Vanguard (Lagos)

27 August 2014

Nigeria: Ebola Scare - FG Shuts Schools Till October 13

Photo: M. Hofer/UNESCO
A student writes on a blackboard (file photo).

LAGOS -- The Federal Government, yesterday, took far-reaching decisions to curtail the spread of the deadly Ebola Virus Disease, EVD, in the country as it postponed the resumption of all primary and secondary schools till October 13, even as government cleared the air on the health status of a sister to the late Dr. Stella Ameyo Adadevoh, confirming that she is Ebola-free.

Announcing the shift in resumption date in Abuja, Minister of Education, Mallam Ibrahim Shekarau, said the decision became necessary in view of the risk posed by the Ebola virus which could easily spread through schools.

His words: "All primary and secondary schools, both public and private are to remain closed until Monday October 13, 2014 which is the new school resumption date for all schools throughout the Federation". The schools were originally scheduled to re-open in the second week of September.

Shekarau, who briefed the press at the end of a meeting with state commissioners of education, added that all on-going summer schools were also affected with immediate effect.

Further, he said the change in the resumption date was also to enable the Federal and state governments, as well as school authorities put in place adequate preventive measures before the pupils returned to school.

"All state Ministries of Education are to immediately organise and ensure that at least two (2) staff in each school, both public and private, are trained by appropriate health workers on how to handle any suspected case of Ebola and also embark on immediate sensitization of all teaching and non-teaching staff in all schools on preventive measures. This training of staff must be concluded not later than September 15, 2014".

He further directed states Ministries of Education to establish Working and Monitoring Teams for effective supervision of school activities before and after opening of schools.

"Each state Ministry of Education should appoint a designated Desk Officer not later than September 1, 2014, who should also receive appropriate training and who must report on daily basis to the Honourable Commissioner on situation in the schools. The names of such Desk Officers, their phone numbers and e-mail addresses should be communicated to the Headquarters of the Federal Ministry of Education not later than September 1, 2014.

"All primary and secondary schools, both public and private should be provided with a minimum of two (2) Blood Pressure Measuring Equipment by the State Ministries of Education. The State Ministries should determine the number of such equipment required and forward same to the Federal Ministry of Education not later than September 1, 2014. Ministry of Education will liaise with the Federal Ministry of Health to ensure that appropriate equipment are procured," he added.

Summer schools closed

"All summer classes currently being conducted by some private schools should be suspended with immediate effect until October 13, 2014.

"All private primary and secondary schools must comply with the directives given under these preventive measures. State governments are called upon to support their Ministries of Education with all necessary funds to ensure effective implementation of these preventive measures", Shekarau said.

He warned that any private or public school that failed to comply with the directives would be sanctioned.

"Our concern is for the children and we would go to any length to ensure both private and public schools comply. You can imagine if a child is infected in a boarding school of say about 600 children, it would be very dangerous. We are not saying there is Ebola in all states of the Federation but we are putting some preventive measures in place."

He also advised all tertiary institutions to suspend exchange of staff and students programmes, visits and major international seminars and workshops until further notice. They are also to monitor the movement of foreign students in their campuses. They are to liaise with appropriate government health institutions to organize and ensure effective sensitization programme for all their teaching and non-teaching staff."

Adedavoh's sister not positive -- FG, LASG

Also, yesterday, cheering news came from both the Federal Government and Lagos State Governments as both have cleared the air over the health status of a sister to the late Dr. Stella, Ameyo Adadevoh.

Briefing the press in Abuja on the update of the EVD in the country, Minister of Health, Professor Onyebuchi Chukwu, debunked rumours that a sister to the late Adadevoh tested positive to the virus.

Corroborating the minister in Lagos, State Commissioner for Health, Dr. Jide Idris, who raised alarm over false stories being disseminated via social media, lamented that such rumours being circulated have been a critical and pervading challenge to the fight against the virus.

Idris said: "These rumours have the capacity to undermine the efforts being made to contain and manage the outbreak as those who ought to present themselves for treatment may get discouraged, malign government in the face of residents and fuel stigmatisation of individuals and businesses.

"I do not want to mention names because that is part of what we are told not to do but I must say that the report on the woman is false. She was discharged yesterday (Monday) as negative."

