Dr. Sani Aliyu is the National Coordinator of the Presidential Task Force for the Control of Coronavirus. He spoke to The Nation
Presidential Task Force
We have been meeting virtually every day, with the Chairman being the Secretary to the Government of the Federation. A lot of the decisions have been taken. For instance, the issue of restriction in terms of mass gathering and restriction of movements and stay-at-home advice were taken by the Task Force. Already, we are working on escalation of testing as well as the provision of equipment and machines for lab tests. We have also been working with different sectors. Remember the Task Force does not consist only of people from the health sector; there are also people from the aviation sector, humanitarian affairs, security and a host of other sectors. All these agencies come together and have a harmonized plan on how we intend to deal with coronavirus infection.
Lack of enough testing centres
In summary, we are doing everything that we can to expand testing. We have gone to NCDC; they already have a plan for week one, week two and week three. We are really looking for pushing up tests up to 1,500 per day.
Those that need to do coronavirus test
What we really need to re-emphasise to the public is that they only need to do the test for coronavirus when they have the symptoms and you are linked to a positive contact case or you have the relevant travel history. Those who don’t have symptoms don’t need to test for coronavirus because it is a visual test. In the test, we are looking for the presence of the virus. The excretion of the virus is linked to respiratory symptoms and those symptoms are three: fever, which happens in about ninety per cent of cases; cough, and shortness of breath. Anyone with any of these three symptoms and who has the history of contact with a positive case or you have just returned from travel from any of high incidence countries, we will test you right away. But we really want to turn off the tap when it comes to request from the general public for general coronavirus; it needs to be linked to a symptom.
Members of the public that have had contact with a positive case and who do not have symptoms only need to self-isolate themselves for 14 days to observe the presence of the symptoms. And if they have any of these symptoms, they should call us and we will prioritise them and get them tested. We need to get this right; otherwise, we will continue to have inappropriate demand for tests that are limited and for resources that we need to prioritise to get all the positive cases. Those that have had contact with positive cases, we will reach out to them and tell them to isolate themselves for 14 days and watch for the presence of symptoms. And if they show any of those symptoms, they should give us a call and we go in and test them. Why? Because on the average, every single positive case of coronavirus will transmit to between 2 to 3 persons; he or she is not going to transmit to everybody. On average, it is between 2 to 3 persons. So those that have developed symptoms are possibly those that have been unlucky enough to get the infection and they are the ones that we need to prioritise. We need to reduce the inappropriate demands while prioritising those that need the test. We want to appeal to the general public to know that this is not a serological test that is looking for the presence of exposure. This is a test that looks for the presence of mildness when you have symptoms.
A negative test has no value if you do not have symptoms; it does not tell you anything. If you are in the incubation period, the test will be negative. People need to understand that it gives false assurance to people who have been exposed that they are okay when in actual fact they may be incubating it. They need to isolate themselves and look for the presence of symptoms. There is nothing like screening for coronavirus; there is also nothing like screening if you have contact with a case or you come from a foreign country provided you don’t have symptoms.
What the rising number of confirmed cases means
When you have an epidemic, at the initial stage you may have few cases. For instance, if you have one case, it will give it to three. Three cases will give it to nine and then nine cases will give it 27 and so on. That is how it will continue to go up and that is why it is important to break the spread of transmission early. It does not go up by one; it goes up in a multitude. As a government, we are committed to tracing everybody who has had contact with a positive case and also try to get people to report symptoms. The essence of contact tracing is to let them know so that they lookout for these symptoms; not to test them. We know the impact this is going to have on the general public, especially the elderly and those who have underlying ailments because they are the ones that are more at risk of dying from this infection. The vast majority of people, eighty per cent, will only have a mild disease or even no symptoms. It is that twenty per cent that we are concerned about because about five per cent of them will require intensive care. They are the ones we are most concerned about. And that is why we need to get on top of this situation early. We are doing all that we can. But this is a pandemic; every country is struggling with it. We still have the window of opportunity to get out of this and we are committed to doing the right things to make sure that we do together with WHO and the international community.
Palliative measures for the masses
The Ministry of Humanitarian Affairs is represented in the task force. So also is NEMA. We have discussed this issue virtually every day. We understand the difficulty our citizens will go through if they are restricted to their homes; it is not an easy decision. We also know that the vast majority of our citizens live below breadline; they need to go out on a daily basis to get their daily bread. Whatever restriction we put in place, we are doing so because we need to get on top of this pandemic. You need to be alive to be able to enjoy your life. We will not give the virus the opportunity to wipe out our elderly class. That is why we have to take it seriously.
Other countries have imposed restrictions. That is why we are allowing the financial sector to continue to function during the restriction; also those supplying foods and medicines. The Humanitarian Ministry will look at government’s social intervention programmes that are targeted towards the very poor. Of course, we have to do all this within the limit of available resources. That is what other countries have done. I am not aware of any country that is significant in terms of population that have been able to provide welfare across the board for everybody because of restriction.
Availability of test kits
The test kits are quite expensive. Because coronavirus is a relatively new disease, very few manufacturers are able to manufacture them. We recently had a donation of 20,000 test kits from Jack Ma Foundation, which we have distributed to the states. There are also orders that have been placed on our behalf by the UN system. We are in the process of procuring more test kits.
More importantly, we are also looking at technologies that we can use to open more labs around the country. We are partnering with the private sector, the Coalition against Coronavirus, which is led by the CBN governor, Dangote Foundation and a host of other business people.
At the moment, there are parts of the country that are not covered in terms of test centres. But molecular labs need a lot of skills that need to be validated; the steps are not like when opening a normal diagnostic or haematology lab. There are steps that need to be taken because, for every positive, it counts against the country.
We have to internationally report every single case of coronavirus. So we have to ensure our testing gets quality assurance and meet biosecurity requirements. There are various propositions and we are working round the clock ad NCDC is working on laboratory expansion. A lot more labs will come on stream very soon. We want to test only those people who need the test; people should stop asking for coronavirus test if they do not have symptoms or meet criteria for testing.