Lara Adejoro
A professor of medical virology at the College of Medicine, University of Lagos, Sunday Omilabu, in an interview with LARA ADEJORO, says Nigeria needs to screen travellers from China and other countries with an upsurge in COVID-19 cases
With high cases of COVID-19 being reported in China, the United States, and the United Kingdom, is there a need for the Federal Government to review its relaxed COVID-19 protocol to curb fresh outbreaks?
Yes, there is an urgent need now for our team on COVID-19 to look into the reports from those countries that have seen an upsurge in the number of cases and deaths coming from COVID-19. It will be proper for our country to look into it, vis-à-vis those travelling to those countries and people coming from those countries for visitations. They should be screening them to make sure that they are free of the virus, or if they are tested positive, they have to be isolated until the virus is cleared from their systems, just as we did during the serious outbreak of the virus in Nigeria.
This will prevent them from spreading the virus in the country because we know that the virus is airborne and can easily be shared. We have to be active on all our borders where they come through, especially at the airports. They have to look out for those coming from those countries, either through Lagos airport, Abuja airport, Kano airport, or other international routes. We should be on the lookout for travellers from all the countries where they are having a surge in cases of COVID-19.
What are the factors driving the high number of cases and deaths?
According to what we’ve heard, it’s SARS-CoV-2 variants because there are mutations. The virus has mutated seriously, and they have a generation of mutants that the vaccines people have received are not adequately protecting them against. The winter weather is another factor because the virus grows well in cold weather.
What are the variants, and how virulent are they?
There are so many variants that they have reported now, like the BF.7 in China and the XBB.1.5 in the UK and the US, that the immunity is not strong enough to fight them, which is why they are virulent. B.5.2.1 has been detected in Nigeria, but there are now new strains from those mutants. The mutations are generating new strains from them.
They are virulent, and that is why people are dying. You can see the number of deaths in China; it shows that the strain will determine if it is more virulent; otherwise, people should have had enough immunity to suppress it. But because they are new strains, the immunity finds them too foreign to counter them, and that is why people are dying, and the cold weather is helping the virus to grow more. Even in the UK and the US, they are all in the winter season now.
With our level of vaccination, can we escape a resurgence if we have such variants in the country?
We need to do surveillance—a scientific study of our response to the vaccines—before we talk, not just merely give the vaccines. Some people may develop immunity, and some may not. So, we need to actually check the level of our immunity to the vaccines we received before we can determine the level of our immunity to the virus and whether we will be able to counter it if we have a resurgence. Scientifically, we need to do that, not just based on the number of vaccines taken, but also to check whether we have enough antibodies.
What is your assessment of the surveillance system in the country now?
The surveillance system is still not where it is supposed to be for lack of funding because you have to mobilise people who will go around to collect information and samples. The level of health education is going down because of the impression that we won’t have the virus again. We need to restart so that people are aware that, based on reports from China, the United States, and the United Kingdom, we may have the virus again. There is a chance that the virus will resurface, particularly in those countries.
According to the Director-General of the Nigeria Centre for Disease Control, the arrival of Omicron demonstrated that travel restrictions had no public health benefits but were disruptive to people and businesses. What is your take on this?
What he means by that is that the virus is already here in the country, and if we are now saying we are now restricting people at the airport, that will not have any impact since the virus is in the country. Once the virus gets into the country and the communities, there is no point in restricting people’s movement.
But now that some countries are reporting an increase in cases and deaths, will the restrictions be beneficial for us in the country?
That is, if we can start now before we allow the virus to come into the country, that will help. So, we need to be screening people who have symptoms and placing them on surveillance, restricting them, testing for the virus, and making sure that the virus has died in their system before they are allowed to move into the country. That is when the restriction will be helpful.
Morocco, Ghana, and other countries have placed restrictions on travellers from China, but the Presidential Steering Committee said there are no red flags to warrant such restrictions yet. What is your take on this?
It is left to them because some countries have begun to take precautions to keep the virus from entering their environments.
There are concerns that China hasn’t been transparent with its data. What is your take on this, and how will a specific and real-time understanding of the situation in China help in an effective response?
Ideally, international health regulation demands that when it comes to issues of public health importance, there should be openness, especially with data sharing, so that it will help other countries prioritise their control measures. But they have been saying China has not been upright in terms of figures because it is the figures that will tell us how rampant the virus is and how to plan prevention and restriction. At least, we are now gathering that they now have more cases surging; the figures show that there is an increase in cases and there are more mortalities. The data will help countries start taking measures.
What can China, the US, and other countries do to reduce the large number of cases and deaths they are reporting?
There is supposed to be more research into the development of vaccines that will be more potent and drugs that people can use, as well as isolation and restrictions. You can see that the Chinese are not observing the restrictions that are in place. All these could aid in the spread of the virus. When we have good vaccines and good antiviral drugs and people are restricting their movements and screening themselves regularly, just as we had restrictions during the heat of the virus in Nigeria, those are the kinds of things that are very helpful.
Shouldn’t we have come to the end of the pandemic thus far?
The whole world knows that the virus is still there, and that is why the World Health Organisation said that the virus is still there and we should not relax. It is now left to the countries to start looking inwardly at how to address the cases of COVID-19. The WHO has said that the virus is still there and we have not conquered it completely, so we should not relax. We should continue to look for possible traces of the virus so that we can quickly prevent its spread. We need to continue with our surveillance and inform our people regularly about the situation on COVID-19.
What should be the responsibilities of Nigerians so that we don’t have a fresh outbreak in the country?
Our responsibility towards preventing the virus is what is more assuring and active when we do a self-assessment of the situation. All of the non-pharmacological measures that were implemented, such as avoiding crowds and wearing face masks as we did during COVID-19, must be reinstated, especially now that the weather is cold, as there is a tendency to have an increase in respiratory tract infection, especially during this cold weather, and people should not expose themselves to cold weather, which could support the growth of the virus.
Is there a need for the PSC to reinforce the use of facemasks and reduce large gatherings?
They need to start stimulating Nigerians now that we have seen an upsurge in cases in other countries, and we need to start applying non-pharmaceutical measures and health education so that people don’t have the impression that COVID-19 is all over because it is not over yet.
Apart from COVID-19, we have other diseases like cholera, measles, meningitis, and others that we are battling in the country. What is the way out of these?
For cholera, we have to educate people and let them know the type of water they can use or provide enough water for people because we know that the source of cholera is a poor hygienic society and that meningitis is high during the dry season because the bacteria thrive during the dry season.
For measles, it is also high during the dry season, and that is why we have to be more active in terms of measles immunisation.
We need to increase our level of health education during the dry season so that there will be surveillance where there are suspected cases, and they should call the attention of the healthcare officers at the local government level. We need to be proactive and make sure that we supply them with enough water.
As we speak, not many states have adequate measles vaccine coverage and we should not rely solely on vaccine coverage. We need to check to see if the children respond to the vaccine for conversion.
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