We have contained Ebola - Chukwu

Thirty eight days after importation of the Ebola Virus Disease, EVD, into the country by the late American-Liberian, Mr. Patrick Sawyer, the threat of the disease may have been contained, following the survival of eight of the victims, seven of who have been discharged; screening of a total of 321 persons, even as additional 10 contacts were listed Monday in Lagos.

Disclosing this in Abuja, the Health Minister said two more patients with the Ebola virus disease have been discharged from the Isolation Ward in Lagos State, bringing to seven the number of patients that have been treated and declared free from the virus in the country even as the number of deaths from the killer disease scourge still remains five, including the index case, Patrick Sawyer.

Chukwu added that the nation has had 13 cases of EVD including the index case.

"Of these 13, five including the index case unfortunately did not survive the disease and are now late.

However, seven of the infected persons were successfully managed at the isolation ward in Lagos and have been discharged.

"Two of the treated patients, a male doctor and a female nurse were discharged yesterday, both of them primary contacts of Mr. Patrick Sawyer, having satisfied the criteria for discharge.

"As I speak to you, Nigeria has only one confirmed case of EVD, a secondary contact of Mr Patrick Sawyer. This is an indication that, thus far, Nigeria has contained the disease outbreak.

"I wish to reassure Nigerians and indeed the global community that the government shall remain vigilant and will not relent as government continues to work with her partners to ensure that the disease is kept out of the country," the Minister added.

Besides, the minister informed that 129 persons had been freed from surveillance, having passed through the 21 days incubation period for the virus without testing positive. Similarly, 128 persons are still on the radar of government for the virus, the minister stated.

"All those who are under our surveillance, only one person is symptomatic; we are investigating, the result is not out. All others are not symptomatic," the Minister stated.

Speaking further, Dr Idris explained that the recovery of seven confirmed cases in the state have buttressed that Ebola infection is not a death sentence.

"The suspected case is awaiting confirmatory test result to inform the next line of action. Currently there are two cases, one confirmed and one suspected in the isolation centre at the facilities in Mainland Hospital, Yaba."

He disclosed that the seven Ebola-free patients are being re-integrated successfully with their families and communities.

"The common thread amongst the recovered cases is their early presentation for supportive treatment. There is no need to hide friends and relations we suspect have come down with the disease. The earlier they are brought for screening and surveillance, the better the outcome."

Idris explained that three bodies were cremated and two properly buried after full decontamination of bodies.

Nigeria records 61.5 percent survivors

Nigerian and the world at large yesterday received the cheery news that the country has con tained the threat of the dreaded EVD following the discharge of seven infected persons out of the 13 confirmed cases. Currently, only one person is at the isolation centre in Lagos and her condition is stable. Two more patients with the Ebola virus disease have been discharged from the isolation ward in Lagos State,

Nigeria lost five persons to the disease including the index (first) case, Mr Patrick Sawyer, the late Liberian-American who brought the disease to Nigeria on July 20, 2014.

With the development, the disease killed 38.5 per cent of those affected in Nigeria. The World Health Organisation (WHO) estimates that 90 per cent of those affected die from Ebola.

Through sheer determination and care on the part of government and awareness by the citizenry, Nigeria ensured that only 13 persons out of a population of 167 million were affected and 61.5 per cent of Ebola victims survived the disease. The record is bettered by Uganda, which in 2007 had 149 cases and 37 deaths (25 per cent fatality) and Cote d' Ivoire that had one case and no death in 1994.

Since the outbreak of the disease in four West African countries -- Guinea, Sierra Leone, Liberia and Nigeria, late December 2013 and this year, the WHO, as of August 22, said that 2615 cases and 1427 deaths (54.57 per cent fatality) have been recorded.

The breakdown of the figures is as follows:

* Liberia--1082 cases, 624 deaths, 57.67 per cent fatality

* Sierra Leone--935 cases, 392 deaths, 41.93 per cent fatality

* Guinea-- 607 cases, 406 deaths, 66.87 per cent fatality

* Nigeria-- 13 cases, five deaths, 38.46 per cent fatality.

Nigeria is by far the most populous of these countries with a population of 167 million and yet recorded the least number of cases, an indication of the professional manner the government, health authorities and the citizenry handled the challenge.

The populations of the other countries are: Uganda (37 million), Cote d Ívoire (16 million), Guinea (10 million), Sierra Leone (six million) and Liberia (3.5 million), whose total of 73 million is about half of Nigeria's population.

