COVID 19: Nigeria to establish more ICUs, says Boss Mustapha

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Nigeria is to establish state of the art intensive care unit and treatment/isolation centres in all the 36 states and FCT as well as ensuring all states have an accredited testing centre with a view to checking the COVID 19 pandemic.

The Secretary to the Government of Nigeria and Chairman Presidential Task Force (PTF) on COVID 19 Boss Mustapha disclosed this on Tuesday while addressing the leadership of National Assembly. 

He said the PTF is ensuring that adequate structures and systems are out in place all over Nigeria to deal with infections like this that would be of public threat in near future. 

According to him COVID 19 was declared a global pandemic on 30th January, 2020 and has spread dramatically with 3.640,473 cases worldwide as at 4th May, 2020, and 1,192,909 recovered and 251,817 fatalities across 212 countries.  

However, in Nigeria’s, her index case was recorded on 27th February, 2020 and as at 4th of May, 2020, she had recorded 2,802 cases, 417 recovered and 93 fatalities. He said.

Continuing the SGF said 6th May, 2020, will mark 100 days since the novel coronavirus (COVID 19) was first detected in the nation.

Boss Mustapha said the impact of COVID 19 has not only disrupted the global economy but also the healthcare systems that were hitherto regarded as standard stable and more sophisticated systems.

He said with the inauguration of the PTF by the President it has carried out numerous activities amongst which are:

i. Policy Focus:

✓ Developed a multisectoral Response Action Plan to guide our national response through:

▪ High level engagement with the organized private sector for better coordination of their core competencies and expertise.

▪ Mobilization of the States and Local Government areas resources in preparation for the possible spread of the disease into communities.

▪ State Needs Assessment and state of preparedness

▪ Stimulating economic national interests to mitigate the negative   effects of the pandemic i.e

▪ Encouraging our indigenous researchers to develop appropriate solutions for our environment.

▪ Arrangements are underway to evacuate Nigerians from different parts of the world.

▪ Mandatory 14-day quarantine for returnees from other parts of the world.

▪ Support for strengthening sub-national level response;

▪ engagement of local manufacturers across the board for the stimulation of local production of essential commodities to reduce dependence of imported commodities.

▪ Local production of face masks, hand sanitizers, protective gear etc.

▪ Critical Review of state of health systems in focal States and the FCT.

▪ Identification of available capacities for isolation and treatment of COVID-19 patients which has yielded over 3,787 beds across facilities.

▪ Improved surveillance systems

ii. National Response Strategy: This strategy involves:

✓ Detection, Testing, Contact Tracing and Treatment

✓ The efficiency of the identification, testing, evacuation and isolation process increased significantly

iii. Testing & Manpower Expansion:

✓ Increased the number of laboratories from 5 to 21 with a final objective of establishing one lab per state; 

✓ Increased testing capacity with over 80% conducted in Lagos, Kano and the FCT;

✓ The laboratories in Lagos and the FCT were expanded to have the capacity to test a minimum of 1500 samples daily;

✓ Increased Bed Capacity to a total of 3,787 as at 4th May, 2020;

✓ Followed-up on 11,840 (95%) of contacts out of 12,504 earmarked for Contact Tracing;

✓ About 9,828 health workers have been trained (Doctors: 2725; Nurses: 1942; Response: 5161) to increase the human resource available for case management; 

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✓ Insurance cover for 5,000 frontline health workers secured through the industry;

✓ Government and health professionals signed an MoU on the hazard allowance and other incentives

iv.​Infrastructure Development:

✓ State Public Health Emergency Operations Centers (PHEOCs) are being activated;

✓ More personal protective equipment and ventilators procured;

✓ Completion of more Isolation Centers with a total capacity for 3,500 nationwide;

✓ Advised each state Governor to provide isolation centers with at least 300 bed spaces;

iv. Mobilization & Management of Resources:

✓ Additional resources mobilized through the international community, the private sector and public-spirited individuals; 

✓ Donations have been received into a designated CBN account by the Accountant General of the Federation

✓ Private sector donors are to deliver specific infrastructure projects to strengthen the system nationwide

