Tag: Challenges

  • Virtual Press Conference on COVID-19- 06 April 2020

    Virtual Press Conference on COVID-19- 06 April 2020

    Originally broadcast live on 06 April 2020, the daily press briefing on coronavirus COVID-19, direct from WHO Headquarters, Geneva Switzerland with Dr Tedros WHO Director-General, Dr Micheal Ryan, Executive Director of the Health Emergencies Programme, and Dr Maria Van Kerkhove, Technical lead, WHO Health Emergencies Programme with special guests Lady Gaga and Hugh Evans, CEO and Co-founder of Global Citizen.

    Transcript:

    Speaker key:

    TJ        Tarik Jasarevic

    TAG    Dr Tedros Adhanom Ghebreyesus

    LG       Lady Gaga

    HE       Hugh Evans

    MR      Dr Michael Ryan JA  Jamie

    MK      Dr Maria Van Kerkhove KA Kai

    KT       Kate

    IN        Innocent

    YA      Yang

    00:00:19

     

    TJ        Good evening to everyone from Geneva and WHO headquarters. Welcome to the regular press conference on COVID-19. Journalists who are online can ask their questions by clicking  raise hand if  you are
    on Zoom.  Today we have a special guest but  I will  let Dr Tedros do his opening remarks and introduce them.  Before I give  the floor  to Dr Tedros, just to remind you, we will also be sending you some news from other
    WHO offices around the world with the audio file  from this  press briefing a little  bit  later. I give  the floor  immediately to Dr Tedros.

     

    00:01:07

     

    TAG    Good morning, good  afternoon and good  evening.  The COVID-19 pandemic continues to take a heavy toll on families, communities and nations the world over but it’s also giving rise to incredible acts of generosity,
    solidarity and co-operation. We have said consistently that we’re all in this together and we can only succeed together. We need an all- of-society approach with everyone playing their part. That includes  people  in  the entertainment
    industry.

     

    Today I’m very delighted to be joined by one of the biggest names in entertainment in the world, Lady Gaga, and my friend Hugh Evans, the founder and CEO of Global Citizen.

    WHO has been working with Global Citizen for several weeks on the Together At Home concert series with artists like Chris Martin and John Legend giving free online performances.

    Now we’re working with Lady Gaga and Global Citizen to take this concept and make it even bigger through the  One World  Together  At Home virtual  global  special on Saturday 18th April. It’s now my great pleasure to invite
    Lady Gaga and Hugh Evans to say more about this very special event, One World.

    00:03:10

     

    LG       Thank you very much, Dr Tedros. Good morning, good afternoon  and good  evening to everyone who’s listening and watching. I would  like  to thank the World  Health Organization and the
    United Nations as well as Global Citizen; thank you very much, Dr Tedros and Hugh Evans, for all of your leadership in this fight against COVID-19 and thank you very much to the World Health Organization  for asking  me to collaborate 
    with  you on this special.

    We are also very grateful to all of the healthcare professionals across the country and around the world who are on the front lines during COVID-19. This  global  pandemic  is  a catastrophe. I’m so thankful to them and I’m also
    praying for those who are sick. It’s been a pleasure to partner with Global Citizen  and we’ve been working  all together  behind  the scenes to raise money for the World Health Organization.

    I would also like to send my prayers as well to people  that are losing  their  jobs  and are having a hard time feeding themselves  and their  children.  We are raising  money  for  the World Health
    Organization’s COVID-19 Solidarity  Response  Fund and seven days ago we held a  call with more than 68 corporate leaders from some of the world’s biggest and most generous companies and I asked them to join my corporate kindness
    list as there have been many corporations and philanthropists that have been very, very generous during this time.

    00:04:38

     

    Since then we have also been calling on philanthropists around the world as well and tech companies included. I’d like  to reiterate our deep gratitude  to the medical  community.  My heart is very, very aching and warm for those
    who are ER doctors as well as nurses who are sleeping in cars to make sure they don’t infect their families  or  their  patients.  What you’re doing is putting  yourselves  in  harm’s way to help the world 
    and we all salute  you and you are a triumph truly.

    I am proud to say that over the past seven days we’ve raised a total of $35 million for the Solidarity Fund. This money will [inaudible]  essential PPE, supplies  and testing kits around  the world and will help improve lab capacity
    to rapidly process tests. It will also [inaudible] research development. It is so important to think globally and to support the World Health Organization to curb the pandemic and prevent future outbreaks.