Don't stigmatise discharged patients

Imploring all Lagosians not to stigmatise all cases and contacts that have been given a clean bill of health, Idris urged them to facilitate their re- integration into the society.

He cited the American doctor who was recently discharged by Emory Hospital, USA and how he was openly embraced by both the hospital staff and family members, "setting for us an example to follow in the integration process of discharged cases and contacts," Idris said.

The Commissioner allayed fears of discharged patients coming down with the virus again saying that the chances are almost nil but does not mean that such patients could not be re-infected with another strain of the virus but not the particular virus that late Sawyer imported into the country.

"The process by which cases and indeed contacts are discharged is also in line with best practices, involving reviews by critical members of the Ebola Emergency Operations Centre," he added.

Further, he pointed out that a contact becomes infective only when symptoms appear-fever being a game changer.

"By and large, only symptomatic contacts are admitted. Asymptomatic contacts are admitted when the index of suspicion that they may be lost to follow up is high.

"Contacts are monitored twice daily for temperature changes and symptoms. On self-admission or evacuation of contacts for conducts of confirmatory test, their homes including areas of common use with co-tenants, offices and relevant general surfaces are decontaminated," he said.

On other challenges, Idris said that rejection of febrile patients in hospitals without proper assessment may also increase stigma and deter self-reporting.

He explained that not everybody with fever or haemorrhage has come down with EVD. A situation where these cases are automatically referred to Mainland General Hospital is not good practice.

The commissioner appealed to medical practitioners in both public and private health facilities to commence the management of these cases using universal safety precautions and only refer them if there is an indication to do so.

Why First Consultants Medical centre is still shut

On when First Consultant Hospital, Obalende, where the first case was treated, will be reopened, Idris said the state government is waiting for directive from the World Health Organisation, WHO, as there will be many decontamination exercises in the facility.

The Commissioner who said already several decontaminations have been done in the place confirmed that it was going to take some time before the facility will be opened.

"I need to get clearance from the Ebola Emergency Operation Centre because they are the one who could give clearance that the hospital is clean and ready for re-opening. It is after that the state government embarks on its own process. Decontamination may not be complete because some of the equipment in the hospital may be discarded, burn some materials and other activities. This is to ensure that the hospital is free of the virus. So it will take some time before the hospital will be reopened, but once we get the approval WHO and EOC the government will do the needful."

No Ebola-free certificate

Idris said there is need to report every death and obtain Ebola-free documentation to facilitate the transportation of out-bound corpses from the state.

He however, dismissed rumours about Ebola free certificate saying that: "There is nothing like Ebola-free certificate being issued routinely to persons applying for visas in foreign embassies in Nigeria. Clearance certificate are nonetheless issued to contacts that have completed the 21-day maximum incubation period of EVD."

N1.9 bn not for Ebola fund - Chukwu

Meanwhile, the Health Minister said that the N1.9 billion earlier approved by President Goodluck Jonathan, at the time he declared emergency of over the disease, widely believed to be used for containing the virus, is for the improvement of the nation's general health systems.

"We did say that the N1.9billion that the President approved was for the Federal Ministry of Health; those ones that the Federal Ministry of Health should champion. That fund was provided based on the budget that the Federal Ministry of Health submitted to Mr. President. It was not termed an Ebola fund."

"I repeat, because now I hear that in some places, even village heads are asking for their own share. Nigeria is always thinking of sharing money. It is money for the Federal Ministry of Health to use in working. They are going to use it to procure more vehicles; which have already been ordered.

"They are going to use it to procure more personal protective equipment which has already been ordered. They are going to use it to provide isolation tents, which again have been ordered, including drugs which will be used to support the patients. It is a budget for the Federal Ministry of Health and its agencies as submitted by the Federal Ministry of Health to Mr. President.

"What I am saying is that there will still be other funds that will still be released in various ways depending on what any of the cognate agencies is requesting from Mr. President that must be done.

"Now, in the case of Lagos State, after the President met with all Governors, together with their Commissioners for Health, it was clear, even from the statement made by the Governor of Lagos State, that Lagos State is also under pressure because many of the workers we are using are from Lagos State. We can't shortly go and start recruiting people. We work with the state. It is just that in every epidemic, the Federal Government with the Minister of Health in the front takes control of epidemics. It is not a state government matter.

