By Ejiro Umukoro
In the second week of June on a Sunday, Yecenu Sasetu, a health journalist in Abuja and a tireless safety and hygiene buff felt a bit of sore throat while at home. She chucked it off to the seasonal flu. Then the fever started, the headaches became persistent, aches and pains throb in every part of her body and her temperature continued to spike. That was when it hit her that this was not the typical flu.
She reached out to friends and families who are medical experts. “I normally don’t take drugs without getting a test,” she says, however under the circumstance she did accept their recommendation to buy an over the counter anti-malarial drug. Two days later, although the fever abated, she was left weak, fatigued, and constantly slept as though she had taken a sleeping pill.
Three days thereafter she lost her sense of smell. “That was when I got alarmed. I knew I had to get tested, even though I hardly go out because I usually do my interviews from home and I have been working remotely. I even made sure I only go to the store at 6:00 a.m.” Sasetu explains.
For Lacy (not her real name), her symptoms “started off with dizziness during the last week of April. My head just pings! and I throw up. The vertigo was strong. So I went to a private hospital, ran some tests and the doctor placed me on malaria treatment. But by the second week, the fever wasn’t going. That was when I began to feel cold and the catarrh was bad. ” She bought over the counter drugs for cold, but it persisted. “At that time I just felt all I had was a terrible flu and it will go away.” Lacy says.
However, a few days later, she lost her appetite, sense of smell, and couldn’t breathe well. Up till this point, it never occurred to Lacy that this may be a different kind of flu. She resorted to using local herbs.
“I am an agbo person. So I got agbo for malaria, got some neem leaves (dogon yaro), papaya leaves, lemongrass, ginger, garlic, and put them to boil because the second test I did again showed I had malaria plus-plus.” She could not understand why malaria refused to abate. She told her brother to keep his distance from her even though her sibling helped with running errands for her. Rather than go to the hospital for tests for her status, based on the negative reports she had heard from many of those who had gone for the Covid19 test, Lacy opted to stay at home and treat herself for what she believed to be a bad flu but suspected could be the virus as she displayed all the symptoms.
“For me, it was just a terrible bad flu. But I made sure not to come in contact with anyone because I don’t think I would have been able to live with myself knowing I may have infected others. So I locked myself up at home practising self-isolation.” Throughout the course of the disease, she says “I kept breathing through my mouth, chewed lots of ginger and garlic and took shots of the liquid herbs mixture every four hours.”
For Sasetu getting tested proved more difficult than she expected. “By the time l started displaying the symptoms and needed to get tested, the FCT frontline workers were on strike because of lack of funding and non-payment of their allowances. So the FCT emergency number went unanswered.”
As a health journalist, she explored other options using her network with access to medical doctors to get tested. She says ‘but there was no team to take my sample, so I had to take it to them. I was told I would get my result in 24 hours.” The next day her COVID-19 status was confirmed positive. Unfortunately for Sasetu due to the strike, the admin office did not get back to her for three days. “I was rattled. I didn’t know if what I was doing was enough. I didn’t have any guidance on what to do.” she explains.
However, someone from the media office of the NCDC reached out to her and she explained the steps she’s taken. However, when her report was checked she says “the NCDC told me they could not find my result. That they didn’t have my records.”
At this point, Sasetu’s only concern was focused on contact tracing, worried for her friends and families who have come in contact with her, and who needed to get tested too. She says “even though I wasn’t as sick as others who had COVID-19, my concern was I needed to know what drugs I had to take and if I had to go to an isolation centre or not.
And if I was going to do home care I needed guidance and counselling on what to do. It was at this point I knew the value of having mental health experts as part of the COVID Presidential Task Force (PTF) team. The feeling of abandonment I felt was real. I felt like I was a statistic because there was no communication.”
Taking the route of self-care in managing her COVID-19 was the only option left for Sasetu. With support from family and friends, she self-isolated and put in place stringent hygiene practices keeping herself locked away in a well-ventilated room and making sure she had her own personalized utensils which she used for the 25 days she was in self-quarantine and battled with the symptoms of the disease. She lost her appetite, sense of smell and became weak. Her family could only watch from a distance because she would not let them break the social distance protocol to help her with basic needs. “Then one night I woke up and I began to write my will because of how bad I began to feel.”
Looking back, Sasetu says “I was so overwhelmed, nauseated, couldn’t move, too weak to get up and I felt annoyed and embarrassed and I think when it happened to me it was a confirmation of the fear that I had.
It was like my mind attracted it and it came to pass. What I feared came upon me.” Thankfully, none of her friends and family members tested positive. “My family helped me pull through COVID-19.
I am so grateful for their support,” she says.
For many who get tested and confirmed positive, the general complaint made is that the NCDC does not carry out proper followup with patients whose status is positive. This, more so, during periods when health and medical workers go on strike. With the number of COVID-19 cases on the rise, public officials and everyday persons who test positive are opting for home care self-treatment and guidance as the health care facilities and workers are not enough to care for these large numbers.
The general consensus, Charles Aniagwu, Commissioner for Information in Delta State and also a COVID-19 survivor who opted for home treatment says “is because people are more comfortable in their homes.”
Many public officials, according to health care professionals and familes, often opt for home care rather than receive treatment at the centers especially when their cases are not as severe with underlying complications. Security and safety reasons have also been cited.
For Lucy, it has been five weeks since she experienced the symptoms of what she described as “a really bad flu.” Although she feels much better, she says “I still feel my brain shutting down on me. But I don’t want to go to the Isolation Centre because there is still no vaccine for it.
