COVID-19: Why we declared Kogi high-risk state – Mukhtar Muhammad, PTF national incident manager

The National Incident Manager (NIM) of the Presidential Task Force (PTF) on novel coronavirus (COVID-19) pandemic, Dr. Mukhtar Muhammad, in this interview with JULIANA TAIWO-OBALONYE, spoke on why the task force had to come out now to declare Kogi a high risk state, shed more light on the national response against the pandemic, vaccine procurement, distribution and the conspiracy theories around it, as well as the issue of the recently discovered variant of the virus.

Why did it take the PTF this long to declare Kogi a high risk state considering how the governor has been carrying on?

You know the PTF is working all along with state governments and what we are doing is not trying to bring everything to the public. We have been working behind the scene to try to reach out to the governor and to the people in the state. We have also tried to have some useful discussions and understanding. It is not in anyway trying to put any state in bad light or put any person in a bad light. Just understand that the discussions are ongoing and the PTF will not want to do anything that will scuttle that discussion and the progress that we are making.

Recently, the co-founder of the Bill and Melinda Gates Foundation, Bill Gates, asked Nigeria to prioritise the development of its health sector rather than focusing on the COVID-19 vaccines. What is your opinion on this?

What he is saying is not different from what we have been saying. The foundation to building a solid health system is by looking at your primary healthcare facilities and building the infrastructure and the systems there. So, that is exactly what we are doing. However, understand that the frenzy we are in now with vaccines development and also all countries trying to acquire vaccines, Nigeria is not left behind and we are trying to get the best for our people. Because, we know and we believe that this is going to work and it’s going to help our people. So it is not a question of either or rather, it’s a question of taking both at the same time.

Compliance is a serious problem with managing the pandemic because many Nigerians still doubt there is anything called COVID-19. How can compliance be best handled?

The issue of compliance is a difficult one; no matter the amount of information out there on the field, you still have people who are resistant, but it is good to know that we’ve made somesignificant progress since these activities started. You’ll recall that early last year, around March/April some people did not believe that COVID-19 existed, but I think through the work the media have been doing, people have now been sensitised. We do what we call the NYE polling, which is calling people randomly to find out some information. It has been consistent, over 86% of the people are aware of COVID-19 and are aware of PTF activities. So we are making progress in that direction.

There’s still a lot to be done in terms of debunking false news, the conspiracy theories, which actually keep evolving and changing; from those that say the NCDC is manufacturing figures so that we can get money from foreign donors, to those who are saying that we want to vaccinate everyone so that we’ll place microchip on people to monitor what they are doing. From the sublime to the ridiculous, all those are going on, so it takes the continuous efforts of those who have the responsibility to make sure that people are continuously educated, people are aware of the issues and to make sure that people in position of influence; political leaders, religious leaders, community leaders are taken along and they understand. That’s one of the things we make our priorities and we are really engaging these groups of people seriously to ensure that the public is fully aware of the consequences of their actions.

Conspiracy theories about the vaccines; any reason to fear?

Vaccines are not new, they have been used all over the world for a long time and there are scientific ways of manufacturing or using vaccines. The vaccines themselves are either the virus or the organism, or a part of the organism or something that mimics the organism, that when it’s introduced into a human body, the body prepares itself and attacks that false organism, so that when the invasion by the real organism occurs to the body, the body already knows how to fight it, it has produced neutralising agents. It’s like simulation exercise; you have an army, but your army doesn’t know who the enemy is, so when you bring someone and show him that the person wearing dark glasses or covering his face or whatever is the enemy, your body reacts and recognises that person.

In real life, we have dogs in our houses, some visitors will come and the dog will not bark, but some people will come, may be because of their looks or may be because they came late in the night or something, the dog will start barking. That’s the way the immune system works with vaccines. The vaccine trains our body so that when we have the real infection our body fights it back.

Now to the conspiracy theories, like the COVID-19 vaccine, it is used globally and there’s a huge scientific community that is involved in developing this vaccine. With science, when we produce something and you say this thing will work, the natural tendency of every scientist is to say it doesn’t work. There’s no effect of using that thing until it is proven and there are scientific ways of proving that these vaccines work. All protocols must be followed from stage one, stage two, stage three, community trial. All that has to be followed before a vaccine is certified for use.

