COVID-19 Patient can use 6 cylinders per day, as Lagos hit more by ‘extremely aggressive’ second wave of infections

ANTHONIA OBOKOH

A lack of testing gives a false impression that Covid-19 is on the decline in Nigeria’s most populous city Lagos. Reported infections neared 1000 a day, deaths shooting up, and the state accounted for the highest number in the country in total recorded cases.

From January 1 to 8 the state reported 4,687 cases. Lagos epicenter for COVID-19 in the country has seen an increasing rise in cases over the last week with new variant thought to be driving the surge and this second wave of coronavirus infections hitting the state is “extremely aggressive” and stronger than the first, as fears mount new variants of the virus are behind the faster spread, more people dying and health officers testing positive.

Since January, Lagos has recorded the fastest rise in new cases in the country. The number of new infections rose test positivity Rate is21.8 percent and 34,875 cases, according to figures from the Nigeria Centre for Disease control.

A total number of 3,055 cases has been discharged from Lagos Care centres and 24,885 recovered. Cases currently under isolation- 171and Active Cases under Home based care- 6,550 and total deaths 247 have been recorded.

“It seems like it’s affecting a younger age group. When you catch this COVID-19 it can cause respiratory failure faster than the first wave and we do not want people to die. We want to be able to admit people in a way, Infectious Disease Hospital (IDH) is almost full, but we have more capacity outside and other isolation centers. So Lagos has excess capacity,”

“In critical situation, a #COVID19 patient can use 6 cylinders per day,”said Akin Abayomi, commissioner for health, Lagos state.

Lagos, which was reporting 157 new infections at a previous peak in July, is now recording over 700 new cases every day. Still, Nigeria has so far recorded about 1,342 confirmed deaths and 97,478 cases, a section of the Africa caseload.

The rise has largely been driven by Lagos, where a new, more infectious variant of Covid-19 is spreading fast and an influx of patients has left the isolation Centre with a struggling beds without oxygen and deaths has left many families and friends disheartened.

Presently, Abayomi said the reason for the second wave of COVID-19 is due to reopening of schools, General Laxity, False Sense, of Security and Non-adherence to guidelines; opening of the economy, variant, large religious congregation and social gathering and entertainment.

Currently, Lagos has 21 accredited private and 4 public health laboratories.

“ Lagos State had increased its testing capacity per Day (August – December 2020), as the state is now testing between 2,000 and 3,000 per day adding that in the public laboratories about 128,519 samples has been processed which is equivalent to 52 percent and the private Laboratories, 237,898 samples processed 45 percent

Bed occupancy at COVID-19 Care centres across the state has increased to 53 percent,” he said.

However, top 5 Local Governments with high numbers of COVID-19 positive cases are, Eti-Osa, Ajeromi, Surulere, Amuwo and Mushin.

A recent report from Lagos shows Local Government Areas (LGAs) data representations in the samples collected at the collection sites reveals that Eti-Osa has about (27%), Ajeromi (26%), Surulere (26%), Amuwo (25%), Mushin (25%), Apapa (20%), Agege (20%), Ibeju- Lekki (19%), Oshodi-Isolo (19%), Lagos- Island (18%), Kosofe (18%), Alimosho (17%), Ifako- Ijaye (16%), Lagos- Mainland (16%), Epe (15%), Badagry (14%), Ikeja (13%), Ojo (12%), Somolu (12%), Ikorodu (11%) and inbound travellers (4%).

Scientists said that the variant identified in Africa’s most industrialised nation may be more transmissible, resistant to vaccines and more difficult to pick up through testing.

The second wave of COVID-19 is getting more serious. More patients depend on oxygen at the Lagos State Yaba Infectious Disease Hospital (IDH) and some major medical facilities in the city and assigned laboratories are getting overwhelmed, patients competing for ambulance services, oxygen supply and ventilators already short in supply. Medical doctors and health workers are in fear as most are testing positive and many already down with the flu.

At IDH, 70 gas cylinders were used overnight and in the CACOVID ward most of the patients can hardly breathe in the room without oxygen,” says an exclusive interview report by Adedoja Salam-Adeniyi of TVC continental on How COVID-19 patients are battling with second wave of deadly virus at the IDH, Yaba.

Globally, there is an oxygen supply chain crisis. The demand for all oxygen over weighs the supply. Meanwhile a flow rate of oxygen that the average COVID-19 patient uses is 15 liters per minute is now tripled, a regular sick patient uses five liters.

