Home treatment may trigger spike in infections, says NMA, others

Health care workers on Saturday advised government to jettison the planned home-based management of COVID-19 patients in view of its potential capacity to trigger a spike in infections.

The Nigerian Medical Association (NMA) and the National Association of Nigeria Nurses and Midwives (NANNM) said government should live up to its responsibility of providing  enough isolation centres to meet the overwhelming demand for treatment, instead of leaving it  to households.

The Director-General, Nigeria Centre for Disease Control (NCDC), Dr. Chikwe Ihekweazu, said in television interview last week that government was thinking about reviewing its protocol on institutional isolation and treatment of patients because available centres were overwhelmed.

“The Presidential Task Force and everyone involved in this response have to think about alternatives – community management, home isolation. We haven’t come out with any definite policy but we are thinking about these things because we have to.”

Reacting to Ihekweazu’s statement on Saturday however, the President of the Nigerian Medical Association (NMA), Dr. Francis Faduyile, said government could not afford to abdicate its responsibility in handling the COVID-19 pandemic.

“You cannot put the burden back to the public, household and the family, and it is very unfortunate,” Faduyile told The Nation.

Continuing, he said: “The government must be able to arrange for a space that will be on a longer run, cheaper for individuals who are infected by COVID-19.

“You cannot put the family at jeopardy. Who puts a family of six or seven in their house and who takes care of the patient if the family has to vacate the house for him? If it is a kind of house that they share toilet and bathroom, are you going to ask the entire household to leave for just one person who is sick? This makes it very unrealistic and not visible for such suggestion.

“We cannot just take WHO’s guidelines hook, line and sinker. We must find a way to adapt it to our system. In more advanced countries, most homes may have two or three people in the household, but in Nigeria, the average is six. We have told them that they have to be cautious before they start asking for the home treatment.”

He said that NYSC camps can be refurbished for the purpose of managing COVID-19 patients. The government can also make arrangements with small hotel owners.

“The likely consequence of going ahead with home isolation is staring at us.

“When we called for lockdown, they couldn’t do it early and we continued to have transmission unabated.

“When the curve was going up, the government also decided to ease the lock down. By the time the lockdown was eased on the 2nd of May, the total number of cases was 2388. Today, we have 7,000 plus cases, which is up to three times the number.”

The President of the National Association of Nigeria Nurses and Midwives (NANNM), Comrade Abdurafiu Adeniji, described the home-treatment proposal as a danger signal

He said: “everyone must be aware and be more cautious in obeying the guidelines on prevention and stay at home.”

The President, Association of Medical Laboratory Scientists of Nigeria (AMLSN), Dr. Bassey Enya, said: “The government has an overwhelming responsibility to ensure that the people are protected, and also to ensure that the welfare of those who are affected is also of paramount importance to them.

“I think that additional sacrifices now will be the responsibility of government to provide for families and ensure their loved ones are treated in facilities where it will be convenient for the medical team to manage them properly. Anything short of this means the government is abdicating its responsibilities to the citizens.”

However, the President, National Association of Resident Doctors of Nigeria (NARD), Dr. Aliyu Sokomba, believes that home-based management of patients may turn out to be the best option now because our facilities are overwhelmed.

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