Lessons That COVID-19 Must Teach Us By Dr Gani Enahoro

In a way, the SARS-CoV-2 that caused COVID-19 choose a grand entry into the world for it to be noticed and given a deserved attention, and that it has accomplished, today undoubtedly it has taken the center stage for months already and would most likely remain for long with the man. In history, it has become chief amongst viruses and could be described as a very successful virus albeit in terms of what viruses do.

Unfortunately, since Covid-19 started from abroad the world would never know what the African combo of roots, herbal menthols like ‘Aboniki’ and easy picks of self-prescribed drugs, including capsules of different colours that are hawked or sold in dispensaries and pharmacies over-the-counter, would have done to the coronavirus.

Had the virus struck Africa at first, it would have been dealt with by several other ‘social viruses’ that have become our way of life, and it would never have been so reckoned with as to become a pandemic worldwide.

At best it would have joined its other more senior frontrunners like Lassa fever virus that we have learned to cope with since 1969 and Ebola virus that was a recent threat across West Africa.

Even when H5N1 virus that caused ‘Bird Flu’ attempted to take a birth here, the refusal of our veterinary authorities to agree with international cajoles on universal principles that expected us to vaccinate all our birds played a big role in wiping off the virus. We simply insisted on a “no vaccination policy” and it worked for us.

In Africa, we are peculiar breed. A very large population despite educational sophistication and social status still look inwards to the use of herbal products in different concoctions for prevention or treatment of diseases, even when scrutiny and regulation on these efforts are scarce or non-existent.

Although, the lack of clinical trials for the potency of herbal medicaments does not in any way diminish the efficacy of unorthodox medicare. Our traditional healers are gifted, they go through the hard way ‘talking’ to plants and tracking the footsteps of animals into thick forests and learning from God-given approaches to dealing with illnesses in the wild, plucking leaves and roots for direct use in humans when they return home.

The absence of time tested documentation and not commercially refining the extracts from these herbs may have been our generational losses for what should have been our contributions to the body of global medical knowledge today.

These positive comments does not apply to charlatans amongst the herbalists; even though the brilliant ones are certainly more, just like professional quackery exist with medical and veterinary practice even today and they have taproots in most villages, creating a lot of damage to standard operating procedures, leading to several avoidable deaths.

They have accounted for antimicrobial resistance (AMR) everywhere, by their indiscriminate abuse, such that the use of antibiotics that was the greatest bullet against bacteria have suddenly in recent years appear more like rubber bullets on germs.

If Africa had been its entry point, COVID-19 wouldn’t have been a pandemic as to test the elastic capacity of a World Health Organization, and against all statistical predictions from disease modelling, our health system even now would never be overwhelmed like they witnessed in other parts of the world.

Africans have a way it is just a small fraction of our sick population that gets treated in hospitals, more because there is no effective and widespread national health insurance schemes. The majority sits back and manage to get by on their own, through self-medication and the use of all sorts of roots and herbs, although with an unplanned advantage of building different levels of premunity beyond what is known to science.

Strange and unusual things that could kill elsewhere, we have always gone free with. Imagine boiling paracetamol with meat, which can only happen in mother Africa! In other climes, you won’t even have the pharmacies sell the drug to you except with a signed and crosschecked medical prescription earlier forwarded to them. Although the freedom of non-compliance to international standards may have found value in dealing with coronavirus, we stand to gain more by sticking to the right tested attitudes.

There are quite a lot that must be learned when disciplines interrelate. In the management of infectious disease outbreaks in animals, be it poultry, dairy and food animals, the veterinarians deploy the best of population medicine and it works excellently to keep the animal world kicking. Nigeria must learn from what they do and that is in the spirit of One-Health. In the United Kingdom, animal ventilators in veterinary clinics were deployed with minimal conversions to save Covid-19 patients in several isolation centres. In 2012, Rinderpest, a deadly viral disease that had decimated our cattle population for decades was certified eradicated in Nigeria by the World Animal Health Organization (OIE).