✓ Government funding has just been released and utilization is at advanced stages of implementation

v. Relief Materials & Distribution:

✓ Government has released 70,000 MT of grains for distribution as relief;

✓ Release of 158 trucks of rice and other condiments by the Nigerian Customs Service;

✓ Payment of the Conditional Cash Transfers is being made

✓ List of beneficiaries of the CTT is being expanded by one million as directed by the President;

✓ Authorized employment of 774,000Nigerians

✓ Authorized continuation of the school feeding program to sustain the nutritional value for children

✓ Distribution of Palliatives has commenced and is on-going, in collaboration with the States;

✓ Focus is on the poor, aged, sick and the vulnerable

vi. Consultation with Stakeholders:

✓ Consulted with Governors on all processes

✓ Traditional and religious leaders

✓ Labour sector

✓ Security Agencies

vii. Non-Pharmaceutical Measures:

In order to contain the spread of the pandemic, the PTF recommended the introduction of non-pharmaceutical interventions, which includes:

✓ Restriction of travel to and from 15 high burden countries worldwide;

✓ Closure of the land, sea and air points of entry

✓ Lockdown of Lagos, Ogun and Kano States as well as the FCT;

✓ Launched the Stay at Home campaign;

✓ Introduced the policy of Physical distancing;

✓ Observance of personal hygiene like washing of hands, etc;  

✓ Introduced the wearing of masks/coverings in public

viii.​Revised NPIs & Guidelines:

​​After 28 days of lock down and three broadcasts by the President, ​​​the easing of the restrictions was introduced with ​effect from 4th ​​​May, 2020.

✓ Overnight curfew has been imposed

✓ Interstate travels restricted to movement of goods, agricultural produce and essential services;

✓ Mandatory wearing of masks/coverings introduced

✓ Phased reopening of the economy commenced

✓ Physical distancing and personal hygiene reemphasized

Speaking on the current situation in Kano state, he said, the state is emerging as the epicentre of the COVID-19 pandemic in the North, which necessitated Mr. President’s specific directives in his broadcast of Monday, 27th April, 2020.

Continuing the SGF said the PTF has been working closely with the Kano State Government and key stakeholders to identify the issues and seek immediate solutions with the  deployment of technical team of 41 staff from NCDC supported by 17 staff from WHO to provide technical assistance to the State Emergency Operations Centre (SEOC). 

He added that a team of clinicians and public health experts under the auspices of the Federal Ministry of Health is also in Kano to provide training on case management and strengthen the capacity of the State to handle emergencies.  

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But he identified key weakness of the Kano COVID-19 response  as tack of adequate manpower for surveillance and contact tracing adding that the PTF has mobilised resources from across the health sector including multilaterals, bilaterals, MDAs and the private sector to push through an accelerated expansion of the rapid response teams (RRTs) from 21 to 50. This required the provision of 30 additional vehicles from INEC and 15 ambulances from the PTF and private sector. A further 10 hilux vehicles and 10 ambulances have also been pledged by the private sector.

He said”‘ working with partners, we are establishing at least one sample collection centre and two facilitators per LGA. In addition to a 7-day motorised campaign across major urban areas in Kano. We have mobilised about 3300 informants through the WHO/polio programme for house-to-house search and reporting of suspected cases. The Federal government will in due course announce significant additional material and technical resources to complement the State government’s efforts in combating the COVID-19 pandemic in Kano””

He said based on the PTC assessment, the following specific additional measures have been put in place in Kano:

i. Lockdown of Kano for two weeks

ii.  Manpower Support:

✓ Sent a team of experts to review the response structure and assess the situation;

✓ Been working closely with the political and professional authorities

iii.​Equipment Deployment:​

• Deployed equipment to the medical facilities;

• Trained the Kano state teams of health workers

• Some service ambulances from the FRSC have been deployed

• The Armed Forces Hospital in Kano is also being retooled to provide additional infrastructure

iv.​Palliatives Delivery:

• Deployed 100 out of planned 200 trucks of assorted grains for relief

v.​Testing Capacity

• Handed over a new Diagnosis Lab by 54Gene, supported by Dangote Foundation on Sunday 3rd May, 2020;

• Increased the testing capacity by 400 tests per day.

