For stakeholders who have persistently called for the supply of experimental drugs to Ebola patients, a word of caution has come from the World Health Organisation (WHO).
While WHO noted that efforts were underway to accelerate the production and supply of experimental drugs on Ebola, it, however, cautioned against their use.
Besides, the First Consultant Medical Centre Ikoyi, Lagos yesterday confirmed to The Guardian that only one of the two female doctors that were quarantined at the Infectious Disease Unit of the Lagos Mainland Hospital for having primary contact with the index case, Mr. Patrick Sawyer, had been discharged.
The Medical Director of First Consultant Medical Centre, Dr. B. N. Ohiaeri, Sunday, in a telephone interview told The Guardian: “There were two female doctors. One of the female doctors has been discharged and she is clean, negative and fine. The other one is still there and still receiving treatment.”
Ohiaeri further explained: “There are two female doctors. One is the senior one and the other, the junior one, a medical officer, has been discharged.”
The Minister of Health, Prof. Onyebuchi Chukwu, told journalists on Saturday in Lagos that the first Nigerian Ebola patient had been declared fit and discharged from hospital.
Yesterday, the minister clarified that the infected doctor discharged from the hospital was not Dr. Adadevor as reported in some media (not The Guardian). The Special Assistant on Media and Communication to the Minister, Dan Nwomeh, said the name of the discharged doctor who had recovered was not Adadevor.
A statement issued by Nwomeh yesterday noted: “It has been brought to the attention of the Honourable Minister of Health, Professor Onyebuchi Chukwu, that the first Nigerian to be diagnosed of Ebola Virus Disease, a female doctor, who treated the index case and who was discharged home from the ward yesterday, is being reported in some section of the media to be one Dr. Adadevor.
“The Honourable Minister wishes to clarify that the name of the patient is not Dr. Adadevor. This should be noted. The minister’s statement yesterday while indicating that it was a female doctor did not indicate the name of the patient.”
Trial drugs limited – WHO
WHO said at the weekend that the supply of experimental drugs was limited and may not be augmented for several months to come.
“Even then, supplies will be too small to have a significant impact on the outbreak,” the organisation said.
WHO’s position was disclosed by the group’s Media Officer, Gregory Hartl, who stressed: “The scale, duration, and lethality of the Ebola outbreak have generated a high level of public fear and anxiety, which extends well beyond West Africa. Such reactions are understandable, given the high fatality rate and the absence of a vaccine or cure.
“Recent intense media coverage of experimental medicines and vaccines is creating some unrealistic expectations, especially in an emotional climate of intense fear. The public needs to understand that these medical products are under investigation. They have not yet been tested in humans and are not approved by regulatory authorities, beyond use for compassionate care.
“Evidence of their effectiveness is suggestive, but not based on solid scientific data from clinical trials. Safety is also unknown, raising the possibility of adverse side effects when administered to humans. For most, administration is difficult and demanding. Safe administration of some requires facilities for intensive care, which are rare in West Africa.”
He went on: “WHO has advised that the use of experimental medicines and vaccines under the exceptional circumstances of this outbreak is ethically acceptable. However, existing supplies of all experimental medicines are either extremely limited or exhausted.
“WHO welcomes the decision by the Canadian government to donate several hundred doses of an experimental vaccine to support the outbreak response. A fully tested and licensed vaccine is not expected before 2015.
“Another source of public misunderstanding, especially in affected areas, comes from rumours on social media claiming that certain products or practices can prevent or cure Ebola virus disease.
“Decades of scientific research have failed to find a curative or preventive agent of proven safety and effectiveness in humans, though a number of promising products are currently under development.”
On talks about other possible therapies for Ebola, the statement noted: “All rumours of any other effective products or practices are false. Their use can be dangerous. In Nigeria, for example, at least two people have died after drinking salt water, rumoured to be protective.
“The most effective personal behaviours are avoiding well-known high-risk situations, knowing the symptoms of infection, and reporting early for testing and care. Evidence suggests that early supportive care improves the prospects of survival.
“The Ebola virus is highly contagious but only under very specific conditions involving close contact with the bodily fluids of an infected person or corpse. Most infections have been linked to traditional funeral practices or the unprotected care, in homes or health facilities, of an infected person showing symptoms.