The Nigerian veterinary authorities have scored great goals over the years working with public and private sector veterinarians in the interest of public health. Animal-human interphase would continue to bring both medicines together for the benefit of public health and lessons must be learned in this regard. Bird flu was a test case. We did not adopt foreign suggestions wholesale in dealing with it like it has been done with COVID-19 presently. It would have been counterproductive and perpetuation of poultry deaths with its fears of spillover to humans.

Egypt that ‘follow-followed’ standard practice of vaccination, became the epicentre of bird flu in Africa and had reported persistence of different strains of the virus several years after we had forgotten about the disease. That was one-kudos up for boldly finding a domestic response to tough challenges.

The benefits of good hygiene in handwashing should not normally require a virus to teach, avoiding the needless touching of our faces for the flimsiest reasons and social distancing should endure with us. Whereas, quarantine and isolation for the sick is effective to confine outbreaks, the principle of lockdown has its benefit only when there is a total compliance by the entire population, and that is where the demerits lie.

The intention is to wear out the virus by running its incubation course for the maximum number of days with people in seclusions and sufferers identified for critical care while contact tracing becomes easy to do. But a disobedient single escapee from lockdown becomes a potential hazard and there were quite a number of Almaijiris running riots all over the country, sneaking with animals to cross interstate borders. All of which rendered lockdown less effective.

All over the world the attitude of man, made lockdown instructions difficult to enforce necessitating the President of Philippines, Rodrigo Duterte to order his security officers to shoot at sight anyone found outside their homes in violation of the strict quarantine, and in some places, wild boars and other animals were carefully let off the zoos to stroll about on the streets to maintain compliance.

The lack of institutionalized social security plans in Nigeria haunted the governments and the cry for palliatives caught everyone napping, and this should be a lesson for the future by the leaders, who were forced to part with their secret savings to make emergency provisions.

Their security was indirectly threatened as they were face to face with their angry constituents and there was no escaping to Abuja or overseas, as they used to do. The strategic national grain reserves in big silos played some roles, just as the stockpile of seized imported rice at the depots of Nigerian Customs Service was shared, perhaps that was enough for just a few days in some critical places.

Now we need to learn from COVID-19 how deep we should plan for the rainy days in our future strategies. We must gradually whittle down our hydrocarbon dependent economy and go green with agriculture, building more silos not only for grains, but also for dry rations generally in all the 36 states and FCT. Tomorrow, it may not be COVID-19, but another type of war that would require that palliatives be shared to everybody, particularly the more vulnerable.

By now and seeing the stupendous financial support from within and outside the country, there should be several permanent infrastructures springing up in the health sector as gains to point at post-COVID-19.

However, knowing my beloved country, these billions would rather be explained away for meeting recurrent ‘emergency’ expenses alone. The President must shine his eyes if he truly must be on the right side of history.

Another lesson we should not miss concerned with the self-preservation displayed by China and India as soon as the pandemic was announced.

The two countries shut their export windows, preferring to keep whatever they had in stock for their domestic strategic reserve. That decision should serve as an eye opener for us to develop maximally the internal capacity for critical sectors that manufacture life dependent products. We have for long remained as import-dependent economy, bringing in almost everything that should sustain life including our medicines for human and animal use.

At whatever it would cost, we must stockpile some of the basic medical equipment, and disposables, PPE such as isolation gowns, hand gloves, face mask and goggles, and so many non-expiry materials. Medical and veterinary researches on vaccines must be enhanced such that local domestic needs would not depend on importation and the right strain of virus spreading locally would be properly targeted.

We also have learned that savings in the cost of governance is possible if certain ranks of civil servants below GL 12 could stay away for weeks and activities of government will not grind to a halt. Virtual meetings have conveniently sprung up at several fronts proving that the huge sitting allowances for most meetings could be saved while also saving people from needless deaths in avoidable road accidents.

These are immortal lessons that we must sustain post COVID-19, as a compensation for the scare it mongered on all of us.

Dr. Gani Enahoro is Former Councillor for Africa at World Veterinary Association (WVA); Vice President, African Veterinary Association (AVA) and Former National President, Nigerian Veterinary Medical Association (NVMA).