The UK variant of COVID-19 is now in Nigeria. What is the PTF doing to prevent its spread in the country?

It is normal for viruses to undergo mutations, a lot of viruses do change within a short period of time, but viruses keep multiplying and they use the body of the person to start producing. So it is normal for viruses to undergo mutation and have variants. However, these particular cases we are talking about are mutants that are thought to be quite different from the one that had been seen, so any small change is not a problem, but when you have major changes, then they can be more pathogenic or there can be more severity or they can affect more people easily in terms of transmission.

What happened is that some people traveled and in Canada they found two people whose travels originated from Nigeria and they were found to have those mutants. One was also found in Japan, whose travel also originated from Nigeria and had that mutant. That is now making us to look onwards to say do we have this mutant circulating in Nigeria. Even before this incidence, we have been isolating samples that are positive for people who arrived from the UK or from South Africa and these samples are undergoing sequencing, that is to identify the specific virus, the type of virus, the name of the virus or the mutant that is out there. So we checked back on our database and realised that as far back as October, there was a mutant that came to Nigeria, which the UK announced only in December, you know that we already had that mutant in Nigeria. These ones that have been found, we are still looking at our database. We’ve continued doing the sequencing and we’re also checking to find out if we still have those mutants in the country. So it’s an ongoing exercise, our centres that are running the sequencing have continued to do that and they’ve continued to send these samples to them to find.

Is this new variant more virulent than what we used to know?

This is the problem with viruses, even globally now, it’s only speculation to say that this particular variant actually has more pathogenicity or is causing more severity, we have not actually established that, but there is fear globally that the new mutant can actually be more virulent or can be more pathogenic in terms of transmission, we have to establish the fact. If you hear from the UK, some of the companies claimed that their vaccines can work against the new mutants of the virus. That is a claim, it has to be subjected to scientific rigour to establish that it really works. So we need to distinguish sometimes news made by politicians or those made by businessmen. When somebody makes a claim, you have to put it under the scientific scale and go through the rigour and establish that this is really the case.

The research is going on and we have not yet been communicated that this statements are actually valid, but from the look of things, even though the mutants are different, they may not actually have high transmission and not likely to have more severity, this needs to be proven.

President Buhari recently charged the PTF and Nigerian scientists to ensure we have Nigeria-made vaccine. How soon do you think this can happen?

We are highly optimistic that Nigeria should be able to commence processes of getting our own vaccine, but the process is a very long one and it requires lots of resources. It is not something that government will handle, but rather the private sector needs to come in and invest a lot. If you look at the countries that are producing the vaccines now, they are all private companies and they injected billions of dollars into the research and development before they come out with the vaccines.

Talking about the potential, absolutely Nigeria has the potential to produce vaccines, it is not new to us. In the early 1970s Nigeria was producing Yellow Fever Vaccines in the National Institute of Medical Research in Lagos. Even currently, Nigeria is producing a lot of vaccines, but mostly for use in veterinary services. Our Veterinary Research Institute, Vom in Plateau State is actually doing that. So we only need to have the right conditions, the right institutions and you need the fund to produce our vaccines, but like I said, it’s a process that involves a lot of resources.

Nigeria has the human resource, we believe that in the future we will be able to produce our vaccines, but right now the world is in an emergency mood, even the developed countries that have the resources are not using their government machinery to start producing vaccines, rather they go to the manufacturers, put in their money and procure these vaccines and Nigeria will not be an exception; we’re in an emergency, we need to build our hard immunity as fast as we can and therefore we cannot wait for another three to five years before we do that.

So the marching order to come out with an indigenous vaccine for West Africa is not likely to yield fruits very soon…?

Absolutely, doing a vaccine from the scratch is not possible. If you look at even the companies that started, with the waivers and accelerated approvals and whatever, it took them one year, that is those that already have the infrastructure in place to be able to do that. However, what is being done now is for the companies that are already producing the vaccines to provide a licence to others who can now start manufacturing. You can do it on behalf of Pfizer or on behalf of AstraZeneca, use an existing plant and start producing. That may be what is possible in the next year or two, but to start the research from the beginning, I’m afraid, we won’t be able to…

Can pharmaceutical companies, like SmithKline Beecham take up the challenge?

