Asymptomatic patients driving COVID-19 second wave –Physician

Yusuff Moshood

The Head of Infectious Diseases Unit, Department of Medicine, Lagos University Teaching Hospital, Dr. Iorhen Akase, says asymptomatic COVID-19 patients are driving the spread of the viral pandemic in the country.

Akase noted that the pandemic is driven locally through community spread.

According to the infectious diseases expert, efforts to contain COVID-19 in this second wave should be focused more on asymptomatic patients, some of whom are spreading the viral infection unawares.

Speaking on a live TV interview on Monday, Akase said it was important for Nigeria to find ways to interrupt the spread of coronavirus infections.

“There is no argument at all that asymptomatic people are the major drivers of this rising numbers of COVID-19 cases that we are seeing in society.

“The spread of COVID-19 infections is not by people with symptoms, but by people without symptoms,” he said.

The infectious disease expert while urging caution on the reopening of schools said the nation must be careful not to pass the wrong message to the populace with the decision to open schools.

“Opening schools and other institutions may be necessary, but we must be careful not to pass a wrong message to the society that things are now okay and that we can move on with our lives as this is really what is fueling the wrong behaviour of people in motor parks and market places.

“Many people are getting the impression that there is no problem and that it is okay to move on. That is very dangerous,” he said.

Recall that a recent study published in JAMA Network had found that over half of COVID-19 cases are likely caused by people without symptoms.

According to the study, approximately 59 per cent of all transmission is caused by pre-symptomatic individuals who hadn’t yet developed symptoms and asymptomatic people who never developed symptoms.

The researchers say the findings show how identifying and quarantining symptomatic patients aren’t enough to control the rapid transmission of COVID-19.

The researchers, therefore, called for strict public health measures — including mask-wearing and physical distancing — and widespread testing of people without symptoms, stressing that it has become necessary to identify people who have COVID-19 and who may be silently transmitting the coronavirus.

Akase reiterated that science has confirmed that adhering strictly to the three preventive measures of wearing facemasks, complying with hand hygiene and the principle of social distancing can significantly help the society to overcome the pandemic and move on.

“Unfortunately in Nigeria, we have not done that and I feel that even though we keep on saying wear your facemask, observe hand hygiene and stay away from the crowd, many people are not listening nor complying.

“We are now at a stage where we must change the kind of message we are delivering to get it across better as we are in a serious situation.

“If for instance we decide to shut down society again and people are asking why we are doing that. We can say it is because society has not done the right thing as regards complying with preventive measures.

“We must collectively fight the pandemic. We cannot just leave it to the society, health officials or the government because even if vaccines come now, it would take a while before we can build the immunity we need in the society.

“We all need to make sacrifices and everybody must contribute. Until we are all working together against this virus, it is unsafe to say let’s move on with our lives,” he said.

On the mental health effect of long school closure on children, Dr. Akase said the concern of mental health effect of long closure of schools should be considered alongside how children would feel if they got to know that they are responsible for infecting their family members.

“I agree that there are mental health issues with keeping children at home. However, there are stronger and bigger mental health issues as children could come down with post-traumatic disorder for losing their loved ones, especially when they know they infect them.

“A child who finds out that it was because he went to school his grandmother died is going to live with that for the rest of his life.

“So mental health concern applies to both sides of the coin and we cannot be trying to solve the problem of one side by creating another one,” he said.

According to the Nigeria Centre for Disease Control, the total number of confirmed COVID-19 cases in Nigeria as of 18 January are 112,004, which include 89,939 discharged cases and 1,449 deaths.

Author: Histidine