Dr Ali Muhammed Inname is the Commissioner for Health in Sokoto State as well as the chairman of the state’s task force on COVID-19. In this interview by OLAKUNLE MARUF, he speaks about the efforts of the state government on the management of the pandemic, among other things.
What measures has the Sokoto State taken to curtail the spread of COVID-19 in the state?
Since Governor Aminu Waziri Tambuwal set up the task force on COVID-19 on 19 March, 2020, we have been responding to the challenge in different ways, ranging from coordination to case management and surveillance at the points of entry into the state to research into the coronavirus. So, we have been able to take care of things.
We are involving traditional and religious leaders in the state, including the Sultan of Sokoto, Alhaji Muhammad Sa’ad Abubakar, in making decisions on measures to take to curtail the spread of the pandemic. We thank God that the lockdown, ban on the interstate movement and other measures taken at the initial stage have been successful so far.
Since the 28th of March, there have been no movements into or out of Sokoto State in order to prevent people from coming into the state with COVID-19. We are in the 10th week of the interstate movement lockdown, but there are movements within the state, from one local government to another. We have a rapid response team through which we receive reports that allow us to respond appropriately to emerging situations.
We recorded our index case on April 19 and everything changed from that moment. The first index case happened to be a health worker. We quickly went into active contact tracing and two days later, we had two more confirmed cases. But so far so good as regards the restriction of movements into the state and other measures put in place by the state government to protect the people like the activation of the state’s response team and continuous sensitisation of the people.
There is a committee in charge of case management and we have an isolation centre at Amanawa Infectious Disease Centre that can accommodate 200 patients at a time. All these interventions have been ongoing since March 19.
What would you say is the level of people’s compliance with government’s guidelines to stop the spread of the disease?
The people of the state have been very cooperative, although at initial stage, we had a challenge with regard to people coming in from neighbouring states like Kebbi and Zamfara. We faced the challenge of some people following unofficial routes but after a while, we were able to address that. But by and large, the people of the state have been very cooperative and supportive of all the measures that have been taken by the government. We have received more than 800 alerts/complaints regarding people that just came in or people with suspected COVID-19 symptoms. The level of awareness on the COVID-19 pandemic has been very high in the state.
A number of unexplained deaths occurred recently in some northern states, Sokoto inclusive. Has your state been able to find explanations to such deaths?
Yes, we conducted investigations on the deaths that occurred between mid-April and the first week of May. That was a period when Sokoto recorded an unusual spike in number of deaths. There was the same experience in other states like Kano, Yobe and Bauchi. Our investigations showed that the deaths occurred mostly among the elderly and other people suffering from terminal diseases such as hypertension and diabetes. We ruled out COVID-19 in these deaths because their cessation happened in the first week of May, when the number of COVID-19 cases started to rise. We were able to establish that the deaths had no link with the pandemic. As I said earlier, we recorded our index case on April 19 and between that date and the second week of May, we had a spike in the number of positive cases. We once saw 13 positive cases in 24 hours, which is the highest number we have ever recorded in a single day.
After the second week of May, the number of COVID-19 cases started declining and concerning the phenomenon that occurred, the state, with the support of the Federal Government, conducted an in-depth research to understand what actually happened. Our preliminary finding is that other diseases than COVID-19 caused the deaths.
How many COVID-19 deaths has the state recorded so far?
We have recorded 14 deaths relating to COVID-19. As a state, we have decided that any case suspected by doctors to be COVID-19-related, especially where such a patient died, we would take a sample from the corpse in order to get confirmation. If it turns out to be COVID-19, that would help us to embark on contact tracing.
Many in the state still believe that COVID-19 is a ruse. What are you doing to convince such people and get them to protect themselves against the virus?
It will take us some time to convince such people on the reality of COVID-19. After the index case in the state, it became clear that COVID-19 is real. About 95 per cent of the positive cases are from the urban areas; very few of the cases were from the rural areas. We also discovered that those with positive cases of COVID-19 in the rural areas were returnees from high-risk places.