“Apart from these specific opportunities for exposure to the virus, the general public is not at high risk of infection.”
The WHO reiterated its position that the risk of transmission of Ebola virus disease during air travel remains low.
The Director of WHO Global Capacity Alert and Response, Dr Isabelle Nuttall, in a statement said: “Unlike infections such as influenza or tuberculosis, Ebola is not airborne. It can only be transmitted by direct contact with the body fluids of a person who is sick with the disease.”
On the small chance that someone on the plane is sick with Ebola, the likelihood of other passengers and crew having contact with their body fluids is even smaller. Usually when someone is sick with Ebola, they are so unwell that they cannot travel. WHO is therefore advising against travel bans to and from affected countries.
Nuttall said: “Because the risk of Ebola transmission on airplanes is so low, WHO does not consider air transport hubs at high risk for further spread of Ebola.”
In early August, after the meeting of the Ebola Emergency Committee under the International Health Regulations, WHO provided advice to countries to help contain the current Ebola outbreak and prevent it from spreading further.
The guidance recommended: No ban on international travel or trade; that countries be prepared to detect, investigate, and manage Ebola cases; including access to a qualified diagnostic laboratory for Ebola virus and, where appropriate, the capacity to identify and care for travellers originating from known Ebola-infected areas who arrive at international airports or major land crossing points with unexplained fever and other symptoms. Worldwide, countries should provide their citizens traveling to Ebola-affected countries with accurate and relevant information on the Ebola outbreak and measures to reduce the risk of exposure.
Despite the assurance from the WHO, Cameroun has closed its borders with Nigeria for a minimum of one month.
Fashola: patients are receiving the best care
Meanwhile, the Governor of Lagos State, Babatunde Fashola, yesterday denied the charge made last Thursday by the families and colleagues of the victims of the Ebola infection that they had been neglected by the government.
The families and colleagues had also called on the US government to intervene to avert their death from the disease.
However, in a state broadcast, Fashola said it was not true that they had been neglected or there was a paucity of fund, stating: “They are receiving the best care that the experts have recommended to us, given the circumstances.”
He reminded Lagosians that the state was perhaps facing its biggest challenge to public health and the safety of human lives with the discovery of the Ebola virus in the state, which “poses a threat to the primary purpose of our government which is to save lives”.
He added that in the light of the text messages, e-mails and telephone calls that he had received, it had become necessary to reiterate the measures adopted by the Lagos State Government to keep the people in the state safe.
“This has become imperative moreso in the light of allegations that are making the rounds, either that victims are being neglected, or that a useful drug or vaccine is being rejected or that there is a shortage of funds. I wish to state very categorically that none of these is true.
“What is true is that we should perhaps never have been in this situation, but we are now in it. What is true is that the Ebola virus did not break out from within Nigeria, it was imported into Nigeria.
“What is true is that we have followed all the contacts that we know who have had primary and secondary contacts with the patient who imported the virus into our state, or with people who had contact with him.
“Because we had to react to an unexpected situation, we had to react in a proper and methodical way, according to acceptable global health standards,” he said.
Although he acknowledged the death of four persons, Fashola assured Lagos residents that it would be ‘fair to say that we are not yet at an epidemic stage and we are determined to do everything not to get to that stage; because of the grave consequences to the safety of human lives”.
He added: “We have provided information to the public on all state-owned media, while the private media have commendably joined in this effort. There is also information available on the social media platform.
“Since Monday last week, precisely on the 11th of August, I commenced meetings on an almost daily basis with stakeholders in our society, religious leaders, traditional rulers, market men and women, community development associations, to brief them of the risk, to re-assure them that we are daily gaining control, to advise them and all of you to be cautious but not to panic.
“My view of the fact that we are gaining control is informed by verifiable facts that I receive daily from our health workers that all the cases of those who have either unfortunately died, or those who are sick, and those who are contacts under surveillance are directly traceable to the imported case.
“There is also now the news that a confirmed victim has fully recovered, which reinforces the advice from our experts that it is not an automatic death sentence.
“This is encouraging news from which our containment strategy can profit greatly, because it means that we do not have any case of unknown origin, which will raise the risk of an epidemic.”
