Private health care providers and the Guild of Medical Directors have expressed dissatisfaction with the decision of the Federal Government not to allow private hospitals without accreditation treat persons who test positive for the novel coronavirus disease.
The private health care providers, under the aegis of Association of General and Private Medical Practitioners of Nigeria, and the GMD said it was wrong for the government to sideline them in the treatment of the COVID-19 patients.
As of the time of filing this report, the number of cases in Nigeria had risen to 542, out of which 166 had been discharged while 19 persons, including the Chief of Staff to the President, Abba Kyari, had died.
The Minister of State for Health, Olorunnimbe Mamora, announced recently that the ministry was working with relevant institutions to expedite the process of assessing and providing accreditation for private medical facilities with relevant capacity to manage COVID-19 cases. But the Minister of Health, Dr Ehanire Osagie, said on Friday at the task force briefing that none had been accredited so far.
Ehanire stated, “There is none (private hospital) that I know that has been accredited. If you as a private hospital want to run a treatment centre for coronavirus, you have to show first of all that you have the staff; a doctor who must be an infectious disease specialist and nurses and even cleaners who are trained in infection prevention protocol.
“The operations are different from what obtains in other hospitals. While this is not prohibited, there is no private hospital that has met those criteria at the moment.”
Also, at the PTF’s media briefing on Thursday, Ehanire threatened that government would shut down private hospitals secretly treating COVID-19 patients. The Kano State Government also said it would shut any private hospital treating COVID-19 patients.
Meanwhile, in their response to the government’s decision, the two associations said it was unfortunate that the Federal Government did not recognise the contribution of the private sector to health care delivery in the country.
The National President, AGPMPN, Dr Ugwu Odo, questioned why private hospitals needed to apply for accreditation before being allowed to treat COVID-19 patients.
He said, “Is that the way government collaborates with its people? Do we need to apply? Does every hospital apply anywhere in the world? Health care is predominantly a concern for public and private sectors and you cannot successfully separate them. That is why we now have the public-private partnership, knowing that no matter how wealthy or powerful a government is, it cannot do it alone.
“The Federal Government should not wait for us to apply, they should mobilise their human and material resources to support the public and private health care providers.”
“It bothers us that even up till Thursday, our own minister is still making the world feel that the private sector is not part of this scheme and the private sector is to just identity possible or probable COVID-19 patients and refer to the nearest centre. Is that what the doctor has become?
“It’s not done. The doctor has to be the doctor he’s trained to be. He has to show compassion; the National Health Act which they are part of in putting in place recognises that doctors have to care, provide that initial emergency care, stabilise their patients before they make referral.”
He said the association had tried to engage the Federal Government, the health minister and the directors in the ministry on the need to protect, empower, motivate, encourage and pacify everyone to combat the pandemic.
He explained that there is no private or public malaria and that no Nigerian who dies of COVID-19 would be said to have “died a private or public death”.
Odo said a sector that takes care of the health of the over 70 per cent of Nigerians could not be sidelined at a time of national emergency, adding that about six to seven COVID-19 patients out of eight to 10 are most likely to first visit a private hospital. “The point is that the private sector is still being sidelined; we are not getting the attention, we are not being encouraged and we are not even seen as stakeholders,” he added.
He said government should give the private sector the honour due to it.
He said, “We cannot be seen as a sacrificial lamb. When Ebola came a few years ago, it first landed in a private hospital. It took the courageous spirit of Dr Stella Adadevoh who obstructed that difficult case from leaving the hospital. She eventually paid with her life.
“As we speak, most of the Lassa fever cases that have been recorded in the country were reported in private hospitals. Our doctors and nurses are dying all over the places in private facilities. Our government should see the health sector as one, because indeed we are one.
“The data we raise speak for Nigeria as one, the success we record as a sector is seen as one anywhere in the world. This is not the time to divide the house, it’s a time to heal every wound and act in unity.”
Also, GMD’s National President, Prof Femi Dokun-Babalola, corroborated Odo’s position, saying many COVID-19 patients first visit private medical facilities before being referred to the accredited government hospitals.
He said it was therefore unfortunate that the Federal Government had not given the private hospitals the needed support in the management of COVID-19 patients.
He stated, “To the best of my knowledge, not much has been done to collaborate with us. We have had meeting with the Federal Government where we told the Minister of Health that we are not being carried along in management of COVID-19 in the country so far.
“One of the things we told the minister was that the private hospitals are always in the frontline of attack by these patients. They will come to the private hospitals without knowing they have COVID-19 before we start treating them.
“Even though we have warned our members to take precautions, you cannot really tell that a patient has COVID-19 until you have interacted with them during which period we may have been exposed to that patient.”
No fewer than 155 doctors and nurses are in isolation in Lagos, Kwara and Edo states, findings by Sunday PUNCH have revealed.
In Edo State, about 25 doctors comprising house officers, resident doctors and a consultant had been in self-isolation after coming in contact with COVID-19 patients. A doctor had died as a result of the disease, while two doctors in the state had also tested positive for the virus.
In Kwara State, no fewer than 65 nurses and midwives are to remain in isolation, while 14 doctors at the University of Ilorin Teaching Hospital who have been in self-isolation may resume work next week after testing negative for the virus.