    I know Dr Tedros is particularly concerned about Africa and [inaudible]. We also need to act globally by supporting local charities  and initiatives so that the front-line health  workers in most immediate need have the resources they need
    to survive during this time. It has been an honour to help with this huge broadcast event, which will take place on April 18th, where we need to tell the stories of and celebrate the front-line community, healthcare workers and their acts of kindness.

    We will be on different networks, many networks actually and I want to [inaudible] about what we’re going to be doing. What’s very important is that two things happen for all of us; that we celebrate and we highlight the singular, kind global community
    that is arising right now. Two, we want to highlight the gravity of this historically unprecedented cultural movement and, three, we want to celebrate and encourage the power of the human spirit.

    00:06:47

    I would like to, on behalf of  the World  Health Organization  and Global  Citizen,  thank Dr Tedros as well as everyone that has donated so far. We are going to continue fundraising but I would like to also let you know that
    this broadcast special is not actually a fundraiser. We all wanted to raise the money before we went on air so when we do  air  live  on  April  18th  put your wallets away, put your credit  cards away, anything 
    away that you need to and just  sit back and enjoy the show that you all very much deserve.

    I’d like to pass this now to Hugh Evans, who’s been a wonderful partner of mine. Hugh, thank you so much and thank you, Dr Tedros.

    HE       Good morning, good afternoon,  good  evening  and thank you,  Dr Tedros  and thank you, Lady Gaga. Your Excellencies,  ladies  and gentlemen;  Lady Gaga, Dr Tedros, 
    you’ve both demonstrated extraordinary leadership at an unprecedented moment when our society is being challenged like never before and we are so thankful for your leadership. I’d like to echo Lady Gaga’s sentiment and commend the incredible acts
    of bravery demonstrated by the front-line community  health  workers around the world  and I hope  that we as a shared humanity emerge from this moment forever grateful for the work of doctors, nurses, teachers, grocery store workers and all of those who are
    the backbone of our communities.

    Global health is at the very core of the global citizen mission and we must  ensure that the world’s poorest and most  marginalised  people  have  access to resources to cope with and tackle this health crisis. Through One
    World:  Together At Home on April 18th  we’ll be calling on philanthropists, corporations and governments to fund critical global COVID-19 response efforts including distribution of resources and PPE to critical front-line healthcare
    workers.

    00:09:09

    In our partnership with the WHO and United Nations Global Citizen is committed to driving action to help ensure our global health systems are strong enough to stop a future pandemic before it happens. April 18th is going to be a moment of global unity
    connecting the world through a historic global broadcast. We are bringing together the greatest artists in the world under the passionate and extremely talented curation of Lady Gaga.

    In alphabetical order some of the artists we’ll be announcing today include Alanis Morissette, Andrea Bocelli,  Billie  Eilish,  Billy  Joe Armstrong  of Green Day, Burna Boy, Chris Martin, Sir David Beckham, Eddie Vedder,
    Sir Elton John, Finneas, Idris and Sabrina Elba, J Balvin, John Legend, Kacey Musgraves, Keith Urban, Kerry Washington,  Lang Lang,  Lizzo, Maluma, Sir Paul McCartney, Priyanka Chopra Jonas, Shah Rukh Khan, Stevie Wonder and many more to be announced over the coming weeks from all corners of the globe under the passionate and extremely talented curation of Lady Gaga.

    We’re grateful to all of you for participating and supporting this critical effort. One World Together At Home will be broadcast live on Saturday April 18th 2020 at 5:00pm PDT, 8:00pm EDT and 12:00am BST, airing on ABC, NBC, Viacom and CBS networks,
    IHeartMedia, and Bell media networks and platforms in Canada. Internationally BBC1 will run the programme on Sunday April 19th and additional  international  broadcasters include BN Media Group, Multi-Choice Group and RTE in Ireland.

    00:11:43

    The digital broadcast will celebrate and support brave community  health workers who are doing life-saving work on the front line and we’ve all seen the limitations of world leaders around this world to step up and face this extraordinary challenge 
    and we want to do our best to support the essential work of the World Health Organization, driving action and raising critical funds. Thank you again, Dr Tedros, and thank you, Lady Gaga, for your leadership.

    Thank you all.

    TJ        Thank you very much to our guests for their remarks. Dr Tedros, I guess you would like to thank them too.

    TAG    Once again I would like  to thank Lady Gaga and Hugh Evans for their  partnership. We had a call last week and I was so amazed by the energy and passion of Lady Gaga. It’s incredible commitment to humanity and that’s
    when I said, I think what she has planned can happen. It’s bringing the world together to improve awareness and to mobilise  resources to fight the pandemic so I thank her for her incredible passion and commitment  and leadership and
    also to my friend, Hugh Evans, for connecting all the dots and for his leadership.