We have been holding constant talks with residents as well as traditional rulers and religious leaders, especially in the rural areas, to enlighten people on the reality of COVID-19 and the need to adhere to safety protocols. We have made headway in creating awareness but some people still perceive the pandemic as a ruse or merely a disease that afflict wealthy people. This wrong perception exists among a very small population because the awareness on the reality of the disease has been very high.
How is the state handling other health challenges among the populace alongside the COVID-19 pandemic?
The issue of COVID-19 has really affected the health system negatively. At a time, so many public hospitals scaled down their services, which means many people were managing their health problems at home. I am aware that most hospitals only attend to emergencies and so people with chronic illnesses are deprived of care. That also explains, to some extent, the assumption that COVID-19 was responsible for the sudden wave of deaths we talked about earlier. In view of this, we set up two committees to monitor and improve clinical services at the health centres at the primary, secondary and tertiary levels. We realiased that health workersare being cautious about seeing patients and patients, too, are apprehensive about seeing health workers. This is because of the way the COVID-19 infection started in the state, where the majority of the positive cases we had were health workers.
Many people are under the impression that if they see a doctor, they might contract the disease. They are scared of going to hospitals, especially those within the metropolis. We have to really address this issue going forward, especially now that we are having fewer cases.
There has been clamour for increase in the hazard allowances and provision of personal protective equipment (PPE) for health workers. How far has the state go in addressing these issues?
When we started the fight against COVID-19, the governor graciously approved 100 per cent increase in the hazard allowance of all health workers, whether they are in the front line or not, for the month of April and May and that was done across the board. Thereafter, we came up with the allowances for front-line health workers, those doctors and nurses working at the isolation centres. They are getting weekly allowances. Consultant doctors get N15,000 daily which we pay every one of them every week. The document is before me as we speak. For medical doctors, we pay them N7,500 daily. Nurses earn N6,000 allowance daily; pharmacists, N6,000; environmental health officials, N1,800 and ward attendants, N3,150. Security agents attached to the isolation centres also earn N1,000 daily.
This is meant to encourage them, especially those in the front line at the isolation centres. Also, people working at the points of entry into the state, especially environmental health workers and those that are taking temperature, are being paid. The payment of these allowances is on the order of the governor, who said that everyone must be captured.
What about the provision of PPE?
PPE are very much available at the various isolation centres and all the government hospitals in the state. As I said earlier, we are trying to stimulate health services to return to the pre-COVID-19 era. We are also providing additional PPE because we have a policy that all hospital workers must wear face masks. That is the minimum. We have made provision for that. The committee monitoring clinical services distributes face masks to everyone whenever it goes on advocacy visits.
What is the essence of the volunteer scheme recently launched by the state?
The volunteer scheme was launched at a time when there was a sharp increase in the number of positive case. We are being proactive to ensure that we have a pool of health workers. Doctors and nurses were particularly the target. It is a well-known fact that we have a lot of locations where we were keeping patients. We are working with some of the volunteers to distribute locally produced face masks to the general public.
What advice do you have for the people going forward?
I want to appeal to the Sokoto people to continue to obey the laid down rules and regulations, especially frequent hand washing, use of face masks and avoidance of large gatherings. I also urge people to go to the hospital when they are ill. We want to go back to the normal services that we used to provide. We are also hoping that as people go to the hospitals, we will be able to get people proper treatment in the event that any of them present with COVID-19 symptoms.
What is the present situation at the isolation centres?
We only have five positive cases in the state as the tests carried out on new samples were negative. We carry out tests on a daily basis, depending on the number of available samples. We recorded one positive case in Gada Local Government Area. It was an individual who came back from a wedding ceremony in Imo State. Whenever there is a suspected case, we act fast and get the sample of the person for test. We thank Allah for the successes we have recorded so far. We appreciate Governor Tambuwal for the support he has given the task force. The Sultan of Sokoto has also been helpful, especially when we have to make regulations that have to do with religious activities and other things that affect the Sokoto State tradition.
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