Yes, not only SmithKline Beecham, but many others have written to the Federal Ministry of Health to request for this kind of licence. Now, it’s up to the private company to go and negotiate and establish that contact with the parent company that is producing it and Nigeria’s government will do anything possible to support these companies so that at least we’ll have a plant here where more vaccines can now be produced.

Why does testing in Nigeria take a long time for results to come out?

We are really concerned about the turnaround time, which is the time between when you test and when people get their results. For now, we are using what they call the PCR test. The PCR test takes longer period to produce result than what we call the Rapid Test Kit.

With the PCR, it takes us about 24 to 48 hours to get the result. Now, many people have been complaining that they are not getting their results after 48 hours, we understand this happens because of the pressure on the laboratories; so many people have now woken up to their responsibilities and people want to confirm their test result. People who had traveled out, who had had to do a test on day seven, initially many of them, over 60% would not turn up to do the test, but when we rolled out the policy of invalidating or suspending their passports for six months, many of them turned up in these laboratories and want to have their tests done. All these are factors that have increased the pressure on our laboratories, making them to have low turnaround, but that is not an excuse. We have charged the Nigeria Centre for Disease Control to up their game, ensure that they recruit more staff in these facilities and increase the testing hours; may be instead of doing eight hours in a day, which is the normal working hours, they can have two or three shifts so that they can clear all backlog of samples that have been taken.

We have small machines, which is Virginia Expert Machines, which don’t do much. The maximum they do is may be 16 to 24 samples in a day and these machines also need frequent servicing, they can run out of cartridges. We have now supplied these commodities to most of the states that require cartridges so that they can also help to clear the backlog. Then lastly, you are aware of our drive to increase testing because we believe if we don’t test, we cannot find the cases and if we cannot find the cases we cannot isolate them and we cannot reduce the risk of other healthy people interacting with these people and then also come down with the disease. So we are expanding testing to all 774 local government areas, we have mandated every state to ensure that they generate between 450 and 500 samples in the next two weeks for every local government. We have provided supplies and manpower to ensure that this activity is done successfully because where we have high prevalence now, we want to, as much as possible, identify those that are positive. Where you have low prevalence today, if we don’t identify these people very early, they will also eventually become high prevalence because the infection will keep circulating. So we are intensifying this effort, the state governments are cooperating and we are doing everything possible to ensure that we have increased the testing numbers. This is also increasing the demand on our laboratories, making them to work more and have more samples to test and possibly increasing the duration of the turnaround.

To avert a second lockdown, protocols have to be strictly enforced. Are we going to see more serious enforcement of the guidelines?

Lockdowns help to minimise people’s movements and it’s very effective because if you don’t go out or if you reduce the degree of your movement, you’ll also reduce the risk of getting infection. Lockdown is not completely out of the table, we are monitoring the numbers, we are monitoring the statistics across the country and where necessary we’ll have to take severe measures.

For now, the PTF is very much aware of the hardship that lockdown brings, particularly for low-income earners, for small businesses, for people who have to go out daily to get their daily bread, so we are doing everything possible not to have a total lockdown in the country, but as you rightly observed, for us not to reach that stage, we have to ensure that people take responsibility; we have to take responsibility as individuals, as families and as communities and everyone has a role to play. The leaders, either political, religious or of communities, will have to ensure that everyone plays his part so that we’ll remain safe.

There are plans to introduce these enforcements and what we are doing now at the PTF is trying to identify areas; cities or towns where the infection has been reported to be very high, both in terms of people who have been tested and found to be positive, and also in terms of what we call incidence, which is the number of people that are positive, divided by population.

We are looking at these areas and we have identified where we’ll need to implement these stringent measures. We will have teams that will ensure compliance, we are working with state governments to ensure that they set up task forces that will move round to ensure compliance. Mr. President has accented to the recommendation from the PTF. We’ll start prosecuting people who are violating protocols, we’ll also start closing down and locking down businesses, institutions, public places that are not complying with the protocols.

As I mentioned, if all these do not work, then we’ll have no option than to introduce the total lockdown.

We don’t want to do it, but if our figures and statistics continue to rise, making more people to become vulnerable, there’ll be no option than to ensure that we halt this epidemic by a total cessation of movements. (Saturday Sun)