Dr Odunayo Talabi, a public health physician and Harvard Global Health Fellow, talks about Covid-19, popularly called coronavirus, with SIMON UTEBOR
COVID-19 is a novel virus and there have been various opinions about how it came about. What are the likely causes of the virus?
Yes, it is a novel virus. It means that it is a relatively new virus compared to the others we used to have. And because of that, we cannot make broad statement on it because the knowledge about that virus is evolving. However, we had Severe Acute Respiratory Syndrome in the past; it means that we have known the family. Perhaps, it is this you are now trying to gain an understanding of. In that regard, we may not be able to conclusively talk about how this virus came; we can however talk more about how it spreads. That is what we should say because that is what is actually causing the pandemic that we have now.
How does it spread?
From what, perhaps, all of us now know, it is a respiratory virus in the sense that it affects the respiratory system and it is spread through droplets. So far, we have many theories, but one that has been sustained so far is that it is spread from person to person via droplets. So, if droplets from an infected person get to another person, either by spraying directly or by someone touching it on a surface and then of course, without washing that hand and touching the mucus membrane, the next person can get it. And from that person, it goes to the other person. The evidence we have is that one person can actually spread it to about 2 to 2.6 persons – that might explain the level of infectivity of that virus.
There is no vaccine yet for the virus, yet persons are recovering, testing negative, how are they being treated?
Viral infections, in most cases, are self-limiting unlike bacterial infections. Even the common cold that we have, such as catarrh and cold are viral infections. Usually, they are self-limiting in the sense that the body fights them. When the body has a very good immune system, it fights the virus. What doctors do is to help the body of that patient to fight the virus.
They try to make sure they put the body in optimal condition, treat the symptoms as they appear until the body now overcomes that infection. In the same way, because this particular organism is a virus, it will behave exactly like that. It is now left for the body to fight it and overcome it.
Do you think there is more to the virus than people are made to understand?
I will say it is too early to make real categorical statements about the virus – where it came from and many other things. Secondly, we have to rely on evidence, what we can see. The evidence we have is that people have this virus. People are getting sick, people are being admitted, people dying and people are recovering. So, the contagion is there, the infection is there and then of course, they are being managed. And some of the knowledge we already have of virus, it is conforming to those things – we can do the test for the virus via PCR, which is used for many other viruses.
For now, let us restrict ourselves to science and believe that because you have seen the virus, it has been isolated, people who were sick with it have been identified, they have been treated, they have been discharged, and some of them have even formed antibodies. Then, let’s just stick to that and say the virus exists.
Do you support the use of alternative medicine as a way of treating the disease since there is no known cure yet?
As I said before, whatever we want to do must be evidence-based. If we have alternative medicine that can cure the virus, not harmful, (or) with side effects that are manageable, of course, it can be used. The issue is you test and prove it works and not harmful to individuals.
What do you think are the predisposing factors to contracting the virus?
As the health authorities and government have been telling us, based on evidence that we have had right here in Nigeria and of course, globally, we know that the first thing is coming in contact with someone who has had the infection. Perhaps, that is the greatest predisposing factor. It is so, in the sense that if you come in contact with someone that has the virus, that is one important predisposing factor.
That was what birthed the idea of ‘physical distancing, staying at home, and not coming in contact with people’. Even when you are going to have that minimal contact, protect your nostrils and mouth. What you are trying to do is to contain the virus by preventing spread. There are other factors: we look at age, gender, low level of immunity, among others. Therefore, people with diabetes and pregnant women are some of those that are kind of immuno-compromised; they will be more susceptible to the virus than others.
There is fear that during the wet/rainy season, the rate of infection will increase. Do you think so?
No, just like I said before, we cannot make such a statement yet. If you remember, initially, they were saying that dry regions would not experience this thing because the virus doesn’t survive in tropical climate. We can see what has happened in Florida, US and in fact, Nigeria and other countries. So, currently, we can’t pin it down to weather – those things are evolving – scientists are still studying it and we believe that in the next couple of months, people will be more confident to speak more about the virus.
