A physician with the Lagos State response team on COVID-19, Dr. Abisola Adebayo has revealed the response structure of the state in combating the pandemic.
Adebayo who works as a Team Lead at the Lagos State University Teaching Hospital (LASUTH), said, the state has a structured formation in handling the disease which has greatly stemmed the speed of infections.
Explaining the various pillars within the structure, she said, “We have the Epidemiology and Surveillance, Laboratory, Case Management, Physical teams among others.
“I don’t think all the states have, but Lagos has the Emotional and Mental Health Unit, Infection Prevention and Control Units. Their work cuts across because one of the mainstay is to stop infection, hence the Evacuation and Decontamination team,” she explained.
Still on the structure, Adebayo said, “Lagos State has a very functional Ambulance Team that picks up patients and transport them to the Isolation Centres. It works hand in hand with the Decontamination Unit. They always need to decontaminate homes, offices, cars. Then we have Logistics pillar; they are the blood of the responses. They make sure consumables like sanitisers and PPE are available.”
According to her, the Logistics, Communication pillars send preventive messages and are behind the messages on the radio.
Stating further, she said the Coordination pillar make things happen while the office of the Permanent Secretary of the Ministry of Health, Health Service Commission provide the team that work in the isolation centre.
She also said the job starts when there is a rumour that someone is sick or someone is calling. “Some just need counseling, they counsel them and monitor them even if it is not COVID-19, it might look like it sometimes. So they also get back to check on the person. The Surveillance team has a database. So when they hear the rumour they collate the rumour at the end of the day, they send to another team. We have about six teams that cover the 20 LGAs recognised by the Federal Government of Nigeria and we have the 37 LCDAs.
“We need to know the stories from each location. We need to know a lot of things, we need to ask questions. Many times they have to go to the hospitals, at the level of the LGAs now we have working sites, we have surveillance taking contacts, they take details.
“They are all there working at the LGAs, each LGA has a rapid response team. We have a team that works on the results. We try our best, it is a system that works. When we have cases we have the data, we have details, they send reports,” she explained.
Enlightening the public on the importance of data gathering, Adebayo said, “Mr. Governor has a cabinet that the Honourable Commissioner is part of. They use our data, they don’t just announce things.”
“Things are based on data, so if we give them wrong data, we are totally misleading them and misrepresenting the responses. That is why when I’m home, it is data, and till I sleep it is data because everything is data. I’m helping to clean up the data, analyzing, sometimes it is almost overwhelming because of the amount of data we are generating.
“We have so much data we are generating, almost 70,000 data to sort out on results alone, we have a sheet for rumour alert, we have a sheet from LGA results so we have a lot of data we are analyzing,” she said.
Continuing, Adebayo said data determines whatever steps the state government is taking and that sets the pace for guidance.
“Data is everything. It guides the response; it determines what Lagos would do. Data for instance determines whether they would open the schools or not. The quality of data is very important even on surveillance, we are constantly working on data, we are not in a hurry to start presenting nonsense, we have many points to work on data. I think that is the overwhelming response,” she said.
Talking about the challenges to prepare for from the Local Government levels, Adebayo said there are serious challenges especially in the area of funding.
“There are so many challenges, especially in the area of funding. Lagos has spent so much and people can’t even believe how much the state is spending. You may need to Google how much Lagos spends on testing alone. Funds can never be enough. Lagos has spent more on COVID-19 than any other thing in recent times,” she said.
Commending the efforts of the Lagos State government further, Adebayo, who has been on the response team since the first case in February 2019 said the structure in Lagos is so organized with several pillars.
“We have several pillars in Lagos State and everybody works together, we can’t work without each other,” she said.
Explaining further, she said the state has started the home based care. “Before now, we pick up cases but now we have the Eko telemedicine working with the LGAs. They have officers that go round and there is the home base kit. The Eko telemedicine team is handling that. We have contact tracers, we have supervisors for the wards, one supervises three or four wards. When a person is positive we try and trace the contacts.
“We have contact listing, contact tracing and follow up, we trace them, we monitor them for two weeks. You have the contact tracers at the wards. We start from rumour, we investigate the rumour. We have the medical officers coordinating. It is not only COVID they are tracing, we are helping the state epidemiology. In case investigation we have many people there too, we have the structure. We have Mainland, LUTH working sites, we have LASUTH. A lot of cases go to LASUTH being the state facility. We also have the data team. We have to make sure we provide adequate data. We have the data officers too. We have over 300 people in the structure.”
Complaining that people don’t come out for testing as they should, Adebayo said however advised Nigerians to help the government by presenting themselves for testing so as to curb the spread of the disease.
“People are not coming out for testing. Many times people have symptoms and they say it is not really bad. In the LGAs we have personnel who are rising up to the occasion and they must know we are not ignoring their efforts. Not coming out for testing is a major challenge.
“Also, the issue of contact tracing is another thing. It is not a Nigerian thing. People here are worried about their confidentiality, you know how Nigerians are, people are very defensive, that is why now before you test, we collect your contact. Those are the main challenges in at the fore front of the battle,” she lamented.
The physician is also worried as the international airports are operating fully in Nigeria. She is more worried because of the volume of travelers who may overwhelm the system.
“I would personally have wanted restriction on some countries that can come in to Nigeria. I don’t have current data but we should have a team that is studying rates of increase and those countries that are having high rates.
“Though some people may argue that they have tested negative before coming but they could be on incubation without knowing. Now the strategy for Nigeria is that you test before coming and you test after seven days, are we doing that? Who is monitoring? I don’t know and they are so many people coming in. I would say if we even have these travelers coming in make sure you are collecting details of their contact address, functional phone number just to put a call through, but presently it’s a lot of work. You need a lot of personel except you are doing an automated system and that is putting more pressure on the LGAs.
“On the other hand we may need to know whether we have immunity in Nigeria we are waiting for report on that because we are risking it, the economy has to open up, life has to continue and to be honest I don’t see COVID-19 leaving soon, so we have to have a new normal,” she advised.