In this interview, Seun Olukayode, an Anatomist with the Department of Pathology in one of the Federal Medical Health Centers in Nigeria, shares his knowledge and understanding of COVID-19, the psychological effect the pandemic already has on Nigerians, and many more.
Q: Tell us what you know about COVID-19
A: Time will not permit me to tell you all I know, but note that: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), which was first reported in 2019 in Wuhan, China. Common symptoms may include fever, cough, muscle pain, shortness of breath, multi-organ failure, among others. The virus is typically spread during close contact and via respiratory droplets produced when people cough or sneeze. Respiratory droplets may be produced during breathing but it is not considered airborne. It may also spread when one touches a contaminated surface and then their face. It is most contagious when people are symptomatic, although spread may be possible before symptoms appear. The virus can live on surfaces for up to 72 hours. Time from exposure to onset of symptoms is generally between two and fourteen days, with an average of five days. The standard method of diagnosis is by reverse transcriptase-polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab. The infection can also be diagnosed from a combination of symptoms, risk factors and a chest CT scan showing features of pneumonia.
Recommended measures to prevent infection include frequent hand washing, social distancing (maintaining physical distance from others, especially from those with symptoms), and keeping unwashed hands away from the face. The use of masks is recommended by some national health authorities for those who suspect they have the virus and their caregivers, but not for the general public, although simple cloth masks may be used by those who desire them. There is no vaccine or specific antiviral treatment for COVID-19. Management involves treatment of symptoms, supportive care, isolation, and experimental measures.
Q: Considering the chemical composition of lopinavir and ritonavir, do you think it could be effective in the treatment of COVID-19 if combined with interferon-beta?
A: I don’t think so, considering their adverse effects. Moreover, research has shown that in hospitalized adult patients with severe COVID-19, no benefit was observed with lopinavir-ritonavir treatment beyond standard care. Future trials in patients with severe illness may help to confirm or exclude the possibility of a treatment benefit. So far, no therapeutics have yet been proven effective for the treatment of severe illness caused by SARS-CoV-2.
Q: Does heat reduce the possibility of being infected by the virus?
A: Obviously, this virus is something we’ve never dealt with before, but if we look at other viruses, they all have their peak during the cold season. Studies have shown in the past that viruses breed and survive longer when it’s cold and dry. So, when it’s warmer and more humid and there’s a lot of sunshine, a virus is less lethal, it spreads less efficiently and less effectively among humans.
Q: Is there a particular type of mask people should use as a preventive measure for those who feel it is necessary?
A: Yes there is. The most appropriate face mask if properly worn is N95 respirator. This has to be a snug fit on the nose and mouth to be effective. It may not be ideal for people with beards and facial hair.
Q: There have been reported victims of COVID-19 in Nigeria, what control are hospitals putting in place to ensure the safety of health workers and uninfected hospitalized patients?
A: Hospitals? I wouldn’t know what ‘’hospitals’’ are doing! Permit me to mention few of the measures a particular unnamed hospital I am used to has put in place. For example, hand washing and the use of hand sanitizers have been mandated at all entry points, no social visit to the hospital, all patients on admission must have hand sanitizers by their bedside, social distancing is compulsory in all clinics and waiting areas, among others.
Q: You mentioned supportive care and not treatment for the infected persons, considering the ongoing study trials for the treatment of COVID-19 globally, can you throw more light on that?
A: Yes, what is obtainable for now is not really a treatment, but management (supportive care). The symptoms are being taken care of. The care may include rehydration, relieving the pain, supporting other affected organs, mechanical ventilation, etc., depending on the extent of the manifestation.
Q: Schools and shops have been instructed to shut down in Lagos state while churches have been advised to reduce public gatherings, how do you think these measures would help to curb the spread of COVID-19?
A: I am not in Lagos State! But of course, the measures will help. The population of people at a particular place should be kept at a minimal level. It will reduce the spread of the virus.
Q: What do you think will be the psychological effects of a lockdown for Nigerians?
A: Fear! This is due to the misinformation on social media and all over the internet. Stigmatization of infected persons if adequate care to protect their identities is overlooked. Depression, as a result of being at a particular place for long, worrying about the future. Being proactive by subscribing to educational websites, newspapers, seminars/webinars, working judiciously from home and engaging in forums and communities with a common interest, can help in dealing with weirdness of being indoors indefinitely, also with depression and boredom.
Q: Compared to Ebola and Lassa fever, do you think COVID-19 is deadlier?
A: I don’t think so.
Q: What do you think will be the most challenging factor for Nigerians, and the government in terms of combating COVID-19 if people get infected?
A: There will be a challenge of submission of infected/sick persons for testing/care. People of integrity are few in Nigeria. We hear about the great numbers of infected people in other countries because of their integrity. They felt free to submit themselves to medical facilities. Nigerians will rarely do that. They will prefer to run and hide. Moreover, I don’t think our diagnostic and management centres are well equipped for such occurrences.
Q: What is your advice to parents with children at home concerning their education and safety?
A: They should remain calm and be hopeful. Our health and safety are paramount. They should understand that our Nation is passing through hard times especially in matters concerning economy and health. They should actively engage children in reading, exercising, games like crossword puzzle, chess and then subscribe to educational websites with supervision. In all this, safety first and that means observing proper all-round hygiene. Once the situation is normalized, the number of days missed can be made up for.
Q: Nigerians who are deeply religious are unhappy about the restriction in church activities, what is your advice on how church activities could be managed?
A: Are they really unhappy? The restrictions are for the benefit of all. I have heard many church leaders looking at the possibility of having many canopies where few people can gather at once. Some have started broadcasting online for their members. They can also resort to what they call ‘home cell/house fellowship’, where very few people can come together to worship.
The measures taken by the government at this time is out of necessity. Everyone should think health and safety first before lamenting on the inconvenience of the lockdown. Parents should endeavour to keep their kids up to date on the happenings around the world, and the country, and also enlighten them on the importance of personal hygiene at this time. An adequate supply of disinfectants, alcohol-based hand sanitizers, soaps and water, paper towels and bleach should be available in homes and hospitals.