A professor of Virology, Department of Virology, University of Ibadan and University College Hospital, Prof. David Olaleye, in this interview stresses the need for adherence to COVID-19 protocols, policy evaluation by the Federal Government, infrastructural development and citizen education as schools resume.
Nigeria recorded 2,000 cases of COVID-19 with death toll rising beyond 1,420 as schools resumed across the country on Monday, how wise is the decision to reopen the schools?
As I once said, it is a matter of balance; a very delicate balance between what we have to do and the unfortunate situation of the pandemic. One basic fact is that this virus is not going to disappear just overnight. Increasing the rate of infection is an indication that the virus is getting adopted to human infection. The fact is that respiratory viruses are very difficult to control because of the mode of spread. You know, we are sharing the same air. Then school or education is time-bound. One has to attain a certain level at a certain age. There is no doubt that school closure or lockdown has been shown to help but you really also have to look at our situation in Africa. When schools are shut down in the West and other advanced countries, they are able to continue their education using the virtual method and other platforms, but it is really very difficult to achieve such here.
Do you consider another lockdown a wise decision at this time?
Some states locked down for several weeks or months last year, but what do we have today? We still have a very high rate of infection. In places where lockdown becomes effective, the essence is to keep everybody indoors and when you now have symptoms, you call and they take you to an isolation or treatment centre. Such things do not easily come by here. Some of these things that we copy, when you look at the economic side, is huge. Look at schools; students are there playing all around and doing all sorts of things, while the parents are out there.
So, what should the nation do in that respect?
What we should do is to ensure that we adhere strictly to the measures that have shown to be effective. For hand washing and hygiene, common detergent will kill the virus. So, wash hands when you come from outside under running water. Anywhere that you are not alone, you have to use a nose mask, because you interact with people and you don’t know the person who has been infected or not.
Over 80 per cent of those who are infected are asymptomatic, so you don’t just assume. The statistics that we have now is indicating that a major channel through which the virus spreads is the family. If one person gets infected, before you know it, the whole household gets infected. People travel from different places and they get infected and then infect those who are at home. So, what is the principle to apply? The principle is physical distancing. You should combine all the measures; one should not be used as a substitute for the other.
To interact with people, use your face mask, observe physical distancing, and as you get to where you can wash, wash your hands with detergent under running water. If you picked the virus from where you were coming from, you would have washed it off. You must actually ensure that there is enough distance. People should know that the virus is not actually in the air. It is not in the air, but it goes directly from one person to the other through droplets and all sorts of things. When you maintain a good distance, the droplets of the other person talking to you would have dropped down before getting to you. Then use 70 per cent ethanol spray on surfaces. It will die.
These are the measures that are non-pharmaceutical because they do not involve the use of drugs. They work very well. These are what we should ensure are available and done in schools. Otherwise, how long do we close schools? As teachers monitor the children in schools, parents should do the same at home. This idea of pecking everybody doesn’t work. It does not show a good understanding of the mode of spread. You monitor. That is what they do in other places and this has shown to be effective with influenza and other respiratory viruses; so, we should adopt it and stop copying things from outside.
They do things that soothe their environments. We should do things that soothe our environment. If you lock down, how does the woman that hawks bread survive? How will the one who is surviving on okada manage? We are all human beings and survival is the first instinct of every human being. You must survive to do every other thing. If you lock somebody for two or three weeks, how will the person get means? You want such a person to comply? He will not. Somebody is grinding pepper and has four or five children at home to feed and you say because of coronavirus the person should not go out. The person will say which one comes first? Should I wait for these children to die of hunger or face coronavirus and pray that it should not affect us? Now, put that against educating that person on how to ply her trade in a safe manner by observing hygiene, wearing masks and taking care of and observing her children. They will survive and there won’t be infection.
People handling these policies are on government salary. Whether something happens or not, they will collect their pay. But what is the percentage of people taking salaries in this country? It is less than 10 per cent of the population of this country, whether in private or public organisations. There is going to be a lot of backfiring or consequential effects of lockdown. All these will be negative. We don’t solve one problem to cause another.
What should be done?
What should be done is to sit down -people in education and people in policymaking – it is going to be a lot of work for them. But if you talk of lockdown, how long are we going to lock the children at home? Now, the hearts of the children are stiff. Some of them keep hawking on the road. When you close schools, they are doing something else. You can’t keep children at home from morning till night, because of COVID-19. It is the duty of parents and government agents – in this case teachers – to really teach them about COVID. What is it? Why are we worried and why must we worry about it? How can we prevent it? You will see that the children will start doing it right. That will be with understanding and not reeling out directives. Directives don’t work.
Aren’t experts anticipating higher rates of infection and death with the resumption to schools?
I am not saying resumption will not translate to more cases, but we should do everything possible for it not to translate to more cases. Whether schools resume now or not, the schools will still resume anyway. It is how we handle it and what we do that will make the difference. Since we know the prevention strategy, it will be nice for us to ensure prevention. That is what we should lay emphasis on. We cannot close schools forever and the virus is not disappearing now. Even when the developed countries are vaccinating, they are still educating that the people should take the measures seriously.
Nigeria is expecting 100,000 doses of vaccines, what measures should be applied for the safe keeping and distribution of the vaccines?
It depends on the vaccine that they are importing. If they are bringing in the Pfizer vaccine, it must be stored at a temperature of 70 degrees centigrade. It has to be stored at ultra-low temperature. Except those core virology laboratories in the country that have ultra-low technology. You know, this is the government, resources are there if that is what they want to do. Even for the distribution, you have some special crates to carry it around. But if you ask me, I will suggest vaccines that can be stored at refrigeration temperature. That one is easily manageable in our system. With very good supervision and handling, that can be easily managed in the country.
The question is what will 100,000 doses do for a population of over 200 million? That is about 1,500 thereabout per state. Where will that go? I think it is just for a start. For 100,000 doses, we are not talking about vaccination yet. Even if you talk of health workers, who are at the frontline, you then talk of the aged, people with co-morbidity, where does that go? Maybe it is a trial dose to see if it will work or not.
What are the side effects of taking degraded vaccines?
If a vaccine is degraded, it will not work; that is simple. At least, I know that is the case in vaccines. But for drugs, it is completely different and that is not what we are discussing. It can be toxic or poisonous for drugs. For vaccines, it means one has been given false protection and it is very dangerous for somebody to think that he is protected whereas there is nothing like that.
Which one takes higher premium, adherence to protocols or procurement of vaccines?
Well, both are, but at the stage we are now, you just talked of 100,000 doses for the entire country and you know that number goes for 50,000 people. By my own thinking, that (vaccine) is not there yet. The thing to do now is adherence to the measures that we know work and have been proven to work. Even then, where a vaccine is available, a combination of the vaccine with adherence to protocols will be necessary. Principally, we don’t know how long this vaccine will protect. If one is vaccinated today, we don’t know how long the vaccine will protect against infection. The risk is for anybody to say because I had been vaccinated, I can disregard the measures. That will be unreasonable and suicidal.