Fashola said the challenge of the virus was big, but the state government’s resolve to contain and defeat the scourge was even bigger, adding, “That resolve is demonstrated by the courage shown by the first set of health workers at state and federal levels who stood up to be counted, and the leadership of the state and federal Ministries of Health with the support of our international partners.
“In spite of fear, they stood up to be counted at a time of grave danger. We should salute their courage, professionalism, patriotism and humanitarian disposition.
“They are the heroes and heroines that we have looked for, for a long time. I cannot thank them enough.”
While assuring the health workers of their safety and promising to give them the confidence to proceed, he appealed to the public not do anything to distract them or demotivate them.
“What they need now is our encouragement and support to gain even stronger control of the situation. What they do not need are rumours and the distractions that they can bring with them.
“I appreciate the concerns and anxiety that friends and relatives of sick victims must be going through. I assure you that our thoughts and prayers are with you.
“I understand that you expect special care for your loved ones, and this is to be expected. I assure you that they are receiving the best care that the experts have recommended to us, given the circumstances; because they say that this is the best way to proceed especially because experienced personnel in Ebola containment and management have always been a challenge.
“What will be helpful to the situation now is additional medical personnel, who are willing to volunteer to join hands with those on the frontline.”
He cautioned that volunteers who sign up cannot immediately start to participate in the isolation ward where sick people are being treated, no matter how qualified and experienced they are.
“They must undergo a few days of training by our international body of advisers and understand the protocol for operation in the isolation ward for their own safety, and the sustenance of the containment plan to stop the virus from spreading.
“To those who are seeking to do brisk business from this situation, I offer a word of caution and re-assessment. This is not our way. I must also say to those who are seeking to raise funds that we appreciate your concerns but we are not yet at a fund-raising stage and I cannot foresee that eventuality,” Fashola added.
He stressed that Lagos has enough resources to fund everything that is needed, pointing out, “This is what your taxes can do in emergencies. Our House of Assembly has thankfully approved a request for any needed expenditure.”
He further acknowledged that President Goodluck Jonathan and the Minister for Health had shown the appropriate levels of concern about the national and global risks that Ebola poses and expressed confidence that they would provide funds should the need arise.
“The combined team of state and federal personnel, our international partners, are daily sharing information with the public and the federal government about the status of the patients and contacts in a transparent way, and we should all please listen to them. They are the ones who have the facts.
“What all of us must do is to follow all their advice, especially about reporting any suspected cases and about increasing our personal hygiene by constantly washing of our hands with soap and water.
“We should stop unhygienic practices of urinating in public and defaecating in public because those are body fluids and waste through which the virus is known to thrive.”
He reminded Lagosians that this week and the next one would be the most challenging that the state expects to pass through, saying. “Last week, we cleared a total of 61 contacts after the 21 days surveillance which is the known lifespan of the virus.
“These people were not sick. They were persons who needed to be monitored because of real or suspected contacts to be certain that they did not eventually fall sick.
“We cautiously wait to see how many more people will be cleared and hope that there will be no new cases. Nevertheless, our strategy is to prepare for the worst by making plans to expand the facility to take any new case, while we hope for the best.”
Fashola noted that this was the first time that the virus had infected people in an urban centre, making “it is a steep learning curve for everybody but it presents a huge opportunity for us as a people to show the world how to overcome it.
“With your support and understanding, we will do no less, because we intend to overcome and defeat this threat.”
Enugu is Virus-free
Also assuring the people of his state, the Governor of Enugu State, Sullivan Chime yesterday said that the state was free of the Ebola virus.
Speaking through his Special Assistant on Health Matters, Johnny Ezievuo, the governor clarified that the state government had mobilised all health institutions and personnel to effectively contain the spread of the dreaded disease.
Ezievuo explained that all those who were suspected to have had contact with the nurse who travelled from Lagos to Enugu have been investigated and had been given cleared of any infection.
According to Ezievuo, “Even with that assurance, we are not taking anything for granted. We are taking all precautionary measures to ensure that nothing is left to chance. Interestingly, health care delivery is one of the cardinal programmes of Governor Chime’s administration.”
Ezievuo observed that all the programmes of the state government were geared towards ensuring that people are sensitised on how to prevent the spread of the virus. Additional report culled from Thisday, The Guardian