NCDC Issues New Guidelines on Discharge of COVID-19 Patients

NCDC Issues New Guidelines on Discharge of COVID-19 Patients
  • Symptomatic patients to spend 10 days, asymptomatic, 14 days
  • Negative test no longer required
  • 350 new cases move tally to 11,516 with 323 dead; 3,535 persons discharged
  • Nigeria, UK, others seek global funding for vaccines
  • WHO explains resumption of Hydroxychloroquine clinical trials
  • Mosques, churches to reopen in Lagos June 19

Segun James, Martins Ifijeh in Lagos, Olawale Ajimotokan, and Onyebuchi Ezigbo in Abuja

The Nigeria Centre for Disease Control (NCDC) Thursday unveiled new guidelines for the treatment of COVID-19 patients, which will quicken their discharge from isolation and treatment centres.

Under the new guidelines, which provide that a negative test will no longer be required to discharge a patient, symptomatic ones will be discharged at least 10 days after symptoms onset and at least three days without symptoms.

For asymptomatic patients, they will be allowed to go home 14 days after their first positive test.

The release of the guidelines coincided with a further rise in COVID-19 cases in the country, with 350 new incidences recorded to bring to 11,516 the number of confirmed cases in the country. The nation also recorded eight COVID-19 related deaths, raising the tally from 315 to 323 in the last 24 hours.

Announcing thursday, the NCDC said Lagos recorded 102 new cases, Ogun 34, Federal Capital Territory (FCT) 29, Borno 26, Kaduna 23, Rivers 2, Ebonyi 17, Kwara 16, Katsina 14, Edo, Delta, Kano and Bauchi 10 each, Bayelsa nine, Imo eight, Plateau four, Ondo three, Nasarawa two, while Gombe and Oyo recorded one each.

It said: “Nigeria has recorded 11,516 cases of COVID-19. 3,535 persons have been discharged, while 323 have unfortunately died.”

The guidelines were announced as Nigeria has joined the United Kingdom and other countries of the world to initiate moves on raising funds in support of research efforts to produce vaccines for the treatment of the virus.

Speaking yesterday in Abuja during the media briefing by the Presidential Task Force (PTF) on COVID-19, the Director-General of NCDC, Dr. Chikwe Ihekweazu, said the centre had revised the COVID-19 case management guidelines in line with recent recommendations of the WHO.

He said that NCDC held a review meeting with various case management teams in the Ministry of Health and came up with new guidelines for discharging the patients.

He explained: “There has been new science emerging about the duration of infectivity of individual patients. It led to the WHO issuing new clinical guidelines.

“We then convened colleagues across our organisation, the department of hospital services of the Federal Ministry of Health, as well as other colleagues with whom we work, to review our guidelines and issue new guidelines for the country and of course adapting it to local circumstances.
“The key thing is that the management of COVID-19 will be made primarily supportive; we don’t have any treatment so far that has any proven impact on morbidity.

“One of the major changes that have happened is the discharge criteria. While these guidelines are obviously and primarily targeted at physicians managing patients, it is important that patients and people know. There are two groups of patients – symptomatic and asymptomatic patients.
“For symptomatic patients, they may now be discharged at least 10 days after symptoms onset and at least three days without symptoms. If your symptoms last for longer, we will wait for longer managing you supportively.

“If you are asymptomatic, you can be discharged 14 days after your first positive test. So, we no longer have to wait for a negative test to discharge. This way you can go home with confidence that you are no longer infective and you’re not putting your family and friends or anyone else at risk.

“We are not encouraging that people be discharged while they are still symptomatic. We are talking about discharging people that are asymptomatic and have recovered. That is, you are symptomatic and have recovered or you are completely asymptomatic throughout your clinical episodes.

“At that point you really don’t need more clinical interventions, even at home; you just need time to recover. It is just like you to recover from any other illness. You don’t need any special intervention once you have been discharged.

“Change is difficult because we have been saying you have to have a negative test. Even though we have published these results, many physicians are still not using them. We can assure them and everyone managing cases that 14 days after, in fact, 10 days is what the evidence says.

“But we have added 14 days to make it two weeks for people to then implement discharge for patients that are asymptomatic.”

He added: “In addition, we have also removed the use of antiviral from our treatment guidelines. The trial for Chloroquine and Hydroxychloroquine will go on.

“We are asking that we limit the use of these medicines to those trial settings and not use them casually around the country. Let us reduce the use of Chloroquine and Hydroxychloroquine and all the other antiviral previously on our guidelines to contexts where clinical trials are going on.
“So, we have withdrawn them from the guideline from management. However, we have kept them within the clinical trial so that we can study and see whether they work or not. That is really the rational approach to this.”

Speaking on the issue of availability of personal protective equipment (PPEs), Ihekweazu urged both public and private hospitals to procure their own PPEs and factor it into the cost for healthcare delivery.

“Our hospitals both public and private really need to include the purchasing of personal protective equipment in their procurement plans. These are things that they have to buy to keep their hospital going,” he added.

