Nigerian doctors have described the use of private hospitals for the management of coronavirus disease by prominent Nigerians, otherwise regarded as very important personalities (VIPs), as a public health threat.
They said the action poses severe consequences for the country, adding that the current lockdown across some states may eventually translate to nothing in the fight against the virus if the development is not urgently curbed.
The doctors were reacting to the use of a private hospital by the late chief of staff to President Muhammadu Buhari, Abba Kyari, and the isolation of governors, who contracted the dangerous disease, at isolation centres outside the designated public ones that are set up in their states.
Also, the confirmation by the Lagos State government that Mr Kyari was treated at the First Cardiology Consultants (FCC)- a private cardiology-focused hospital located in Ikoyi, has contradicted the position of the minister of health, Osagie Ehinare, on the same issue.
The leadership of the Nigeria Medical Association (NMA) and the National Association of Resident Doctors (NARD), body of doctors undergoing resident training in Nigeria’s tertiary health institutions, spoke to PREMIUM TIMES on behalf of their members.
They described the development as a violation of the existing protocol in the fight against the novel virus.
What does the protocol say?
Investigations by our reporter reveals that there is yet to be a codified national protocol guiding the management of the disease in the country. There is, however, a developed document on strategies designed strictly for testing by the Nigeria Centre for Disease Control (NCDC).
Willy Bassey, the director of press at the office of the secretary to the government of the federation (OSGF), who spoke with our reporter, said the documented protocol is just being developed into a proper rule to guide the disease management. The SGF, Boss Mustapha, doubles as the chairman of the presidential task force on COVID-19.
Mr Bassey said; “Yes, there are guidelines guiding the management of the virus, but it is not yet concluded and prepared into a single document. The national coordinator of the task force, Dr. Sani Aliyu, is already working on one, and currently being reviewed by the members. You know the virus is novel, so the strategies are just evolving too.”
However, the health minister, who is a key member of the task force, on Friday, said there is no private hospital registered to manage COVID-19 cases in Nigeria.
Mr Ehinare, who spoke at the daily press briefing by the task force, was responding to PREMIUM TIMES’ question on the development, and the committee’s earlier threat to shut down any unaccredited private hospital that manage patients confirmed of the virus.
He, however, explained that some private hospitals were already being considered in Lagos, and that one had already communicated to him to express willingness to be part of the process.
But as of Friday, the minister said; “there was none that had met the criteria for accreditation.”
The minister made this open claim in spite of the public knowledge that President Muhammadu Buhari’s chief of staff, Abba Kyari, was receiving treatment at a private hospital in Lagos.
Why Mr Kyari opted for private hospital
Earlier on March 29, about one week after he was confirmed positive for the virus, Mr Kyari issued a statement announcing his decision to relocate to Lagos for “further test and observation.”
He said he had made his own care arrangements “to avoid further burdening the public health system, which faces so many pressures.”
He further stated; “This is a precautionary measure: I feel well, but last week I tested positive for Coronavirus, the pandemic that is sweeping the world. I have followed all protocols the government has announced to self-isolate and quarantine.”
But the minister ignored this open announcement and told Nigerians that; “As at today, there is no private hospital that has been accredited to manage COVID-19 case in Nigeria. There is none in Abuja here that I know of. But I think Lagos is looking at some accredited hospitals and there is one large hospital in Lagos that has called me that it wants to become a Coronavirus treatment centre.”
He said the hospital was prepared to remove its other patients and attend to nothing except Coronavirus.
“But if you as a private hospital want to run Coronavirus management, you have to show that you have a doctor who is an infectious disease specialist, nurses and even cleaners who are trained. This is because handling infectious hospitals is different from handling others. They need to be trained in infection prevention and protocols.
“…The facility would then be inspected by a team of accreditors who will give you the go-ahead to do it. But while it is not prohibited, there is no hospital that has met those criteria at the moment.”
As of the time Mr Ehanire spoke on Friday, Mr Kyari’s death had not been announced.
Lagos claims otherwise
Meanwhile, in a contrary position, the Lagos State government through its commissioner for health, Akin Abayomi, on Saturday evening, said the chief of staff, whose death was announced very late Friday night, was managed by an authorised private hospital.
This was also the first time the Lagos government would acknowledge that it knew where the chief of staff was being treated.
Both Mr Abayomi and the governor’s spokesperson, Gboyega Akosile, had consistently maintained silence whenever asked the question.
But on Saturday, Mr. Abayomi said he was responding to enquiries by concerned individuals and authorities on the health facility that managed the former chief of staff.
He said; “Following enquiries on the passing away of the Chief of Staff to the President of the Federal Republic of Nigeria, Mallam Abba Kyari on Friday 17th April 2020, the Lagos State Government states that:
“Mallam Abba Kyari died from complications of Coronavirus infection at First Cardiology Consultants in Lagos. This hospital is a Lagos State designated high care, biosecurity-compliant, COVID-19 facility, accredited by the Health Facility Management and Accreditation Agency (HEFAMAA) of the Lagos State Ministry of Health.”
