The Nigerian Medical Association, NMA and the National Association of Nigerian Nurses and Midwives on Sunday cautioned the Federal  Government against treating COVID-19 patients at home.

The NMA and the NANNM, in separate interviews with The PUNCH, said the implementation of home treatment in Nigeria, where the majority of the infected people lived in crowded houses would create problems for the country.

The NMA specifically said patients, who would be treated in households with a large number of people might infect others, thus increasing COVID-19 cases in the country.

The Presidential Task Force on COVID-19, at its press briefing on April 30, had said the Federal Government was considering treating some COVID-19 patients at home.

The Nigeria Centre for Disease Control  Director-General, Dr Chikwe Ihekweazu, who disclosed this at the press briefing, said the country had only about 3,500-bed spaces for COVID-19 management.

“We are now trying to make more bed spaces available, but ultimately we might have to change our strategy and start considering homecare in certain circumstances where patients are able to provide rooms for their own management,” he said.

As of Saturday, there were 4,151 COVID-19 cases in Nigeria, with  3,278 of them still active and 745 discharged. No fewer than 128 people have died of the highly infectious virus.

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WHO recommends the use of ventilated houses

According to the World Health Organisation’s guidelines sent to one of our correspondents by the NMA President, Dr Francis  Faduyile, all laboratory-confirmed cases should be isolated and cared for in a health care facility.

The WHO explained that where isolation in a health facility was not possible for all cases, emphasis should be given to patients with severe and critical illnesses as well as mild illnesses such as “uncomplicated upper respiratory tract viral infection symptoms.

The WHO added, “If all mild cases cannot be isolated in health facilities, then those with mild illnesses and no risk factors may need to be isolated in non-traditional facilities, such as repurposed hotels, stadiums or gymnasiums where they can remain until their symptoms resolve and laboratory tests for COVID-19 virus are negative. Alternatively, patients with mild disease and no risk factors can be managed at home.

“For those presenting with mild illness, hospitalisation may not be possible because of the burden on the health care system, or required unless there is concern about rapid deterioration.”

It added in cases where care would be provided at home, a trained health care worker should conduct an assessment to verify whether the residential setting would be suitable for providing care and whether the patient and the family were capable of adhering to the precautions that would be recommended.

The WHO also recommended that the patient should be in a well-ventilated room and that face masks or gloves should not be reused.

It added, “To contain respiratory secretions, a medical mask should be provided for the patient and worn as much as possible, and changed daily.

“Individuals who cannot tolerate a medical mask should use rigorous respiratory hygiene; that is, the mouth and nose should be covered with a disposable paper tissue when coughing or sneezing.

“Materials used to cover the mouth and nose should be discarded.”

The WHO also said the movement of the patient and shared spaces in the house should be minimised. “Ensure that shared spaces (e.g. kitchen, bathroom) are well ventilated (keep windows open) and use a mask when providing oral or respiratory care and when handling stool, urine, and other waste,” it advised caregivers.

World leaders past and present insisted on Thursday that any eventual COVID-19 vaccine and treatments should be made available to everyone, free of charge.

South African President Cyril Ramaphosa and Pakistani Prime Minister Imran Khan were among more than 140 signatories of a letter saying any vaccine should not be patented while the science should be shared between nations.

The World Health Assembly, the policy-setting body of the UN’s World Health Organization, holds its annual general meeting next week.

The signatories called on the WHA to rally behind the cause.

“Governments and international partners must unite around a global guarantee which ensures that, when a safe and effective vaccine is developed, it is produced rapidly at scale and made available for all people, in all countries, free of charge,” the letter said.

“The same applies to all treatments, diagnostics, and other technologies for COVID-19.”

The letter was signed by Senegalese President Macky Sall and Ghanaian President Nana Akufo-Addo.

Former presidents and prime ministers among the signatories included Shaukat Aziz, Jan Peter Balkenende, Jose Manuel Barroso, Gordon Brown, Helen Clark, Felipe Gonzalez, Ellen Johnson Sirleaf, Aleksander Kwasniewski, Mary McAleese, Olusegun Obasanjo and Juan Manuel Santos.

The letter comes amid fury in France after pharmaceutical giant Sanofi said it would reserve first shipments of any COVID-19 vaccine for the United States.

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The French multinational’s chief executive Paul Hudson said the United States would get first dibs because its government was helping to fund the vaccine research.

His comments drew outrage Thursday from officials and health experts.

The letter ahead of the WHA said it was not the time to leave the task of resolving the pandemic to market forces or let the interests of wealthy companies and governments come before the need to save lives.

African Union Chairperson Ramaphosa said: “As the countries of Africa, we are resolute that the COVID-19 vaccine must be patent-free, rapidly made and distributed, and free for all.

“Nobody should be pushed to the back of the vaccine queue because of where they live or what they earn.”