, mosques, schools on a systematic bases to take samples, It is when we test enough that we will define the disease burden and know whether the modalities put in place to curtail the disease is effective or not.  We need to have active sampling system to fit these laboratories”.

The Public health expert went ahead to establish that COVID19 was still being taken for granted by many because Nigeria was not having same situation of the pandemic like what is playing out in the European nations, the United States of America and other regions.

However he believes being proactive is the way to go; “Early this year we started hearing about the variant of the covid19 virus. Now, viruses are very dynamic, as they continue to move from one person to the other; permit me to use a colloquial word (they enhance themselves), scientifically we call that mutation. This means that the virus acquire features they already lacked. If they continue to go in and out of humans they can evolve to variants that will be more decimating in their impact and virulent in their impact. We do not have to wait until we begin to drop dead. “For every outbreak particularly a pandemic of this nature, we must learn the requisite lessons, leverage on it to deal with the deficits in our health systems. Let us take advantage of the challenge provided by the covid19 pandemic to see how we can strengthen the weak ends in our health systems in terms of infrastructure, equipment, facilities, and human resources”.