I don’t want to be a sample to anyone since I don’t have any other underlying ailment.” Although her fear is understandable, she says “We have a lot of antibodies in Africa because we have been fighting a lot of tropical diseases.”
The major concern for Lucy, however, is the fear of misdiagnosis at the NCDC. She says “more people die from other illnesses at the hospital than from COVID-19.”
In response to the problems presented by demands for more testing and faster turnaround on the testing results, Ogbonnaya Onu, Minister of Science and Technology announced that Nigerian scientists developed an RNA Swift testing kit to accurately detect SARS-Cov-2.
The National Biotechnology Development Agency Prof. Alex Akpa says the new RNASwift Extraction will help expand the nation’s testing capacity and reduce cost by up to 500%.
According to BMJ studies, a team of researchers from Italy reported that nearly nine in 10 patients (87%) discharged from a Rome hospital after recovering from COVID-19 still experience at least one symptom 60 days after onset. Of the 143 people tested, the study showed that 13% of them were completely free of any symptoms, while 32% had one or two symptoms, and 55% had three or more. The study highlights that although none of the patients had a fever or any symptoms of acute illness, many reported fatigue (53%), dyspnea (43%), joint pain (27%), and chest pain (22%). However, two-fifth of patients reported a worsened quality of life according to the study.
Other studies point out that post-COVID-19 symptoms can include: acute respiratory distress syndrome ARDS, mental health issues like post-traumatic stress disorder (PTSD).
In addition, impaired lung functions studies are beginning to show that COVID-19 can leave in its wake up to 50% organ damage that negatively affects the heart, kidneys, and brain. Medical experts agree that viral infections starting off as a simple cough can last for weeks or months and can result in full-blown chronic wheezing or asthma.
However, it has been pointed out by medical experts that those most at risk are people 65 years and older, according to Dr Gary Weinstein, a pulmonologist/critical care medicine specialist at Texas Health Presbyterian Hospital Dallas. In a contrasting report, however, physicians are seeing an uptick in strokes among young persons with COVID-19.
Originally, it was thought COVID-19 symptoms disappears after two weeks but health experts are now using the term “Long COVID” to describe illness experienced by COVID-19 survivors who continue to report lasting effects of the infection or continue to experience the symptoms longer than necessary even when their test results show negative for COVID-19.
In the UK, studies are being conducted to monitor post COVID-19 negative status. The team behind the UK COVID-19 Symptom Study app developed by the health science company ZOE in collaboration with researchers at King’s College London so far collected symptom information from nearly four million users says “most health sources suggest that people will recover within two weeks or so, but it is becoming increasingly clear that it isn’t the case for everyone infected with the coronavirus.”
Charles Aniagwu who currently experiences no symptoms since his post COVID status was confirmed negative says “that somebody suffers COVID-19 does not mean you will not experience or have another sickness. COVID-19 is a jealous disease that does not tolerate underlying illnesses, and because drugs for COVID-19 is very heavy and strong, some of those pre-existing conditions may not mix well with COVID19 drugs and can lead to another problem, especially with pre-existing conditions.”
He highlights that the only reason malaria and typhoid kill more persons in Africa is due to poverty, lack of money to treat the disease.
“Addressing poverty will cure malaria and typhoid incidences in Nigeria. However, with COVID19, it kills with or without money especially when there are critical pre-existing conditions.”
However, according to NHS England’s announcement “evidence shows that many of those survivors are likely to have significant ongoing health problems, including breathing difficulties, enduring tiredness, reduced muscle function, impaired ability to perform vital everyday tasks, and mental problems such as post-traumatic stress disorder, anxiety, and depression.”
To assess the effect of COVID-19 patients, a new study done in the UK by the Post-Hospitalisation COVID-19 Study (PHOSP-COVID) intends to recruit 10,000 patients who will be followed for more than a year.
Lucy who describes her case as a “really bad flu” feels strongly about the need for state and federal governments of Nigeria to fund the health care system. “We need to have better, honest, and open communication too. The health sector must begin to pay attention to develop our own vaccine from our local herbs, not the Madagascar herbs because that had its complications. Health and education budget should not be slashed due to COVID-19.” she emphasizes.
What is social stigma and how should we fight it.
Social stigma in the context of health is the negative association between a person or group of people who share certain characteristics and a specific disease.
During an outbreak, this may mean people are labelled, stereotyped, discriminated against, treated separately, and/or experience loss of status because of a perceived link with a disease.
Such treatment can negatively affect those with the disease, as well as their caregivers, family, friends and communities.
People who don’t have the disease but share other characteristics with this group may also suffer from stigma.
The current COVID-19 outbreak has provoked social stigma and discriminatory behaviours against people perceived to have been in contact with the virus.Those who have recovered from the virus also suffer from a sense of isolation.
The level of stigma associated with COVID-19 is based on three main factors:
1) it is a disease that’s new and for which there are still many unknowns;
2) we are often afraid of the unknown; and
3) it is easy to associate that fear with ‘others’
Stigma can undermine social cohesion and prompt possible social isolation of groups, which might contribute to a situation where the virus is more, not less, likely to spread.
It can result in more severe health problems and difficulties controlling a disease outbreak.
● Drive people to hide the illness to avoid discrimination
● Prevent people from seeking health care immediately
● Discourage them from adopting healthy behaviours
This report was supported by the Africa Women Journalism Project in partnership with the International Centre for Journalists (ICFJ)