• Preparing to get another lab supported by the eHealth Africa for introduction into service;

• Two government labs in AKTH and BUK are also working.

• By end of this week- Kano will have a capacity to test 2000/day.

vi.​Treatment Centres in Kano

✓ Inspected the treatment Centres. And found two currently functional: 

• Muhammadu Buhari Hosp=76 bed capacity;

• Kwanan Dawarki=75 bed capacity

✓ Both Treatment centres still not full due to:

• resistance primarily, and  

• logistics.

• Two new treatment Centres being prepared by Dangote Foundation – 

• Urology Centre (75 beds);

• Stadium tent (100 bed);

• Sani Abacha (200 beds).

vii.​Strengthening the Kano State Response Structure:

✓ The EOC structure and processes have been improved through reorganization.

✓ collaboration with Kano state is on going

✓ Prevention of spread to neighboring states is a priority

✓ Medical personnel from states around Kano are currently being trained as part of the national response strategy.

The SGF reiterated that the activities carried out by the PTF are applicable nationwide but more emphasis has been placed on the epicenters where community spread has commenced with a threat to family transmission on the increase.

On effective coordination , he said  the PTF is working in collaboration with other structures set up by the President to ensure that there is a well-rounded national response. These include:

✓ the Economic Team headed by the Hon. Minister of Finance to examine the impact of COVID 19 on the economy; and

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✓ Economic Sustainability Committee headed by His Excellency, the Vice President.

✓ The Task Force on free movement of farm produce headed by the Hon. Minister of Agriculture and Rural Development.

“”As part of the PTF’s mandate, we are working towards strengthening the country’s public health emergency preparedness through system building and infrastructure development. The COVID-19 pandemic has exposed the fragile status of our health system and the near absence of the structures or building blocks necessary for the public health protection of our communities.”‘ He said

 He did loses the plan “‘ to establish state-of-the-art intensive care units and isolation/treatment centres in each of the 36 States plus FCT. We will also upgrade molecular laboratory facilities across the country and ensure that a COVID-19 testing centre is available in every State through the utilization of existing GeneXpert machines. This scale-up of infrastructure will also require additional staff training and a review of existing manpower needs for the country. There’s no doubt that a strengthened and well-resourced health system will not only place the country in a better position to deal with future emerging infections such as Lassa fever but will also provide a solid foundation for medical research and development.”‘

He posited that the post-COVID-19 era is going to be a challenging one and as  a country, we need to prepare for what will be major changes to our long-term social interactions, events, personal contacts and economic prospects.  

“‘ust as important is the need to provide a strengthened legislative framework for dealing with future public health emergencies in a changing world. The current Quarantine Act needs to be updated due to the unique nature of emerging infections such as COVID-19, the dramatic impact this has on sectors beyond just health and the urgency required to deal with such pandemic”‘ He said.

The SGF said “the President exercised his powers under sections 3 and 4 of the Quarantine Act LFN 2004 to restrict movement of persons and goods in Lagos, Ogun and FCT. Although this intervention generated heated debate in the legal circles, with insinuations that it may be in direct conflict with section 44(1) of the constitution and article 14 of the African Charter on Human and People’s Rights (ratification and enforcement) Act, the legal basis of the intervention is not debatable. However, the Act needs to be adaptable to the changing nature of human behaviour and interaction.””

Furthermore he said the nation is at war with “‘ dangerous, unseen and ubiquitous enemy and all hands must be on deck to successfully prosecute the war. In addition to providing the kind of leadership already demonstrated, the National Assembly finds itself in the unique position to do the following, though not exhaustive:

• Develop a legislative framework to prepare Nigeria for any future pandemic;

• Develop a legislative framework for reforming and transforming our healthcare systems;

• Strengthen the legislative framework for economic growth through domestic manufacturing;

• Deepen the legislative oversight during this pandemic and beyond;

• Pass legislations that will further ease the ability of the executive to cushion the impact of the economic decline;

• Be part of community mobilization and enlightenment efforts.”‘

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