As the number of COVID-19 cases continue to rise and some of the people who test positive for COVID-19 refuses to go to isolation centres, thus, the idea of treating patients in there comfort zone (home) came in, which many states are not in support of.
The home treatment strategy was proposed in Lagos State as part of the way to curb the rate at which the virus spread and manage the available isolation center in the state from being filled up.
Meanwhile, many states have said they will continue to treat the infected patients at isolation centres rather than resort to home treatment option.
They noted that getting persons who had tested positive for the virus to the isolation centres remained one of their strategies to contain the spread of the deadly virus.
Lagos State had on Thursday said it was considering adopting home treatment option for patients with mild symptoms, noting that it would soon release the guidelines for the treatment option.
The state Commissioner for Health, Prof Akin Abayomi, said the decision to consider home treatment for some COVID-19 patients became necessary because some residents who tested positive for the COVID-19 refused to go to the state isolation centres and had been practising self-treatment in various places.
He said, “There are people who are already practising self/home isolation on their own, because we can’t find them. The (phone) numbers they give us may be false or they don’t answer their calls. When you go out to pick them at their residences, they would have absconded from their residences. So, they are isolating themselves in different places.
“In effect, the concept of home-isolation is being practised by many Nigerians even though it is not yet a state or national practice.
“The people of Lagos are practising home isolation which is one of the reasons why we as the government are trying to transition to home care because it is happening anyway, so we might as well regularise it and make it an official option.”
The commissioner said the state isolation centres were filled to 60 per cent capacity, adding that the centres had yet to fill up because as patients were being admitted, some were being discharged.
There were 245 new cases on Friday, pushing the total cases to 7,261, with 10 new deaths and 100 new persons discharged.
But in separate interviews with our correspondents on Friday, some states said they were not considering the option and they would rather make use of the isolation centres.
In Kwara State, the Chief Press Secretary to Governor AbdulRahman AbdulRazaq and spokesperson for the state COVID-19 Technical committee, Rafiu Ajakaye, said the state government was not thinking of treating patients at home as it had sufficient bed spaces in its isolation centres.
He said apart from the 600-bed space at the Muslim Pilgrim Camp, another isolation centre had been established at the state General Hospital in Offa.
He said, “The possibility of treating COVID-19 patients at home does not arise in Kwara State at the moment and certainly not anytime soon. This is because the occupied spaces at the state’s isolation facilities are not even two per cent.
“The focus of the administration is to continue to flatten the curve of infection, including preventing community transmission of the virus, so that we never have to exhaust our bed spaces.”
Kwara State, as of Friday morning had 66 confirmed cases with 25 discharged and one death, while the results of 96 samples were being awaited.
In Katsina State, the state government also said it was not thinking of treating COVID-19 patients at home, adding that it currently had enough bed spaces in its isolation centres.
The state Commissioner for Information and chairman of the COVID-19 Enlightenment committee, Sirika Abdullahi, said, “No, we are not thinking of managing patients with COVID-19 at home. Our facilities can take care of them. We appeal to our people to shun large crowds, maintain social distancing, always wear face masks and ensure they frequently wash their hands with soap.”
Katsina has recorded 12 deaths from COVID-19 while the state now has over 300 cases of the pandemic.
Also in Ondo State, the Commissioner for Health, Dr Wahab Adegbenro, said the state had enough facilities to accommodate all its confirmed cases.
He added, “We already have a 300-bed capacity isolation centre, but we currently have 22 cases. One is dead and 15 have been discharged while we have six left in the isolation centre. So, treatment of patients at home is out of it and we are not praying for that to happen.”
In Borno State, the Commissioner for Information, Mallam Babakura Abba-Jatto, said it was not considering home treatment for COVID-19 patients so as not to take chances with the health of the people of the state.
He added, “For now, we have not reached that stage. The two centres in Maiduguri have yet to be full. We are not taking any chances.”
Also, the state Deputy Governor, Usman Kadafur, in a terse response to one of our correspondents enquiry, said the state had yet to reach the stage Lagos State was in.
In Gombe State, the Commissioner for Health, Dr Ahmed Gana, said the state was not considering home treatment at the moment unless there was an exponential increase in the number of cases. He noted that there were few cases in isolation centres and that over 91 had so far been discharged.
He said, “We are not contemplating home isolation at the moment because of the high tendency of non-compliance with the requirements by most people. However, this may change if there is an exponential escalation of the cases beyond the planned capacity.”
