BREAKING NEWS… Low Testing in Cross River State, Worrisome and Unacceptable. -NMA CRS

This press release was published by the State’s NMA Secretary.

“May 22, 2020

NMACRS/SG/2020/05/214

PRESS RELEASE BY NIGERIAN MEDICAL ASSOCIATION CROSS RIVER STATE BRANCH ON COVID-19 RESPONSE AND THE STATE OF THE HEALTH SECTOR IN CROSS RIVER STATE

Sequel to the last press release of Nigerian Medical Association Cross River State (NMA CRS) Branch, Ref. No: NMACRS/SG/2020/04/202 dated April 15, 2020, on the above subject matter. The Association has had robust engagements with the Cross River State COVID-19 task force. We extensively reviewed the progress on the level of preparedness and steps taken to prevent and contain any outbreak of COVID-19 in Cross River State and following engagements and feedback from the medical community, have come up with the following position statements:

1) The Nigerian Medical Association Cross River State Branch commends the State Government on efforts towards setting up the 100-bed Adiabo Isolation Centre in the State Capital. We call for more efforts to facilitate the completion of the United Nations High Commission for Refugees (UNHCR) supported Isolation Unit in General Hospital Ogoja. We advocate for the speedy equipping of these facilities in preparation for use.

2) The Association highly commends the efforts of the State COVID-19 task force in the training of Medical and Dental Practitioners and other Health Workers on Infection Prevention and Control (IPC) and case management of coronavirus disease. We advocate for the training of ALL health workers in the State to forestall any weakness in the IPC chain to preserve and reduce to the barest minimum hospital transmission among the scarce health workforce in the State.

3) The early implementation of the compulsory use of face mask by the State Government continues to receive accolades across Nigeria. However, we have observed that the enforcement of this policy is predominantly in Calabar among motorists and passengers of motor vehicles. At the same time, pedestrians are allowed to move freely either without face masks or the face masks hanging around the neck. We advocate for continuous and aggressive engagements and buy-in of various unions and associations like the Market, Automobile dealers and Road Transport unions to activate their internal mechanisms to enforce government policies.

4) The COVID-19 testing breakdown by State as at May 17, 2020, released in the COVID-19 situation report on May 18, 2020, revealed Cross River State has carried out only seven (7) tests with only Kogi State carrying out less testing across the country. This figure is very worrisome leading to the affirmation by the Director-General NCDC that; “no matter how intensive preventive measures are, there is no way to assess a State’s success or failure in managing COVID-19 without more testing to estimate disease burden”. He highlighted the need to intensify COVID-19 testing in Nigeria. The unacceptable low number of persons tested in Cross River State suggests a lack of diligent, expansive and coordinated surveillance response which is the hallmark for effective prevention and containment of COVID-19. We appeal for an expansion of the surveillance unit with the provision of more field staff, utility vehicles, ICT/technical support to enable this vital unit to carry out the critical role of early case finding for testing and isolation of confirmed cases to limit community transmission.

5) As of May 21, 2020, information available to us has it that seven (7) out of the eight (8) samples collected so far are from the University of Calabar Teaching Hospital, Calabar (UCTH). Many questions are begging for answers; Is it only UCTH that has patients that meet the criteria for sample collection? What happened to patients who may have visited the various Primary Health Care Facilities, General Hospitals and Private Hospitals across the State that may have satisfied the criteria for testing? Very worrisome is the fact that most members of the medical community are currently expressing concerns if the samples collected are the samples sent to NCDC. We call on the State COVID-19 task force to create a transparent system for tracking of samples from the point of collection to Testing Centre to restore confidence on the eventual results reported.

6) The Cross River State Government currently has no listed NCDC designated Molecular Laboratory Testing Centre in progress or completed on the NCDC Molecular Laboratory Network. To make matters worse, the NCDC Laboratory catchment for coronavirus testing for Cross River State is at Irrua, Edo State. Irrua is about 447.9km (7h 50min) from Calabar when compared to Abakaliki, Ebonyi State another testing centre that is 188.9km (3h 17min) from Calabar which also shares a boundary with Cross River State. The present situation makes sample transportation very expensive and cumbersome occasioned by restrictions in interstate movement. We use this medium to call on NCDC to change the testing centre of Cross River State from Irrua to Abakaliki. We once again implore the State COVID-19 task force to expedite plans in collaboration with NCDC to fully accredit Dr Lawrence Memorial Hospital which is a Bio-Safety Level Three (BSL-3) laboratory and UCTH, Calabar for COVID-19 testing.

7) The Association has received several reports of delayed response by the State Surveillance and Epidemiology unit to calls for patient review and sample collection. In some cases, delays have led to a post-mortem sample collection. We call for rapid response and urgent transportation of samples within 24hours of the collection with daily situation report (SITREP) made available to the public to avoid fake news and allay fears and anxiety. The quick response time has become more imperative due to the rising number of deaths from suspected cases in the State, the most recent being a health worker.

8) The Association appreciates the efforts made by the Cross River State Government through the Civil Service Commission with advert dated April 27, 2020, calling for applications from Doctors and Nurses into the Ministry of Health Cross River State. We wish to reaffirm that there are no new Doctors or Nurses recruited into the State Civil Service. We further reiterate that without the implementation of 100% revised CONMESS in the State; the recruitment exercise will be an effort in futility as the primary cause of internal and external migration of health workforce in the State due to poor remuneration has not been addressed.

9) The Association calls for caution with the resumption of public worship in the State from May 24, 2020. Our concern is that the order stipulates the number of worshippers to be limited to the sitting capacity of the church/mosque. The usual sitting capacity of most worship centres does not allow for the physical distancing of at least 1 metre that reduces the risk of droplet transmission of COVID-19. We advise that this policy should be reviewed, taking into cognizance physical distancing and local peculiarities of various worship centres.

10) The Association and her members remain committed to working with the State Government and the Federal Government to fight the COVID-19 pandemic.

Thank you, and God bless Cross River State.”

Dr. Agam E. Ayuk        Dr. Ezoke Epoke State Chairman.           State Secretary

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