Liberia: 'Total Lockdown Needed to Stop COVID-19 Spread'

Traitement du Coronavirus

Infectious disease expert, Dr. Dougbeh Chris Nyan, has warned that Liberia's healthcare service will be overwhelmed if the government refuses to lock down the country now in order to control the spread of the COVID-19 pandemic.

In an exclusive interview with the Daily Observer, Dr. Nyan said in order to avoid any ugly situation like Italy, now that the country has had its first community transmission, the best solution is to totally lockdown the country and begin vigorous mass laboratory testing for the COVID-19 so as to know who is infected.

Dr. Nyan's statement comes the same day after the government through the ministry of health declared a national public health emergency as a result of its third case. The third case, a woman in her mid-sixties, attended two private clinics, one referral hospital and a beach party, leaving a trail of nearly 200 contacts, which health authorities are trying frantically to trace.

"What is happening in Italy at the moment could well play out in Liberia and other African countries if proper preventive measures are not enforced," Dr. Nyan said.

"Social distancing helps a lot, but I strongly suggest that a total lock-down will be far more effective as was evidently done in Wuhan to control or stop the viral spread in the population," he added. "This virus spreads vertically via person-to-person contact and has been determined to increase exponentially."

According to Dr. Nyan, the COVID-19 pandemic poses a serious threat to Liberia and other African countries, and this cannot be sugar-coated-in in any manner.

"We see how the virus is ravaging the developed countries and is being imported to Africa. Hence, close all borders and restrict internal travels to a minimum; and, all citizens, as well as foreign residents, should be mandated to say in-doors for at least three to four weeks, while frontline healthcare workers implement measures against the COVID-19 pandemic," Dr. Nyan said.

In her declaration, Health Minister Dr. Wilhelmina Jallah said the decision to declare the third coronavirus case a public Health Emergency in Montserrado and Margibi Counties was prompted because of the number of people that got in contact with the third infected person.

"I have noticed business as usual. There were many people gathered at wells, people holding hands, hugging, and people are crowded in the market," Min. Jallah added. "Based on the result of the third case, and the amount of contact, we have no choice, but to come out with the following directive. In the wake of the Coronavirus epidemic and in an effort to keep our nation safe, the Minister of Health has declared a National Health Emergency in keeping with Title 33, Chapter 14 of the Liberian Code of Law, revised, known as the public health law. I, as Minister of Health, have designated Montserrado County and Margibi County as infected areas which will remain in effect for the next 21 days."

The minister said all schools, public and private, universities, computer schools, and any other learning institution, are hereby ordered closed.

"All bars, nightclubs, casinos, betting centers, cinemas, video clubs, entertainment centers, are hereby ordered closed. All beaches, both private and public are hereby ordered closed. Churches, mosques, religious centers and other places of worship are hereby ordered closed.

However, for Dr. Nyan, such move is not enough to prevent a serious spillover from the country's third case because an undetected infected person is likely to travel to other parts of the county that is not affected by the lockdown.

"We all are witnessing what is happening now in Italy which has registered over 54,000 confirmed cases and almost 5,000 total deaths. Italy, with its highly developed healthcare system, acted very late," Dr. Nyan said.

"It did not prepare soon enough, and the United States with all its sophisticated medical and public health systems are also presently not well-equipped, very unprepared, and are still scrambling for safety equipment (PPEs) for frontline healthcare workers and ventilators for needed patients," Dr. Nyan reminded health authorities.

These trending examples, according to Dr. Nyan, present serious warnings to Liberia and other African countries with already weak healthcare systems.

Dr. Nyan argued that any further delay, Liberias' healthcare system may crumble under the weight of an uncontrolled COVID-19 spread if the necessary preventive measures are not strictly implemented and conducted in a timely fashion.

Besides lock-down, Dr. Nyan has further urged "the government to provide adequate funding to public health institutes to enable the NPHILs efforts of conducting these preventive, containment, and mitigation exercises against the COVID-19 pandemic in Liberia."

With more funding, Dr. Nyan said this will enable the NPHIL to focus more on vigorous laboratory testing on all arriving persons, on all quarantined persons presently under investigation for COVID-19 infection, and on all traced persons who were in contact with an infected case.

Regarding diagnostic capability in Liberia, Dr. Nyan stressed that, for a population of about 4.5 million persons, "this will require that government secures at least 10,000 test kits, to begin with, each kit containing 100 tests."

"Presently, there is a high probability that there could be a lot of positive cases roaming out there in the population that are missed or undetected due to Liberia's limited testing capacity. Infected persons who are not tested could unknowingly be spreading the virus from one person to another," the Liberian US-based medical expert said.

According to Dr. Nyan, the present three known positive cases may just be a tip of the iceberg, which is why a total lockdown of the country is very imperative, in addition to social distancing and other preventive measures.

"Hence, the government needs to act immediately," he said. Remember that I warned the government about the outbreak since January this year and this should have given the government sufficient time to prepare."

Dr. Nyan added: "Now we can see that the delay in preparing, the lack of proper enforcement of screening regulations at the airport, the selective quarantine of persons arriving into the country, giving free passage to some persons arriving from the US and high-risk countries of Europe, and the lack of adequate funding and healthcare manpower are among several deficiencies of Liberia's current response efforts to the COVID-19 Pandemic.

"It is tough, but NPHIL seems to be doing the best it can," Dr. Nyan said.

Meanwhile, he has warned against self-medication, particularly the use of Chloroquine, which is still undergoing additional clinical trials to investigate whether Chloroquine is safe in the treatment of COVID-19 infection and whether it really works in treating COVID-19 infection.

"I don't advise anyone to self-medicate. And, I say again, do not self-medicate! Don't even think about using Chloroquine," the Liberian medical scientist said.

Dr. Nyan further explained that at this point, there must be strict compliance with Social-Distancing; no hand-shaking; no hugging and no kissing; "perform constant hand-washing with soap; sneeze and cough in the inner angle of the elbow; and, perform self-monitoring for signs such as fever, coughing, sneezing, headache, diarrhea, vomiting, and headache, among others."

In a related development, Dr. Nyan has said the Ministry of Information should not be the one communicating health matters, particularly when it comes to public health pandemic issues that require expert-communication.

He said this is meant to avoid miscommunication and to protect patients' confidentiality.

"Thirdly, health authorities should maintain strict confidentiality about ordinary patients who are detected positive for COVID-19 infection," he said. "It is a type of shaming, emotional abuse, and violation of patients' rights by the government to release or make public the names of ordinary patients."

Earlier in January, Dr. Nyan and the Diaspora COVID-19 Focus Group alerted Liberia health authorities and other African countries about the outbreak of the coronavirus in Wuhan, China. Later in February this year, he again cautioned African governments against using the faulty Coronavirus testing kits from the US Centers for Disease Control and Prevention. Rwanda and other African Countries have totally shut down activities in their countries and are conducting large scale testing. It remains to be seen if Liberia will follow suit.

In a related development, World Health Organization (WHO) Director General, Dr. Tedros Adhanom Ghebreyesus, has said that the "pandemic is accelerating" and urged countries to take an aggressive approach.

Meanwhile it remains yet unknown whether the Government of Liberia has approached the governments of China and Cuba for possible assistance to fight the Coronavirus pandemic. China, according to reports has donated more than a million facemasks and related equipment to some countries while Cuba has announced the dispatch to Italy of an 80-man medical team of doctors and other related health professionals to help combat the disease.

It has also announced that it is currently responding to requests for assistance from 15 countries for 22 medications it has produced including Interferon Alpha 2B for the treatment of the Coronavirus (Covid-19).

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