COVID-19: Why Nigeria is discharging patients after 1 negative test

Indications have emerged that the modification of the discharge protocol for COVID-19 patients who were admitted in isolation centres across the country might not be unconnected with a shortage of bed space also as reagents for laboratory testing.

Last week, the Director-General of the NCDC, Dr. Chikwe Ihekweazu, had stated in Abuja during one among the daily briefings of the Presidential Task Force, PTF, on COVID-19 that COVID-19 patients were being discharged before usual.

In his brief, Ihekweazu announced that the Agency had switched to discharging patients who test negative once as against the previous mandatory requirement of testing negative twice before discharge.

He said the choice was to enable the decongestion of some isolation centres. consistent with him, the discharge criteria were

changed from two tests 24 to 48 hours apart to one negative test, claiming that the rationale was that, most of the cases that tested negative also tested negative for the second time. For him, there would be some exceptions.

But he also said: Given the pressure, we’ve on bed spaces especially in Lagos, Kano, and therefore the FCT, we made a practical decision to maneuver to at least one negative test sufficient to discharge people.

Ihekweazu further claimed that new evidence shows that it’s safe to discharge recovering COVID-19 patients even when the results are still positive.

According to him, new evidence is emerging that even when the test remains positive then patient has been in look after a particular amount of time; it’s possible and safe to discharge that patient to home isolation.

However, healthiness Weekly, gathered that Nigeria is being forced to form these changes thanks to a shortage of reagents and bed spaces. as an example, in Lagos, despite the state having an honest number of bed spaces, an increasing number of cases is gradually forcing the introduction of home management, consistent with the state Commissioner for Health, Prof Akin Abayomi.

Nigeria currently has about 3,500-bed spaces identified in isolation centres. In Lagos, there are eight isolation centres with 547-bed spaces. Already, the state is battling bed spaces.

At the Gbagada Hospital, there are 118 beds; LUTH, 60; the Infectious Hospital Yaba, 115; Onikan Stadium centre, 100; Landmark centre,70; Lekki centre, 45; Agidingbi centre, 34, and therefore the First Cardiology Hospital has 5 where critically ill persons are treated.

However, with a complete of three,505 confirmed cases and only 738 discharged in Lagos state, health watchers fear that the health system may are overwhelmed. They also worry that the consideration of homecare may cause more harm than good. healthiness Weekly, also report that states like Kano and therefore the FCT also are battling bed space thanks to increasing positive cases within the areas.

The President of the Nigerian Medical Association, NMA, Dr Francis Faduyile, said Nigeria should be wary of adopting the WHO homecare management strategy because the country was already challenged within the area of housing.

The housing facilities in Nigeria make it almost impossible for somebody to remain on their lonesome during a house or during a room and this might affect home management, but it’s left for the govt to seek out the simplest way because certainly, it’s going to be difficult to treat all the cases in an isolation centre thanks to paucity of bed spaces especially when many of them presented with mild or moderate symptoms.

Discharge criteria

Further investigation by healthiness Weekly revealed that another constraint is laboratory materials just like the reagents. Recently, the Lagos State Commissioner for Health, Prof Akin Abayomi disclosed that a COVID-19 test cost N40, 000 – N50, 000, and with the government spending over N8 million on tests, the choice to limit the discharge criteria to at least one negative test might not be far-fetched.

A medical laboratory expert, Dr. Casmier Ifeanyi faulted the method of testing for COVID-19 in Nigeria. consistent with him, Nigeria failed abinition from on discharge criteria.

Ifeanyi said for a rustic utilising the gold standard which is that the real-time quantitative PCR, there was no got to waste the country’s resources on double testing before discharge.

He said Nigeria did not allow Nigerian laboratory scientists to require over from start but rather allowed non-laboratory scientists to drive the whole process.

Many people who by virtue of coaching shouldn’t perform testing on humans took over, tests, interpret the result of such results because it applies to patient admittance, patient management, and patient treatment and eventual discharge.

When they were doing serial testing to work out positive and that they were doing serial testing to work out discharge, they were wasting human resources, wasting exotic materials that are hard to return by the course of this pandemic.

“What we’ve adopted to use in Nigeria ever since the outbreak started and that we commence intervention and testing of COVID in Nigeria, is that the gold standard. If you’re using the gold standard it means, it’s not it and it’s not love it. With real-time quantitative PCR which is that the gold standard because you’ve got taken the testing to ascertain into the DNA of the causative agents. you’re detecting the DNA of the causative agents. So it’s either the organism or the agent is there or it’s not it in the least.”

He said Nigeria is reviewing the standards because the incorrect persons are giving an interpretation to the results and even to discharge patients. Ifeanyi regretted that because the NCDC was becoming resource-constrained and that they are falling back in using one test to discharge patients.

“In the primary place, the double testing was a waste of resources, they might have deployed an equivalent to try to to more testing to spot more members of the community.

He urged the Director-General of the Nigeria Centre for Disease Control, CDC, Dr. Chikwe Ihekweazu to try to to simpler collaborations with the sister agency within the federal ministry of health, the Medical Laboratory Council of Nigeria, MLSCN, to assist Nigeria become top-notch in standard compliance of testing in molecular testing and interpretation also as subsequent use within the management of the patient.