UK, Nigeria, Others Seek Global Funding for Vaccines

Meanwhile, Nigeria has joined the United Kingdom and other countries of the world to initiate moves on raising funds in support of research efforts to produce vaccines for the treatment of the virus.

Speaking at the media briefing by the task force, the Minister of Health, Dr. Osagie Ehanire, said he represented President Muhammadu Buhari at a virtual Global Vaccine Summit held yesterday afternoon and hosted by UK Prime Minister Mr. Boris Johnson.

“I also had the honour of presenting the statement of His Excellency, President Muhammadu Buhari, at a virtual Global Vaccine Summit this afternoon, hosted by UK Prime Minister, Mr. Boris Johnson, the purpose of which, was to mark 20 years since GAVI was founded, and also to raise funds to support its activities,” he said.

Ehanire also said that he chaired a virtual meeting of the ECOWAS COVID-19 Ministerial Coordination Committee on Health, hosted by the West African Health Organisation (WAHO) and attended by 15 ECOWAS Ministers of Health or their representatives on Tuesday.

According to him, the committee is one of the three committees set up to facilitate the work of the ECOWAS COVID-19 response effort led by Buhari.
He said the meeting compared notes, discussed matters of regional cooperation and collaboration around the pandemic strategy and response, border-related challenges on the movement of people and goods when borders are reopened.

The minister said that WAHO and Nigeria are presently working together on a cost-sharing plan for a common air transport plane to convey COVID-19 supplies of WAHO and Nigeria from Beijing to Abuja.

WHO Gives Reasons for Resuming Drug Trials

Also yesterday, WHO explained the reasons for restarting the solidarity trials on Hydroxychloroquine.

WHO had temporarily halted the clinical trials for the use of Hydroxychloroquine for treatment of patients after a report in a health magazine linked the drug to cases of rising mortality rates and toxicity in patients.

However, WHO said yesterday that it decided to resume the clinical trials after a review study showed that there was no cause for alarm and that it was not true that the use of the drug for clinical trials has led to increased deaths.

It said that it took the earlier measure to suspend the clinical trials as a precautionary move.

While giving the reasons for resuming the solidarity trials at the task force’s briefing, WHO’s Country Representative in Nigeria, Mrs. Fiona Braka said: “The suspension lasted about eight days. Yesterday, the committee met and based on the review of available mortality data regarding the use of Hydroxyl therapy for the treatment of COVID-19 patients and considering information from the ongoing trials in the United Kingdom and also the recovery time, where the data safety committee of that trial also reviewed the data, the members of the committee agreed that there was no cogent reason as to recommend the modification of the protocol and they advised that the trials should be continued as planned.

“The executive group of the study, therefore, decided that based on the advice of the safety committee to resume the inclusion of patients in Hydroxychloroquine study arm of the trial.”

She said that WHO has continued to emphasise that there is still no evidence that Hydroxychloroquine or any other drug is effective in treating or preventing COVID-19.

She said that as far as the WHO is concerned, the drugs are only used for the purposes of clinical trials, adding that self-medication with regard to COVID-19 is advised against.

Fact-finding Team to Lagos, Ogun Submit Preliminary Reports

Ehanire disclosed that the team deployed in Lagos and Ogun States to assess the situation of the COVID-19 pandemic response has completed their assignment and submitted their interim report.

He said though the final report of the team led by the Executive Director of the National Primary Healthcare Development Agency (NPHCDA), Dr. Faisal, is to be ready next week, its preliminary findings indicated “state-specific challenges and gaps.”

Ehanire said that the Federal Ministry of Health team deployed in Kano, Sokoto, Jigawa Borno, Katsina, and Gombe States will be submitting their final report today.

The minister said the preliminary reports from the team that visited Lagos and Ogun showed that the goals of the intervention were met.
While speaking on the nature of COVID-19 infection, Ehanire stated that from findings, about 80 per cent of positive cases do not show any symptom.

FG Laments Disruption of Medical Supply Chain

The federal government bemoaned the disruption caused by COVID-19 on the medical supply chain and availability in human and supply sources.
The National Coordinator of PTF, Dr Sani Aliyu, echoed the concern during the media briefing.

Aliyu also said the pandemic had led to the reduction of care for other essential medical services.

In addition, he said the disease had resulted in a sharp decline in people assessing health care out of fear of getting infected with the virus.
”We have also seen a reduction in access to healthcare for medical diagnosis of other conditions for the most vulnerable of the population like children, the elderly and those with underlying conditions like diabetes. We have also been observing a steady rise in maternal and child mortality as a result of disrupted essential services. We have also seen life-saving maternal and newborn and child health care services, routine vaccinations, access to care for chronic conditions, such as HIV and other treatment not being delivered in our hospitals,” Aliyu said.

The PTF coordinator noted that certain products like second-line HIV drugs like Ritonavir and Lupineva that are being used for HIV treatment, are currently being used for COVID-19 infection.

