The Nigerian Medical Association after a careful observation of the events regarding the response of the covid-19 Pandemic and came up with the Followingp0 observations that
1). Government’s increase in testing capacity in Lagos state has helped to identify more cases and potential contact.
2.) The introduction of house-to-house testing,a positive development especially as we begin to enter the phase of community transmission,even though there is continued concern about the capacity and readiness of Government to speedily scale this up.
3.)Expansion in the number of isolation centres which has given more room to accommodate positive cases,and planned further expansion in phases is also commendable. However, most of the frontline health workers do not have access to adequate PPEs.
4.)The NMA Lagos, however, wishes to cautiously point out that a pattern of mild course of the Covid-19 infection in Lagos, and indeed in Nigeria, may be emerging, given the limited available data of the course in the confirmed cases so far.
5. )NMA has also noted a disturbing trend in the private management of COVID-19 cases in private hospitals where capacity for infection control and surveillance may be limited. This action is likely to be the missing link to the worsening community transmission.
6.)The Association also noted with concern, a document from the HEFAMAA which, among other things, plan to accredit private hospitals for the management of COVID 19. We are concerned that Government may have started yielding to the pressures from business concerns who may see this pandemic as a business opportunity rather than the public health emergency that it is.
7) Based on the above cautious observation (in 4),the NMA is calling for large scale community-based antibody testing to confirm the plausible hypothesis that there is ongoing active transmission but with mild course of disease.
This hypothesis, if confirmed will shed light on the mode of transmission and the clinical categories of community dwellers who have recovered from the infection.
It may also guide the decision on and the mode of re-opening the city for the needed economic activities.
8. That Government should continue to expand the capacity of the isolation centres with the aim to strategically locate them fairly in different parts of the state.
9. The Government should also increase the capacity of the holding areas where suspected symptomatic patients can be kept while awaiting result for proper supervision.
10. That Government should rescind her position, via HEFAMAA, to use the private hospital sector to manage COVID 19 patients. It is still more prudent for any suspected case to be isolated in a holding area within the private hospital while the appropriate government authority is contacted immediately.
The Association will resist any attempt at commercializing the management of this infection as seen in some private health facilities.
11. We suggest that government legislate and criminalize the act of resisting isolation by COVID-19 positive patients in public facilities as this action has been implicated in jeopardizing the efforts of containment, while we appeal that the public isolation centres should be made conducive for all calibres of patients.
DR. SALIU OSENI DR. MORONKOLA RAMON