COVID-19: Oyo’s battle against a growing pandemic

Prior to Governor Seyi Makinde announcing the first index case of COVID-19 in Oyo State, on March 21, the lasers had been beamed on every action taken by the state government since Nigeria announced the first case of the pandemic on February 27. With its proximity to Lagos where the first case of an Italian citizen testing positive for coronavirus was recorded, the readiness of the Oyo state government to prevent a spread to the state continued to be questioned, by each passing day. The calls were loud: shut the inter-state borders, lockdown the state, limit congregations, you were wrong to have organised Peoples Democratic Party unification rally in Ibadan, fix our health facilities and close down markets. Amid those calls, the state commissioner of health, Dr Bashir Bello would waive his hands like a traffic warden to say, “No cause for alarm; no need for limiting measures yet; there is no confirmed case of coronavirus in the state.”

But beyond sensitizing residents on implementing precautionary measures, some concerns revolved around whether the state took into cognizance prescriptions of the World Health Organisation (WHO) that states should also apply administrative controls to include ensuring the availability of resources for infection prevention and control measures such as appropriate infrastructure, development of clear infection prevention and control policies, facilitated access to laboratory testing, appropriate triage and placement of patients, adequate staff-to-patient ratios and training of staff. Furthermore, the WHO demands environmental and engineering controls aimed at reducing the spread of pathogens and reducing the contamination of surfaces and inanimate objects. Such controls also include providing adequate space to allow social distance of at least one metre to be maintained between patients and healthcare workers and ensuring the availability of well-ventilated isolation rooms for patients with suspected or confirmed COVID-19 disease. When Oyo state recorded its first index case on March 21, it became clear that Oyo state had to go beyond campaigns for adherence to precautionary measures to implementing administrative, engineering and environmental controls.

And there came the announcement of a raft of measures: civil and public servants are to stay off work for two weeks, transport operators and park managers should provide hand washing facilities, commercial vehicle operators should limit number of passengers, all schools, mosques, churches and night clubs should be closed, emergency operation centre will be activated, curfew from 7pm to 6am, diagnostic centre should be established, isolation centres are to be designated and equipped, Pediatric and Maternal Centre, Olodo converted to Oyo state Infectious Diseases Centre while the state COVID-19 task force was set up to be headed by the governor, Makinde.

As number of cases grew from one to eleven, so did the state task force increase measures to stem further spread of the virus. Indeed, there was palpable fear across the state when names like Chief Medical Director, University College Hospital, Ibadan, Professor Jesse Otegbayo and state governor himself, Seyi Makinde were given to the state’s cases. With people like Otegbayo and Makinde confirmed to have tested positive and cases in neigbouring states like Osun, Ogun and Lagos growing, there came louder calls for a total lockdown of the state. The Nigerian Medical Association (NMA) in Oyo state, led by Dr Akin Sodipo, was loud in its call for a total lockdown of the state. Such lockdown, according to Sodipo, will curtail the movement of people and reduce people having contact noting that everyone was a potential carrier of the virus. Furthermore, Sodipo urged the state government to expedite action on refurbishment of facilities converted to isolation centres and provide necessary protective equipment for all involved in preventing an outbreak of the virus in the state. Addressing calls for a lockdown, Makinde has maintained that total lockdown remained the last option and the decision will be based on experts’ advice.

With isolation centres needed to house the active cases, Governor Makinde, on March 28, announced that the state had set up isolation centres, with four-bed isolation unit in Ogbomoso, 10-bed at Agbami chest hospital, Jericho, four-bed at UCH and 100-bed capacity at Olodo, Ibadan. The Agbami centre has housed the state’s cases thus far while the Ogbomoso facility is only a temporary isolation facility devoid of testing kits and other equipment to collect samples from suspected cases. According to consultant microbiologist to Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Professor Samuel Taiwo, the Ogbomoso isolation centre requires government’s attention for it to function and serve the needs of Ogbomoso and Oke-Ogun areas of the state.

“The isolation centre is there; some supply came from the state epidemiologist in Ibadan in terms of Personal Protective Equipment but we cannot investigate anybody, we can’t do the test. We can’t even collect samples because the test kits have to be sent from Ibadan. If we have a patient to screen, we have to wait for two or three days to get the materials to collect samples and then send to Ibadan or Ede for testing.

“What we have is a three bed temporary isolation facility. If somebody is suspected, we put the person there pending when we can do the test. But if the person has serious problem, we can’t do anything until we send to Olodo. We have other places that can be expanded but the government will have to support,” Taiwo said.

Meanwhile, the state infectious diseases centre, Olodo, which has been equipped with millions of naira, is meant to serve as treatment centre and deal with severe cases of COVID-19.

Speaking in the same light, Permanent Secretary in the state ministry of health, Dr Adebisi Ayoola said though the initial plan was to convert Olodo centre to a general hospital, the state government had to convert to infectious diseases centre out of COVID-19 exigency. He said the Olodo centre will serve other purposes like tackling Ebola, Lassa, Cholera and other diseases outbreak.

The newly designated Oyo state Infectious Diseases Centre, Olodo has now been equipped for use. Former UCH CMD, Professor Temitope Alonge, who was mandated by Governor Makinde to oversee the transformation, said all necessary equipment for a world-class centre had been procured and installed. Aside from establishing a unidirectional flow for an infectious disease setting, he listed the equipment at the Olodo centre to include Intensive Care unit beds, Intensive Care Unit monitors, infusion pumps, suction machines, oxygen piping, a mini-lab, monitoring system, chlorine water pump system, artificial incinerator and personal protective equipment.

On amount spent, Alonge said he was quoted out of context to have said that N1 billion was spent on the Olodo centre. It was also made known that the state government had trained at least 27 health workers as well as volunteers to work in the centre. While noting that the state was in the process of procuring mobile ventilators, Alonge said he was to proceed to Ogbomoso and Saki to also fix their own isolation centres. On what should become of the centre when COVID-19 is over, Alonge admonished, “What I expect people in the teaching hospitals in the state is to make use of this centre for all manner of epidemiology studies, field control studies, do a lot of research and keep this place running by their own research grants or from government. I have never seen a facility like this become idle in foreign countries.”

In tackling a spread, the state governor further set a target to test about 10,000 residents of the state for COVID-19. Incident manager in charge of the state Emergency Operations Centre, Dr Bode Ladipo, said the state would accelerate its level of testing this week, as only 125 persons had been tested so far. With collaboration with a non-governmental organization named LifeBank, increased equipment of the virology laboratory in the University College Hospital, Ibadan, Ladipo assured of rapid testing. He pointed out that the level of testing will be accelerated in terms of coverage of high risk group and laboratory backup to be able to get results as soon as possible. Meanwhile, the state on Monday commenced decontamination of state Secretariat, with Chairman, Decontamination and Containment Committee, Professor Olanike Adeyemo explaining that it will only decontaminate places where a victim of COVID-19 worked or domiciled.

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