INTERVIEW: How people with terminal diseases can stay healthy during COVID-19 — Expert

The world’s health focus has shifted to battling COVID-19. But what is the fate of patients with terminal diseases, many of whom experts have said have immune systems that may be vulnerable to the novel virus?

In this interview, Olanrewaju Amusat, the Executive Director of SmileBuilders Initiative, which he uses to combat non-communicable diseases, explains what patients with terminal diseases need to do to stay healthy during this pandemic. He also speaks on what the government has to do to improve the health system.

Excerpt:

PT: So have you experienced, first hand, the admission of a COVID-19 patient?

Amusat: No. A patient with confirmed COVID-19 infection would not be made to come in contact with health workers working in an open ward or emergency unit as the case may be as the patient would have to be nursed in an isolation center or specially designated treatment unit. The possibility will be to come in contact with a suspected case. Either suspected or confirmed COVID-19, I have never experienced the admission of either.

PT: So I should ask, what is your job role in the course of this?

Amusat: As a health worker, even with the #StayAtHome order from the government, I still have to go to work to attend to sick people especially emergencies. I’ve had to do emergency surgeries despite the pandemic which puts me at risk like other health workers.

As a healthcare advocate, I have been educating people about the pandemic through social media platforms. Some have been done on a personal basis and some under the auspices of my NGO, SmileBuilders Initiative.

PT: Does this also mean you deal with other emergency cases different from COVID-19 patients?

Amusat: Yes. Those with COVID-19 are managed by doctors, nurses and other health workers working in the infectious diseases unit or in relevant units as the disease progresses.

Other emergency cases are handled by the different specialties. For example, those who work at the adult and children emergencies of government hospitals still attend to emergencies if there are. However, the pandemic has significantly reduced the turnout of emergencies.

PT: What has this been like?

Amusat: It’s been quite challenging especially during this pandemic. Parents who bring their sick children and are financially constrained find it difficult to source for funds or get social support since people are not working actively during this period. This causes a delay in surgical intervention.

For the surgeons in some government hospitals, sophisticated personal protective equipment (PPEs) are not yet routinely available for surgeries. It is still the regular surgical gowns and facemasks (which are also PPEs) used during the pre-COVID-19 period that are used now. This may not be a major challenge except in high risk operations until a suspected case or infected patient arrives in such hospitals. We hope that the government sees this as a call to action to provide all that’s needed by health workers during this pandemic.

PT: So how have you been handling the situation?

Amusat: From interaction with colleagues, some hospitals don’t take patients with suspicion of COVID-19 until they are tested so as to prevent exposure. The issue of inadequate testing is being handled by NCDC as efforts are being made to expand testing centres across the nation.

Poor tracing is also being addressed but I think we need to be more aggressive about it. The management of some government hospitals are also making efforts to source for more equipment and facilities to combat this pandemic. Some hospitals were fumigated recently as well.

We as health workers are doing the best we can within the confines of resources available to work with.

PT: By aggressiveness what do you mean?

Amusat: The government needs to adopt strategies that are effective viz-a-viz proper orientation of the citizens as to what contact tracing means, appropriate contact listing, updating database of citizens, provision of basic amenities and relief items for those who will go into self isolation who may be detected through contact tracing, amongst others.

The government is making efforts but a lot still needs to be done.

PT: The focus has been largely on COVID-19 patients, what’s the fate of other terminal diseases patients?

Amusat: From the government’s perspective, COVID-19 is the major focus for now because of its spread and consequences on our economy.

From the perspective of the health workers, other life-threatening diseases are being taken care of even amidst the pandemic. That is why it is important for the government to ensure health workers are adequately catered for.

PT: But are you really being catered for?

Amusat: Not as it is expected. The fact that one does not have all that is needed to work with is demoralising enough. The remuneration of health workers is also not encouraging compared to what is obtainable in other climes.

PT: Are you owed?

Amusat: Sometimes, it happens. A number of health workers are being owed salary arrears. Salaries are not paid promptly in some states.

We hope this pandemic makes the government see the need to set things right in the health sector.

PT: I learnt that the Lagos State government is rolling out a health insurance package for health workers, is this same for federal health workers?

Amusat: Health insurance exists for federal health workers but the system needs an overhaul to make it more effective.

PT: What’s the level of enthusiasm among health workers as of now? Is there apathy or eagerness to work based on available welfare packages for them?

Amusat: Welfare packages are non-existent. What health workers get is their salaries which is even not encouraging. However, majority still offer the best of care within their purview for patients. With an improved health system through deliberate efforts from the government, the level of enthusiasm will increase.

PT: How would you rate the preparedness of Oyo State, for instance, in case of a surge in the number of COVID-19 cases?

Amusat: Oyo State government is making efforts. However, more still needs to be done in terms of residents obeying stay-at-home order, the state government providing relief packages for needy families, improved testing and contact tracing, provision of adequate PPEs for health workers, amongst others.

PT: This is certainly a period of emotional and mental strain for health workers. How do you maintain a balance?

Amusat: I must confess that it’s not easy. However, health workers have been trying to stay strong and dedicated despite the odds as we hope this time shall pass. The fact that people are also recovering from the disease is another motivation. We hope we get over this pandemic.

PT: What should patients who have other terminal diseases do during this pandemic to maintain their health status?

Amusat: They should endeavour to take their medications as prescribed and in fact, have a stock for at least one month. They can come to the hospital in case of any emergency. They should endeavour to stay mentally healthy as well.

PT: How about the aged, how can they also keep safe?

Amusat: The aged should ensure they imbibe all precautionary measures recommended as they are at a higher risk of having the disease. They should eat healthily and also maintain their mental health by reaching out to family and friends. They should practice social distancing but not social isolation.

PT: How would you rate Nigeria’s preparedness for a surge in COVID-19 cases, judging by the personnel and facilities available?

Amusat: The bitter truth is that our preparation is inadequate for this pandemic. We need more testing centres, more ventilators and other ICU facilities, adequate PPEs for health workers, provision of relief packages for needy families, to mention but a few.

This pandemic should leave an indelible mark on our health system as we can come out of it stronger if we make all efforts to upgrade current facilities. This will reduce medical tourism and reduce premature deaths from myriads of medical conditions ravaging our dear nation.

EDITOR’S NOTE: This interview was edited after Mr Amusat got back to say he spoke with our reporter in his capacity as Executive Director of the non-proft, SmileBuilders Initiative, and not as a staff of the University College Hospital.