"But, we use state personnel as well and local government personnel; we used everybody, our partners are part of it. But, the leader of the team is the Minister of Health.

"So, Lagos State government has been spending money. They pay salary to staff; they've been recruiting more staff. They give these staff incentives. They provided the isolation wards. But, we led and decided who should work there. The Minister of Health created the teams that are working," Chukwu argued.

Earlier, National Publicity Secretary of the Peoples' Democratic Party, Olisa Metuh, had donated one million Naira to help contain the virus.

He said: "This is the first time in the history of our country that our elected and appointed people and leaders have risen to the great challenge we are facing. I want to commend the health workers for the risk they have taken, their commitment, and their dedication to their duties in assisting the entire populace to completely be ready for this challenge.

"There is no way that the Federal Government alone can be left alone to face the burden of the Ebola challenge. It is my well-considered opinion that citizens of this country, corporate organizations should try and make their own contributions to help in the awareness for people to understand what the challenges we are facing with this Ebola scourge," he added.

Ogun free of Ebola -- Soyinka

In a related development, the Ogun State Government has refuted a report making the rounds that the state had recorded cases of Ebola Virus at Imeko-Afon Local Government Area.

Describing the report as false and unfounded, the state Commissioner for Health, Dr. Olaokun Soyinka, remarked that the state is yet to record any case of Ebola virus to date. Speaking in Abeokuta, Soyinka called for calm and urged the people to adopt hygienic steps provided by the Ministry of Health, as government was taking necessary steps to prevent the disease.

"The State government has increased the number of health workers who are well trained on how to restrain movement of foreigners into the state, while some health workers are presently undergoing training on how to curb the spread of the disease," Soyinka said.

Members of the public are directed to report persons showing symptoms of Ebola virus to the Ministry of Health or call toll free 09099140121, 09091140122 and 09021715984.

Youths protest location of quarantine centre

Hundreds of youths in Emohua Local Government have protested the location of Ebola quarantine centre in the community.

The protesting youths who said there was no case of Ebola in the state yet, expressed fear the disease could spread if the community was retained as a quarantine centre.

Speaking on the incident, the State Commissioner of Health, Dr Sampson Parker, allyed their fears, saying the quarantine centre would not create any problem.

Parker, who confirmed arrival of a foreign medical team from the Elizabeth Griffin Research Foundation, USA in Port Harcourt said the team would train medical personnel and doctors in the state on how to manage Ebola cases.

"They are to be trained on how to handle Ebola Virus Disease, if it comes into Rivers State. It is a pre-preparedness training against Ebola.

"The health workers involved are not only to be drawn from the Rivers State government, but from all facilities, private hospitals, multi-nationals, Police, the Armed Forces, every one that has something to do with health care; every facility, every establishment that has something to do with health care is represented here.

Ebola fight gets $150 million from Development Bank

In a related development, the African Development Bank will prepare an additional $150 million in funding for nations stricken by the Ebola virus as the WHO plans to seek more resources and money to fight the outbreak.

The worst-affected countries may see 1 percentage point to 1.5 percentage points shaved off economic growth because of the disease, the bank's president, Donald Kaberuka, stated in Abidjan, Ivory Coast. The money will be distributed in loans and grants to bolster epidemic preparedness and response, the WHO said. The bank previously pledged $60 million to help the countries fight Ebola.

More than $430 million will be needed to bring the worst Ebola outbreak on record under control, according to a draft document laying out the WHO's battle strategy. The sum now being sought is six times more than the $71 million the WHO suggested was needed in a plan published less than a month ago.

"The response at the beginning wasn't robust enough," David Heymann, a professor of infectious diseases at the London School of Hygiene and Tropical Medicine who worked on the first recorded Ebola outbreak in 1976. "It's a step forward that they've made the plans and I'm glad they're emphasizing rapid containment as a start."

Ebola has killed 1,427 people in Liberia, Guinea, Sierra Leone and Nigeria since December. The WHO plan sets a goal of reversing the trend in new cases within two months, and stopping all transmission in six to nine months. It requires funding by governments, development banks, the private sector and in-kind contributions, according to the document obtained by Bloomberg News.

More than half the cost will be needed for the treatment, isolation and referral centers that are bearing the brunt of the epidemic, according to the WHO plan.

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