Chief Executive Officer (CEO) Institute of Human Virology Nigeria (IHVN) Dr Patrick Dakum, in this interview with ISAAC SHOBAYO speaks on the ranging Covid-19 pandemic in Nigeria, the latest index cases in Kano and the way out of the pathetic situation.
IN spite of the government efforts to curb the spread of coronavirus in Nigeria, its spread has continued to be on the increase, what is responsible for this?
First of all we need to provide a little bit background of the mode of transmission which is already in the public domain, it was first identified in Wuham in China and is similar to a group of viruses that are in the respiratory track, which means that it can get into your body and attack your lung, via your nose, mouth and your ears, these are the key areas. Despite everything, the trend is still going on, the question we are going to ask is what are the effort or what are we doing or what we can do better to curb this pandemic. But when people are close together, when someone sneeze, the virus goes out and enter into someone that did not protect himself then why don’t we limit people that are together in one place and that was the necessity for doing the lock down. So that people can stay at home and does not transmit the virus from one person to another. Another thing is that if you must be out you can help another person by ensuring that you cover your cough, meaning that you cover your ear, mouth and nose or being in the region of break cloud, so wear a mask. Also wash your hand every time. These are the measure globally because there is no vaccine yet, so the government did a lock down, when the virus came in and before we could institute these measures, the virus has already gone from person to person. It initially came through the Airport but from there it has spread to the community and right now we have a situation whereby people who do not have the history of exposure to somebody that has coronavirus or in a country with coronavirus but has the virus. The challenge is how do we ensure that people do not come close together until this epidemic is over? If we enforce the measures, the virus has a lifespan it will die off and therefore we would now get over it. However, how do we ensure that people stay in one place? This has become a problem, so now lock down has been relax in Lagos, Ogun and Abuja, so to what extent is this effective, one major thing is that even with the lock down people did not obey, people took it for granted and said there was nothing like that. People never stay at home and never took measures when they are going out that is responsible for the spread up till today. The other aspect that we need to mention is that now that the virus is here with us what do we do? Now that the federal government has ease the lock down, we have gone back again in term of interacting with one another as if nothing is happening, it mean that we would have a huge bump in the number of cases.
Are you saying it is too early for the government to relax the lock down?
What I am saying is that the relaxation of the lock down should come with what people should do, for example the government has said it would relax the lock down, the government has done its own because of the economic reality we find ourselves. Unless you get food for everybody which is not possible people will definitely go get food otherwise it will be foolhardy to say they should not go out. But what do we do during this period of lock down, institution apparently underestimated the number of people that will show up at their doors, I don’t envisage the number of people that show up at the bank during the relaxation will be that much, last week people just jam parked without observing social distancing, so the banks need to have a preplan to guide against this. If I were the bank I will shut down first and put up a notice and come up with the strategy of spacing people than having people crowded and going home with virus. So institutions must figure out how to operate and also a place like bigger markets are extremely difficult place to control , so major markets should remained closed for some time until we get over this, I know that it comes with a lot of pain but unless we do that it will be difficult for us to overcome this challenge. If you are coming to my house now the security men will not allow you to come in unless you put on face mask because I don’t know where you are coming from and who you have met. If you come to my office there is enforcement, so if institution will enforce all these preventive measures it will reduce the workload of law enforcement agents and medical personnel.
Now if we look at the crowded places like Kano, it would be extremely difficult to practice social distancing, but we will still continue to encourage it because it is a method that is working. In addition to this, we must work out how to enforce the wearing of mask. To make this work, do not approach people like police, approach it from their tradition institutions people respect this institution more than the police, even the government. If you go to place like Kano everybody want to go to the mosque, but now many cannot go to the mosque but the Imam can pass messages that can go round, the Emir can pass message that can go round likewise the district head can pass message that can go round, all these institutions have a lot to do in bringing the reality of the situation to the people. Presently, Kano people are beginning to see coronavirus in proper perspective, especially the rate at which their loves ones are passing on; people now know that the pandemic is a reality. About a month ago if you talk about it in Kano no one want to listen to you. But with the reality of the mortality on ground everybody is convince that coronavirus is real, but we should not wait until we are face with rising death like this before we take action. Our lives are in our hands now not in the hands of public health people, everyone now need to take his or her life in his hand. Like I said in one of the programmes, I said your wearing of mask is a sign of love to me especially when you are coming to me. So there must be aggressive information and behavioral change. In Nigeria people listen to their association leaders than the law enforcement agents, so this kind of institution is extremely important. The Institutions that people believe in should be the mechanism or process of taking information to them especially in places where population is unbelievable concentrated.
Don’t you think the culture and traditional believe of the people are militating against the fight of the pandemic especially in a society where there is much emphasis on religion and cultural believe?
I believe our religion should be practiced in a safe way especially in a situation we found ourselves, when they said we have been lock down, does that mean God has been lock down? The answer is no, this virus is teaching us how an individual can commune with his God the way he feels best, as a Christian I can read my Bible in my house, I can pray in my house, I can watch streaming sermon on Sunday. If I am a Muslim I can conduct my prayer alone, it is modified mode of worship for the main time.
In some parts in Nigeria, it is a norm and tradition for people to follow corpse in a large number to burial ground as a mark of respect to the deceased; some even try to touch the corpse. They do this without social distancing and adherence to basic health rules (cut in)
During this season government should discourage people from carrying corpse from home to the burial ground, even if the person died at home let them bring the person to the hospital. If they won’t allow you to normal autopsy they will allow you to do verbal autopsy. And the government has a responsibility to decontaminate that body and put it in a safe bag. You give the body to the relation and advise them to wear personal protective equipment and the workers that are in the grave sites should be should be given Personal Protective Equipment because you can never be sure. One thing with the public health is that it relies on the cooperation of the people and action of the health officials that were responsible for fighting against the pandemic. Government should play its roles but the community must rise up to ensure the virus does not have a place in their communities. The way we practice burial, as long as we can decontaminate the corpses, we can give people the body to go but the fact that that person died of suspected coronavirus and he has relation that will go to the burial ground, you that you are going to pay your last respect to the deceased you stand the risk because you don’t know who has caught it. The corpse itself might be decontaminated but the people might be infected through contact and there is the need for the people to understand that you can pay your respect to the surviving relations or how do you pay respect when someone drown and you can’t find the body, you go to the people that survive and mourn with them and pay your respect to the deceased through surviving relations. Whoever died had passed on, so we mourn with the family, but we must realize that the living must be protected.
Sir, with the index cases rising on a daily basis involving both the effluents and the poor especially in Kano State, also considering the position of the state in the north. What do you think the government can do to halt the spread of this pandemic?
First of all I think the Federal Government has taking a right step in the right direction by sending experts to work along with Kano state public health experts and government there. These experts are distributed across various disciplines, they are going to work with health structure of the state, they will look at how to pass effective messages to the people, how to identify those who are positive? We have index cases in Kano and I thinks it stands now at 385, assuming that each index cases had 10 contacts and in Kano is going to be more, it mean close to 4,000 people will be tracked from 385, So 4000 people will need to be tracked, what is the structure for that, it must structure in such a way that the moment this contact are found, how do you take them to isolation centers, it is huge health machinery that need to be operational there. So in Kano for example while they emergency operational centers are on ground, each local government should have operational centers. There must be community based aggressive testing, meaning it should not be testing of only the contact, it should be testing for everybody that have respiratory illness similar to what Lagos is doing, meaning that they go to a community set up a tent and take the sample of anybody that has fever or cough. For Kano, there must be massive contact tracing and testing including isolation that would take cognizance of densely population of Kano.
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