The statement added that as a basis for its accreditation, the private hospital “established a separate specialist wing with staff dedicated to the treatment of complicated cases of COVID-19, under the supervision of the Lagos State COVID-19 emergency response team.”
The commissioner’s response was a confirmation of PREMIUM TIMES’ earlier exclusive report on where Mr Kyari was managed.
It is unclear where Governor Seyi Makinde was isolated but PREMIUM TIMES can confirm that the governor, who was confirmed positive on March 30, was not admitted at any of the three public isolation centres in his state, which are located at the University College Hospital (UCH), Jericho chest hospital, and maternity centre, Olodo, Ibadan.
But speaking with PREMIUM TIMES, the chief press secretary to the governor, Taiwo Adisa, said the choice of where to be isolated was not decided by the governor but by the COVID-19 management team in the state. The team, he noted, includes representatives of the Nigeria Centre for Disease Control (NCDC) and emergency centre operators.
He said; “The governor did not choose where to be isolated but the COVID-19 management team used its prerogative to choose for the governor. And throughout his isolation period, none of us had access to him.
“The committee considers various conditions before making its decision on where to isolate confirmed cases. Those with underlying medical conditions are taken to UCH. There are other cases who are isolated in other places outside these three public facilities. They take decisions as they deem necessary.”
On his part, the chief press secretary to Governor Nasir El-Rufai, Ibrahim Musa, declined to speak on the matter.
Also the senior special adviser on media to Governor Bala Mohammed of Bauchi State, Mukthar Gidado, neither picked his call nor responded to text messages sent to his mobile line. He also failed to respond to WhatsApp messages.
In separate telephone interviews with our reporter, the doctors said the challenges posed by patronising private hospitals other than government accredited centres, include difficulties in contact tracing, disease spread and management, “and that it also reveals the government’s distrust in its own efforts at addressing the pandemic.”
Speaking with PREMIUM TIMES, the NMA president, Adedayo Faduyile, described the development as ill-motivated, ill-advised and disheartening, saying it poses great danger to the country.
According to Mr Faduyile, a pathologist, the development is a reflection of the public officials’ disrespect for Nigerians and a distrust in their own capacity as heads of government.
He added that the use of public facilities would not only have boosted the morale of the workers but also other patients, and quicken their healing.
He said, “Because there is now flight restrictions, they can no longer travel abroad as they are always wont to do. Now the government is accrediting private hospitals to manage this novel virus. No one knows the criteria for the accreditation and which hospitals are accredited.
“The danger in this is that the private hospitals cannot handle this pandemic because it is novel. Aside from that, avoiding the spread would be difficult because the health workers there are not trained in this area. It isn’t about facilities but what happens to contact tracing, waste disposal, among other containment procedures. So, we are against this practice and that only designated public isolation centres should be used.”
In a similar development, the NARD president, Roland Aigbovo, said the development is a confirmation of his association’s prolonged cry over poor investment in the public health sector by the government.
He said if not urgently curbed, Nigeria stands the risk of achieving nothing with the ongoing efforts to address the pandemic.
Mr Aigbovo said; “This is a dangerous step being taken. This is the only country where all animals are not equal in the fight against the pandemic. And surprisingly, I can confirm to you that we have it on authority that there is now community spread, especially in Abuja here. Who says this isn’t as a result of this breach of protocol by the government.
“They are afraid of their own creations. They built a healthcare system that they don’t trust, so they are forced to seek solutions where there is none. Instead of making efforts to right their wrongs, they keep running away from their shadows. This thing must be halted very urgently, because it is a public health threat that may lead to major crises.”
Seek for prohibition law
Meanwhile, the NMA president has called on the national assembly to initiate a legislation that will bar anyone from patronising private hospitals for the management of the novel virus.
“If it will require legislation, I think we must ensure that we push our lawmakers to do something about this. If not, Nigeria may be sitting on a keg of gunpowder,” Mr Faduyile said.
Also speaking, the executive director of Civil Society Legislative Advocacy Centre (CISLAC), Auwal Musa, condemned the country’s handling of the disease.
Mr. Musa, who spoke on the telephone with our reporter, said the way everything is shrouded in secrecy and the manner of impunity of some unnamed individuals are all contradictions to the much touted integrity of the incumbent administration.
He said; “Because they have stolen our money, Nigeria leaders aren’t interested in using facilities they set up for the public. This is how they view us; the poor Nigerians. They can’t share space with us as their counterparts abroad do.
“We all saw the UK Prime Minister, Boris Johnson, being wheeled into a public hospital and we received updates on his status every hour. But here, everything is secret. And that raises our fear over the monies and material gifts being donated for the fight against this disease.”
Mr. Musa, who doubles as the CEO of Transparency International Nigeria (TI), urged the public to continue their push for accountability in governance.”
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