In Edo State, the Special Adviser to Governor Godwin Obaseki on Media and Communication Strategy, Mr Crusoe Osagie, said the state had no plan to treat mild cases of the novel virus at home because the isolation centres in the state could contain all its COVID-19 patients.
He said, “We are still able to accommodate most of our positive cases in the isolation centres that we have. We have a relatively large number of isolation wards relative to the number of patients we have. In Edo, our patients are still less than 150 at the moment and the isolation spaces we have are slightly above 500, which means we can comfortably admit at least 500 at a time in our isolation centres.”
He added that the state had holding centres for those with severe symptoms.
In Ekiti State, the Commissioner for Health, Dr Mojisola Yaya-Kolade, said on Friday that the state had not recorded any upsurge in COVID-19 cases that would warrant the adoption of home treatment option.
She stated that the state had so far recorded 20 active cases and only two fatalities, noting that the only challenge the state was facing had to do with people sneaking into the state.
She added, “As of now, we have four patients in our isolation centre and we have a 120-bed isolation centre in operation, so we have no compelling situation to start isolating suspected COVID-19 patients or those with mild symptoms at home.”
She said their findings had established that the patient who died in the state on Wednesday was not infected in the state but in Kwara State where she came from.
In Sokoto State, the Commissioner for Health, Dr Mohammed Inname, said he would only speak at the next briefing of the state task force, but a member of the task force told one of our correspondents on condition of anonymity that the state was not considering it.
“Our case has not got to that level and we are nowhere near the capacity of our isolation centres to be considering managing cases at home,” the source added.
Meanwhile, some states have said they are not averse to home treatment for patients with mild symptoms.
In Ogun State, the Commissioner for Health, Dr Tomi Coker, said the state had already commenced home treatment for COVID-19 patients. This, she said, was to stop people who test positive from absconding owing to stigmatisation and not because of bed space shortage.
In an interview with one of our correspondents, she, however, cautioned that the move was not to encourage patients to shun isolation centres.
She said, “Ogun State has started that already. We should, however, be careful about it. We are not saying going to the isolation centre is optional. I’m not encouraging people to stay at home, but if someone who tests positive insists they are not coming in, we just have to go to them and treat them so they don’t spread the virus.
“We have enough beds to treat people and with the option of home treatment, we will never run out of beds. Many people might run away after testing positive, so rather than run away, we treat them at home.”
In Osun State, the Commissioner for Health, Dr Rafiu Isamotu, said in advanced countries, only severe cases were treated in hospitals as he expressed hope that the state would not get to the stage of considering home treatment.
“We hope we won’t have reasons to consider house treatment in our state. Lagos may not have other options, because of the fast rate at which the disease is spreading,” Isamotu said.
In Kano State, the Coordinator of the Task Force Committee on COVID-19, Dr Tijjani Husain, said the state was looking critically at the national guidelines for home treatment before it would consider it.
“We are critically looking at the guidelines to see the possibility of treating the patients at home because each state has the liberty to implement the guidelines,” he added.
He however declined to state whether the state was facing a shortage of bed space.
The Director, Infections Control, Aminu Kano Teaching Hospital and Chairman, Risk Communication Committee on COVID-19, Prof Isah Abubakar, said recently that the state was targeting at least 5,000-bed spaces.
“In the next one month, Kano is targeting 5, 000 or more beds to be provided at isolation centres in view of the increasing number of COVID-19 cases in Kano State,” he added.
In Oyo State, the Incidents Manager for COVID-19, Dr Olabode Ladiipo, said the state task force would review the protocol for treatment of patients who test positive for the virus in view of the growing number of cases.
He said, “We are reviewing our protocol for admission now. We are looking at the situation in which we might have to check whether someone is symptomatic or not. If there are no symptoms and we look at the result and the viral load is not heavy, we can consider their home status if they have an ideal home for isolation. Then, we might be considering self-isolation.”
Ladiipo said contact tracing in the company where many staff members tested positive was ongoing, adding that the state was looking at the purchase of more testing kits and reagents owing to increase in cases.
Meanwhile, the Director-General, Nigeria Centre for Disease Control, Dr Chike Ihekweazu, had explained why the Presidential Task Force on COVID-19 could not go ahead with home treatment of COVID-19 patients it once proposed.
He said, “We have struggled with these decisions in Nigeria because we are struggling with the realities of where we live and the contexts that we live in. We want to prevent transmission; therefore we want to institutionalise the treatment of everyone.
“We recognise that the circumstances that many Nigerians live in make home isolation difficult and sometimes an impossible option for many people who live in very tight accommodation in family groups and communities.” He added.
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