But now, what we know works are physically distancing yourself, protecting your face and of course, generally obeying what the health authorities are saying for now.
What do you think about the use of chloroquine for the treatment of COVID-19?
When the news first came out that chloroquine can actually, not cure it, but shorten the duration of the illness, I felt that for us here, we don’t need to really say too much because chloroquine has been with us here for years. I can say that we have consumed more chloroquine than any other country in the world. So, if any evidence suggests like we have now that chloroquine helps in shortening the duration of the ailment, of course, we will use it. I really have nothing against chloroquine and of course, other drugs that have been found such as azithromycin to shorten the duration of the illness.
Remember what I said that largely we are going to depend on the body to fight this. All these things are now helping the body to combat the disease.
Do you think there is a nexus between 5G technology and the virus as some persons have claimed?
I totally disagree with that theory. Even a layman, looking at the way the virus is spreading, will know that it is definitely a contagion – it is an infective organism. For 5G, we are talking of technology and you know that in the past, when there was a nuclear attack on Hiroshima, Japan, people came in contact with nuclear materials.
For instance, the effects were felt by those who were exposed to that place simultaneously. It didn’t happen that A was tested and they spread it to B and to C. What spreads this way is definitely micro-organism – an infective organism. That totally negates the idea that 5G technology can have anything to do with this infection. No, it doesn’t spread that way. It doesn’t cross borders or move from one country to another. No, I disagree completely.
What do you think are the ways out of this global pandemic?
The ways out are many. And there is no one-solution-fits-all at all. That is why I am advocating that Nigeria should learn from the outside world, but try and localise the solution. For us, we have had over 300 cases, 11 deaths or thereabouts and we have discharged close to 100. It means that in a way, we have done above average; we should give credit to the authorities in containing that virus.
We can move quickly and see how, within the lockdown period, we establish protocols that will ensure that we will be screening the virus in an ongoing way with minimal risks to everyone so that life can return to normal. We are expecting vaccines in the next 12 to 18 months and we have 774 local government areas in Nigeria.
I will suggest we identify one health centre in each other local government area and equip it. They should look for rapid diagnostic kits that work, validate them, put them in those health centres and train workers to use them. Remember that we have other things like Lassa fever we are contending with. We should just do that going forward and we will improve our healthcare system generally in tackling infectious diseases.
What should we be looking at now that the lockdown has been extended by two weeks?
The analogy I will use is this: Rats are trying to come into your building, you don’t want them to come in and try to prevent that, but some of them are able to get in. Of course, what you will do next is to try and chase them so that you can kill them – that is the contact tracing, isolation, and keeping people in quarantine. After doing that and you can’t find any rat again, you don’t stay there looking for how to kill rats for the whole day, you set your traps and return to living your normal life.
What we should be looking at now is that within the next two weeks, we should try and make it easy for people to be tested for COVID-19 on an ongoing basis. What we should not do is to rush and open our borders to outsiders, but within the country, because of the economic and security situations, you have to ensure that you balance it for people. People are going to look at the impact, is it severe, can I manage being at home, which is deadlier – hunger or coronavirus?
You now have to balance that as a nation. It is an opportunity to improve our healthcare system. Fifty per cent of the money donated by the private sector, for instance, can be used to set up an infectious disease centre in each local government area to tackle coronavirus, Lassa fever, and cholera.
COVID-19’s symptoms are similar to those of some other diseases, how can one distinguish coronavirus from other diseases?
It is advised that when you have any respiratory symptoms, immediately ask the relevant questions that will narrow it down, that this could really be COVID-19.
Any time one is not sure, ascertain the travel history or whether the person has come in contact with an infected person, then you test. This is what some other nations are doing – test, test and test. From there, you can now know whether the person has it or does not have it. Whoever has the symptoms must work with their doctor and of course, the Nigeria Centre for Disease Control has a hotline that can be called. By the time a doctor asks two or three questions, they will know if it is COVID-19.
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Source: Sunday PUNCH