About 79 nurses and midwives were placed in self-isolation, out of which 14 had tested negative twice and are likely to resume next week, while the remaining 65 are still in self- isolation until the result of their second test is out. They had tested negative after the first test.
The health workers were made to self-isolate following the death of a suspected COVID-19 patient who allegedly was admitted at the Accident and Emergency ward of the hospital without disclosing that he was a suspected carrier of the virus.
The patient was admitted in the hospital for food poisoning on April 1 but died the following day and was buried in his home in Offa without his samples taken for COVID-19 test.
The Chairman of the Nigerian Medical Association in the state, Dr Mohammed Solagberu, said, “14 medical doctors of UITH are in self-isolation. I think they have completed the two weeks isolation, they have tested negative and have not shown symptoms of COVID-19. They are likely to resume next Monday.”
Also, the state chairman, National Association of Nigerian Nurses and Midwives, Alhaji Shehu Aminu, said the 14 nurses and midwives who had tested negative twice would resume next week, adding that the remaining 65 were still in self- isolation.
He added, “They didn’t have contact with the suspected coronavirus victim but they were exposed to the deceased for one or two days. None of them has shown symptoms of COVID-19.”
The head of UITH branch of the Association of Resident Doctors, Dr Lanre Olosunde, also said, “The doctors as of now are in self-isolation and they are doing fine. I can’t tell you the number but they will resume (work) as soon as the NCDC clears them.”
Meanwhile, UITH Public Relations Officer, Mrs Elizabeth Ajiboye, declined responding to enquiries when contacted by one of our correspondents.
However, the NMA Chairman in Lagos State, Dr Saliu Oseni, told one of our correspondents that there were about 50 health workers in isolation in the state, noting that people should disclose their health status and travel history so as not to endanger health workers.
He said, “We have quite a number of doctors in Lagos now that are under self-isolation because patients present themselves in the hospital denying their status and they expose our colleagues.
“I don’t think we have less than 50 health workers in self- isolation currently, from different hospitals. That is why we have been pleading with the government that they should provide protective gears and that is why we are saying we don’t want private hospitals to treat COVID-19 patients. They should identify the patient, diagnose and refer to the isolation centre.”
Also, the National Association of Nigerian Nurses and Midwives in Lagos State has expressed concern over the working environment in which nurses have found themselves, saying the shortage of personal protective equipment and welfare packages had become worrisome.
While commending the efforts of Governor Babajide Sanwo-Olu in leading a fight against the disease, the association, in a statement by the state chairman, Mrs Israel Blessing, lamented that three of its members had tested positive for the virus, while 25 others are in isolation.
It added, “Most of the expected PPE are not available for use, hence nurses are being exposed to unnecessary risk. Presently, some of our nurses have tested positive for COVID-19 and have presented themselves at the isolation centre for management.
“These set of people will require immediate activation of their insurance policy. Also, about 25 nurses are on self-quarantine after being exposed to cases of COVID-19. This is telling on the already strained manpower at various health facilities, making the work overwhelming for nurses.
“There is need for improvement in provision and supply of personal protective equipment, which include surgical masks, N95 face masks, latex and elbow gloves, disposable gowns, etc. There is also need for concretised arrangements for insurance cover for nurses and upward review of the present ridiculous hazard allowance for all health care workers.”
As a way of protecting its members, the Nigerian Medical Association has advised doctors against treating COVID-19 patients without protective gear, saying the country could not afford to lose more doctors and other health professionals amid shortage of medical personnel.
The National Publicity Secretary of the NMA, Dr Obitade Obimakinde, in an interview with one of our correspondents on Friday, however explained that doctors should not reject accident victims and other patients who did not show symptoms of coronavirus but must take precautionary measures to protect themselves.
He said, “There are not enough PPE in our hospitals despite their importance especially in managing patients with infectious diseases. We don’t want to lose more doctors and that is why we are advising our members not to expose themselves to unnecessary risks by treating patients positive for COVID-19 or other infectious diseases without personal protective equipment.
“But we must clarify this so that doctors will not be rejecting all patients. We are here to save lives and that is our job and we must do our best to save lives. If accident victims are brought and they do not show any symptoms of COVID-19, we advise doctor to treat such patients. They should attend to any patient that does not show any symptoms of coronavirus but they still have to wear gloves, face masks and other protective equipment.
“If they have patients who show symptoms of coronavirus, they should make sure they are protected before attending to such patients.”
Obimakinde also said it was criminal to treat coronavirus patients at home or even in private hospitals because government had not given them approval to manage such cases.
Also, the Delta State chapter of the NMA has urged its members to steer clear of coronavirus patients if they do not have the proper personal protective equipment.
Briefing journalists on Friday in Asaba, the NMA Chairman, Dr Ekeneam Omo, said, “Doctors in the state have been mandated by the association not to go near any COVID-19 patient without the appropriate PPE. The state government should make available adequate PPE for all health workers in the state.
“We request full complement of PPE, including Hazmat Suit, a minimum of N95 face masks, gloves, face shield/goggle and aprons at all times. Health care workers who constitute the first contact are exposed to significant risk and deserve to be properly trained to handle such cases without exposing themselves to any risk.”
The association also demanded an upward review of the hazard allowance of all doctors and health care workers from N5,000 to a percentage of their consolidated basic salary.
They also demanded for compensation for all doctors and health care workers who died or suffered disability from attending to COVID-19 patients among others.