Anambra’s COVID-19 Index Case Was Managed According To Best Practices
1. At about 8pm on Good Friday, April 10, the Nigeria Centre for Disease Control (NCDC) announced that Anambra State, despite the inspiring efforts of the state administration to shield the people from the ravaging coronavirus pandemic, had finally been infected. Just five days later, new specimens from the index case read negative for COVID-19. A second test conducted four days later by the NCDC confirmed that the index case has really been cured of the contagion. Consequently, Governor Willie Obiano on Wednesday, April 22, directed the Commissioner for Health to release the 58-year old man from the protection centre at the General Hospital, Onitsha, Nigeria’s first facility to meet the World Health Organisation (WHO) standards in the management of COVID-19 cases.
2. The management of Anambra’s index case has turned out to be one of the shortest anywhere in the world. Kudos to the team which handled the case. The team is good, very good. Chikwe Ihekweazu, the NCDC Director General who visited the state with WHO officials 24 hours later, described the physicians in the state government as “truly amazing”. Ihekweazu, calm, measured and thoughtful, is not known for extravagant remarks.
3. Nigerian doctors who have been managing COVID-19 cases around the country have generally displayed great competence and dedication to duty. While the global mortality rate of the coronavirus is 6.1 %, the rate in Nigeria is a mere 3%. Our doctors should share their experience, knowledge and skills with their professional colleagues across the globe.
4. Back to the Anambra team. Those of us who have for months been following the state’s team which treats viral outbreaks are by no means surprised at the competence of the doctors. Last February, for instance, the state recorded an index case of Lassa fever. The index case was a 25- year old female undergraduate of a university. Once doctors at the state university teaching hospital began to suspect that the lady could be a Lassa fever patient, they started to discreetly trace her contacts. Therefore, no sooner that she was confirmed at the testing centre at Irrua in Edo State to be a Lasser fever patient than as many as 28 persons with whom she had contact in the previous two weeks in both her school and her hometown were traced and quarantined. The index case Lasser fever case was not just managed successfully but all her contacts were treated in accordance with both the WHO and NCDC protocols. In other words, Anambra did not have more than one case of Lassa fever when some of her neighbours were having quite a number.
5. Still, the state authorities were not carried away by the knowledge, skills and experience of the team in handling viral cases when the COVID-19 broke out in Nigeria the following month. In conjunction with the WHO and the European Union, the state university teaching hospital trained 50 persons on how to manage coronavirus patients. The master trainers have, in turn, been training others. The training is about to be extended to primary health care centres (PHCs), admirably led by Chioma Ezenyimulu, herself a physician of note. One significant thing about the training of personnel to manage COVID-19 patients in Anambra State is that ward cleaners and ambulance drivers are trained, in addition to doctors and nurses. Cleaners and ambulance drivers play a significant part in the coronavirus management value chain. This is a lesson to other states and the Federal Government.
6. Some people consider it a conundrum or puzzle that despite the fact that Anambra indigenes are famous for peripatetic activity and they have some of the biggest open markets in West Africa which are always overcrowded with millions of people from West and Central Africa it has only one confirmed COVID-19 case. What they may not know is that the state started earlier than any other to prepare for the grave coronavirus challenge. By January 27, for instance, Governor Obiano directed the Ministry of Information and Public Enlightenment to initiate the campaign immediately, starting with an advisory against travelling to China; the advisory also counselled the people to watch out for persons who were coughing or sneezing or running temperature in about 13 European countries and kept away from them. This directive was well publicized and is still available on the Internet. The state government had earlier directed the Ministry of Health to set in motion the machinery to deal with both the coronavirus and Lassa fever. It also directed every member of the state Executive Council to go to each of the 63 major markets in the state as well as to motor garages and hotels and engage stakeholders here on the viral outbreaks and how to prevent them. These places were chosen because they have high populations. I was sent to the New Tyres Market at Nkpor, near Onitsha, where I held a rewarding town hall meeting with hundreds of traders, assisted by officials from the Ministry of Health.
7. The state government has devoted much time to the prevention of COVID-19 because of the belief that prevention is better than cure. If the COVID-19 outbreak could paralyse Italy, United States, Spain, Germany, United Kingdom, South Korea and other developed countries, despite their great advances in healthcare, the situation will be cataclysmic if allowed to grow to an industrial scale in Africa.
8. Whether in societal sensitization and mass mobilization against the coronavirus or in the management of the index case, the campaign against COVID-19 has been executed in Anambra State in what is now known as the Anambra way. A culture of excellence now defines the state. This culture has seen Anambra become the most competitive state in the country, beating other states in such critical sectors as education, security and support for small and medium enterprises. The manner the state has responded to the coronavirus pandemic is yet another confirmation that the Anambra way of doing things is the way to go. It is the way of excellence.
C. Don Adinuba
Commissioner for Information & Public Enlightenment.
Wednesday, 23rd April, 2020.