At IDH, the consumption of oxygen is now very high. “The supply of oxygen at IDH at the biobank can produce 16 large cylinders in 24 hours a day. So that is very helpful. We would add to our daily consumption of oxygen, which we are currently using about 300 cylinders a day,” said Abayomi.

“People coming in breathless and when you measure oxygen concentration level in their blood system some have very severe oxygen concentration levels, then the organs of the body can now suffer some form of damage and this damage can actually become irreparable.

“Somebody coming into the hospital, at most will say 20% to 40 %,” Bowale Abimbola, chief medical director, Infectious Disease Hospital, Yaba, Lagos, said.

Chris Bode, chief medical director of Lagos University Teaching Hospital, LUTH also said that most of those dying of COVID-19 complications delayed going to hospital till very late.

“This is not to alarm the people, but rather, to alert us all to what is happening and call on each person to do again what we have done well before. The present trend is worrisome and if it continues, it may overturn our capacity before we can ramp up again to catch up.

“We have seen an upsurge in the number of people who keep treating malaria instead of going for the Covid-19 test and many start using all sorts of steam isolation and home remedies for their cough and chest congestion,” he said.

As Nigeria awaits the COVID-19 vaccine to arrive in Nigeria before the end of January to receive 100,000 doses of Pfizer vaccine, experts say that for Nigerians to accept COVID-19 vaccine in order to help contain the pandemic, and achieving high vaccine uptake rates will require comprehensive communications efforts to manage public expectations and counter vaccine doubtfulness.

They say there is an urgent need for more education as Nigerians need clear, accurate messaging on realistic COVID-19 vaccine timelines, efficacy, safety, benefits, possible side effects, with messages tailored to specific populations as needed.

Meanwhile, the National Bureau of Statistics recently released the sixth installment of its COVID-19 Impact Monitoring, a survey of 1,950 households across the country that it conducts with support from the World Bank, one major result of this sixth installment is that the vast majority (90%) of respondents reported that they were willing to get tested for and vaccinated, if it were free.

“This waiting period should be utilised to educate the public about the real versus perceived potential side effects of the vaccines, as well as the consequences of taking versus not taking it,” said Nseabasi Ekanem, public health expert, founder and chief executive officer of Trinity Healthcare Foundation.

“This is a time where we should engage the community, much more, because a lot of Nigerians have been fed with rumors with all amount of information on WhatsApp voice note videos, wanting them to stay away from the vaccine.”

Ekanem suggested a campaign is mounted to help people understand the vaccines.

“Now, is not about bringing the vaccine, its about who will take the vaccine. Nigerians already have demonstrated apathy for this vaccine and I can bet you that a lot of Nigerian, a whole lot of Legends will not take this vaccine, with the start to score.

“So I feel that one of the things we should be doing at this time is to engage Nigerians now, let us try to analyze the information that is already going viral on social media by telling Nigerians to digest what actually, the truth is, and ensure that Nigerians received all the information or the need to know about diversity.

“This has to be done in an easy-to-understand manner and be repeated across all ways. From social media to news, to every means of communication. Get the mosques, churches and etc involved,” he said.

Lagos response on Oxygen availability

According to Abayomi, In furtherance of the commitment of Lagos to deploy effective response to #COVID-19 pandemic, a brand new oxygen plant situated at Infectious Disease Hospital (IDH) Yaba, was activated yesterday, January 8, 2021.

According to the commissioner, the oxygen plant was built in collaboration with @gatesfoundation in response to the second wave of #COVID-19 in Lagos State. Oxygen plants are industrial devices designed for regular supply into healthcare facilities. The plants separate oxygen from other air components by using pressure swing adsorption or membrane separation techniques.

“High purity oxygen is needed in healthcare facilities and essential for patients undergoing COVID-19 treatments.

He added that the increased demand for oxygen for treatment of patients in the second wave of the COVID-19 pandemic necessitated activation of more oxygen generation capacity in Lagos State and has received express approval of Governor Babajide Sanwo- Olu.

“Oxygen from the newly installed plant will be administered to patients through cylinders made available at hospital wards. This is particularly useful for patients with co-morbidities who require prompt oxygen for survival.

The operation of the plant will significantly make oxygen available for COVID-19 patients and supplement oxygen supply to about 300 cylinders per day and 6 cylinders per hour.

In critical situation, a COVID-19 patient can use 6 cylinders per day.

Oxygen from the plant will be very helpful for effective treatment due to proximity to the plant which serves as a source.