He said that hospitals existed to care for patients and not to turn them back, while also pleading with hospital management not to unduly allow patients to suffer because of the coronavirus pandemic.

FG to Begin Decontamination of Hotels Today

The Minister of Environment, Mr. Mohammed Mahmoud, said the ministry would begin from today the decontamination of hotels where some of the Nigerian returnees from abroad were isolated.

Mahmoud said yesterday that the process of decontamination was ongoing in all the six geo-political zones.

He said the ministry’s last sitting with the aviation sector was a critical one as they finalised the type of chemicals to be used for the sector given the nature of security and safety of the industry.

He also added that the decontamination of schools was also ongoing.


FCTA Issues Guidelines on Reopening of Religious Places

The FCT Administration has issued guidelines on the reopening of the places of worship.

The FCT Minister, Malam Muhammad Bello, chaired a meeting of the FCT Administration and leadership of the FCT Christian Association of Nigeria and League of FCT Imams Initiative to review the guidelines issued by the Presidential Task Force on COVID-19 particularly as they concern places of worship.

The meeting received briefings from the FCT COVID 19 Emergency Response Team on the situation of the pandemic in the FCT.
The report of the committee set up by the minister on May 19, 2020, to draw up protocols to be adopted for possible re-opening of places of worship was equally received at the meeting.

After extensive deliberations, the meeting agreed to adopt the Guidelines as released by the Presidential Task Force on COVID-19 with regards to the re-opening of places of worship in the FCT under the second phase of the ease of lockdown for the next four weeks.
Bello expressed the appreciation of the FCT Administration to the religious leaders for their cooperation and commitment towards a safe re-opening of places of worship in the Territory.


Expect High Cost of Air Fares, FG Tells Air Travellers

Meanwhile, the Chairman PTF on COVID-19 and Secretary to the Government of the Federation (SGF), Mr. Boss Mustapha, has admitted that the flight tickets and transport fares in the country may increase after COVID-19.
He said the pandemic had created a turmoil, which would have a spillover on the transport and aviation sector.
Mustapha noted that the need to maintain social distancing will result in a reduction of passenger capacity as a precaution for the spread of the virus.
” Flying after COVID-19 will be an expensive business because if you are going to maintain social distance, what will happen to the flight capacity that will reduce? The flight will use the same fuel and operate the same crew. I am not indulging the transporters to hike their fares, but it will be the reality of the time and what the federal government will do is what the CBN is doing with its stimulus for the economy,” Mustapha said.

Mosques, Churches to Reopen in Lagos June 19, 21

The Lagos State Government has said mosques and churches will reopen to worshipers on June 19 and June 21 respectively.

The government had through the Commissioner for Home Affairs, Mr. Anofiu Elegushi, on Tuesday said churches, mosques, and other worship centres in Lagos would remain shut due to the continued high number of COVID-19 cases in the state.

Speaking at a press briefing yesterday, the Governor, Mr. Babajide Sanwo-Olu, said there will now be restricted opening of religious houses based on compliance seen and reviewed with the Lagos State Safety Commission.

He said: “From 14 days’ time, precisely on June 19 for our Muslim worshippers and from June 21 for our Christian worshippers. We will be allowing all of our religious bodies to open at a maximum of 40 per cent of their capacity and we will be working with them as being expected by the Lagos State Safety Commission.

“But we know that these places of worship have different sizes but even if your 40 percent capacity is really so large, you cannot have beyond 500 worshippers at once, and keeping that maximum 40 percent capacity is really important.
“We will be encouraging people to have more than one service and ensure that they keep their premises clean, disinfect before another round of worship can take place.”

He also advised that the services will only be Fridays and Sunday for Muslims and Christians respectively, adding that all-night vigils and other services must be put on hold for now until the state reviews the current situation.

Countries with High Cases, May Be Banned from Hajj

In another development, the Chairman and Chief Executive Officer of the National Hajj Commission of Nigeria (NAHCON), Mr. Zikrullah Hassan, has said that Saudi Arabia may ban countries with a high prevalence of COVID-19 cases from participating in hajj.

He made this known at a conference hosted by the Association of Hajj and Umrah Operators of Nigeria, which held via Zoom, and had as its theme, “The Future of Hajj and Umrah Operations after the Pandemic.”

In a statement issued after the conference on Wednesday by NAHCON’s Assistant Director of Information and Publication, Mr. Mousa Ubandawaki, the chairman explained that the conduct of hajj may come with certain restrictions as the Saudi government may introduce some guidelines to curb the spread of the virus.

According to him, Saudi Arabia may also adopt other measures like pegging the allocation of pilgrims allowed for each country, banning pilgrims from countries with prevalent COVID-19 cases, and exemption of certain categories of persons like the elderly and those with underlying health challenges, as well as those who test positive for COVID-19.

“Only the Saudi authorities can make the final decision. We can only take our own decision in the light of Saudi one,” he said, adding: “I still would believe that this may come with certain conditions. It may not be the usual way of doing Hajj. People might have to go through self-isolation or outright quarantine.”

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