Monday, 27 July 2020

COVID-19 Response: Situation Report from Cross River State on Level of Implementation


27 July 2020

1)Update on the COVID-19 outbreak response in Cross River State 

SITUATION REPORT: 
All the incident action plan pillars have continued to be active and constantly updated. The NCDC team on ground has been working with the state response team and they are satisfied with the response. For details of information about the response activities, contact the incident manager or go to the Cross River State Ministry of Health to get details. The website is also up and can give you all the update 24 hours. For social media-friendly people, our twitter handle can give you information on the go.

The risk communication pillar has been on the road from one LGA to the next. The team is constantly informing our people and sensitizing them. The response team has worked with the Christian Association of Nigeria the Cross River State Chapter to reach out to over 260 churches over the last 7 weeks physically, while letters from the state ministry of health have been issued out to all places of worship in Cross River (both churches and mosques). 

All thirteen (I3) pillars are running with daily EOC meetings between 8-10AM as well as daily situation room reports. This is fully supported by the National Rapid Response Team from NCDC which is currently in the state for support activities. 

The state has started active case search in communities with border communities in Etung, Boki Obanliku, Obudu, Ikom and Akamkpa being the initial focus of the last week and is ongoing. 
 
2) Upscale COVID-19 testing in the State.

SITUATION REPORT: 
The presence of two Testing Centres in the State has lead to an upscale in testing. The total positive cases in the state is 37 as at 26/7/2020. The State owned Lawrence Henshaw Memorial Hospital Testing Laboratory has carried out 165 Gene Expert test at the lab and  has tested 16 positive cases with all results given to the client with same uploaded on NCDC dash board (both negative and positive results). 

Unfortunately there is a high public expectation that results from the LHMH should show overwhelming covid positive status. Those who hold this view believe that the results are being manipulated. Obviously, such people forget that unlike the UCTH that deals with critically ill clinical referrals, most persons who are being tested in the LHMH are well. They are mostly healthy people, some who simply walk or drive-in to confirm their status for travel reasons or those who even do so to clear personal doubts. 

Secondly, most of the samples brought into LHMH are collected by random sampling in communities where active case search activities amongst healthy individuals have produced tests positivity of around 98%, a situation that is similar to conditions expected of a screening most tests. The stake holders must understand the difference and appreciate the results that will continue to come from both centers. 

Asymptomatic positive cases by the latest guideline are managed on self isolation at home with follow up from rapid response team, while moderate cases will be managed at Adiabo. As it is now well known to all stakeholders and partners, all critical cases are to continue to be managed in the UCTH Isolation center as the states only level 3 center. 

3) Contact tracing, case identification and surveillance activities.

SITUATION REPORT: 
There is a total of 234 persons on contact tracing at different parts of the state. All positive cases have been contacted and their contacts enlisted while contact tracing and sample collection for contacts is on going. The rapid Response team from NCDC has been supporting the rapid response team on ground to reach out to contacts. In Ogoja where an index case died in a health facility, more than 156 contacts are being followed up for the required period and samples collection is ongoing. The affected facilities have been decontaminated and the relevant sections or whole facilities sealed off in line with IPC protocols. 

In Ikom, fourteen (14) contacts are being followed up. There is contact tracing going on at various parts of the state with the highest contacts being followed up around Calabar and Ogoja metropolis. The greatest challenge faced with contact tracing is stigmatization. Some members of public do not want the team to come into their houses or street with the COVID-19 branded vehicles or PPEs. Their belief is that these items raise eyebrows of persons around them. Landlords are threats to their tenants and the reverse is also true. Most of such people prefer to bring listed contacts to LHMH for testing while others amongst them prefer to meet with LGA rapid response team for secret sample collections. All these present undue challenges and further delay results.

4 Activation of the designated Isolation Centre.

SITUATION REPORT: 
All stakeholders must appreciate the fact that different states have slightly different protocols for managing COVID-19. Presently over 9 states in the Federation have adopted home-self Isolation for COVID-19 patients based on several factors considered by the state including resources available to run Isolation Centers in their various states. 

All three Isolation centers in the state are up and running. However persons will be taken into the isolation centers based on criteria for management as prescribed in our state protocols. The Adiabo Isolation center has been opened for over a week now with the first set of health workers deployed to the center, awaiting clients. Two persons who visited the center without confirmed test results were sent to LHMH for testing and follow up. The center at Ogoja has all its full compliment of staff deployed there and they had already admitted a client at the center this week with contact tracing ongoing. Previous admissions there were held as suspicious cases and all were discharged home in good health. 

The UCTH is the center for critical cases which cannot be managed at Adiabo or in GH Ogoja. As we have written in our report and advocated in several fora, there is need for the expansion of the UCTH center to accommodate more critical cases during the pandemic. We hope the Federal Ministry of Health that has direct jurisdiction over the University of Calabar Teaching Hospital can immediately respond to this request, while as a state we will continue to support all centers within our limited resources.
 
5) Providing free treatment and care of confirmed cases in Government Isolation Centres.
 
SITUATION REPORT:  
The Cross River State Government within its limited resources will continue to support treatment at the various treatment centers in the state. However it is important to note that all centers supported must give report for utilization and also provide acknowledgment of support given to the facility.
 
6) Establishment of a coordinated Emergency Operation Centre with the engagement of all relevant stakeholders.

SITUATION REPORT: 
There is an Emergency Operations Center supported by the Cross River State Government, US government and NCDC. Meetings hold at this center from 8-10am everyday with all relevant key stakeholders. At these meetings issues bothering on the state response to COVID-19 are discussed and resolutions taken on different aspects of the incident Action Plan implementation. The State situation report for COVID-19 response is updated daily on our website and on our twitter handles. 

Persons seeking updates can go to this places to access same. Further questions can be transmitted through the toll free lines. The call lines are opened 24/7 and response will be given to request as soon possible. Members of the public are enjoined to utilize this mediums to get their complaints or concerns across to the Taskforce or come to the state Ministry of Health. Issues will be addressed as we move along. The website is https://crsmoh.cr.gov.ng/



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