    We all look forward to joining you for the One World: Together  At Home concert on 18th April. As the pandemic continues we recognise that individuals and governments want to do everything they can to protect themselves and others and so do we.
    We understand that some countries have recommended or are considering the use of both medical  and non-medical masks in the general population to prevent the spread of COVID-19.

    00:14:21

    First and foremost medical masks must be prioritised for health workers on the front lines  of  the response. We know medical masks can help to protect health workers but they’re in short supply globally.  We’re concerned that the mass
    use of medical  masks by the general population could exacerbate the shortage of these specialised masks for the people who need them most. In some places these shortages are putting health workers in real danger.

    In healthcare facilities WHO continues to recommend the use of medical masks, respirators and other personal protective equipment for  health workers. In the community we recommend the use of medical masks by people who are sick and those who
    are caring for a sick person at home.

    WHO has been evaluating the use of medical and non-medical masks for COVID-19 more widely. Today WHO is issuing guidance and criteria to support countries in making that decision. For example countries could consider using masks in communities where other measures such as cleaning hands and physical distancing are harder to achieve because of lack of water or cramped living conditions.

    If masks are worn they must be used safely and properly. WHO has guidance on how to put on, take off and dispose of masks. What’s clear is that there is limited research in  this  area. We encourage countries that are considering the use
    of masks for the general population to study their effectiveness so we can all learn. Most importantly masks should only  ever be used as part of a comprehensive package of interventions. There is no black or white answer and no silver bullet.
    Masks alone cannot stop the pandemic. Countries must continue to find, test, isolate and treat every case and trace every contact. Mask or no mask, there are proven things all of us can do to protect ourselves and others.

    00:17:13

    Keep your distance, clean your hands, cough or sneeze into your elbow  and avoid  touching your face. Less than 100 days since WHO was notified about the new coronavirus  research has accelerated at incredible speed. The viral genome
    was mapped  in  early January and shared globally, which enabled tests to be developed and vaccine research to start. More than 70 countries have joined WHO’s Solidarity Trial to accelerate the search for an effective treatment and about
    20 institutions and companies are racing to develop a vaccine.

    WHO is committed to ensuring that as medicines and vaccines are developed they’re shared equitably with all countries  and people.  I want to thank the  Medicines  Patent Pool and Unitaid for the initiative they announced last
    Friday to include medicines and diagnostics for COVID-19 in their licensing pool.

    I also want to thank the President of Costa Rica, President Carlos Alvadaro, and the Health Minister, Daniel Salas, for their proposal to create a pool of rights to tests, medicines and vaccines with free access or licensing on reasonable and affordable
    terms for all countries. Muchas gracias, Mr President. I support this proposal and we’re working with Costa Rica to finalise the details.

    00:19:09

    Poorer countries and fragile  economies  stand to face the biggest  shock from this  pandemic and leaving anyone unprotected will  only  prolong  the health crisis  and harm economies  more.  I call
    on all countries, companies and research institutions to support open data, open science and open collaboration so that all people can enjoy the benefits of science and research.

    Finally we’re nearing the end of the Ebola outbreak in the Democratic Republic of the Congo. This is one piece of good news. If there are no more cases the Government of the Democratic Republic of Congo could declare the outbreak over  as early
    as this  Sunday.  We’re not  there yet and we remain in full response mode. We’re continuing to investigate alerts and to test samples.

    This would not have been possible without the incredible  health workers who have put themselves at risk for more than 18 months to stop this outbreak, just as health workers are putting themselves in danger to save lives from COVID-19. Health
    workers in DRC faced the 
    double threat of fighting a deadly virus in one of the world’s most dangerous and unstable regions, exposing themselves to Ebola and bullets.

    Tomorrow, as you know, is WHO’s birthday, a day we celebrate each year as World Health Day. This year we’re paying tribute to the incredible contribution of all health workers, especially nurses and midwives. Nurses and midwives are the backbone of
    every health system. They’re there from the first moments of life to the last. Tomorrow we’re publishing our first report on the state of the world’s nursing which highlights gaps and makes recommendations for all countries.

    00:22:00

    One of the lessons I hope the world learns from COVID-19 is that we must invest in health workers, not only to protect lives but also to protect livelihoods. I thank you.

    TJ        Thank you very much, Dr Tedros. Also, as always, we have Dr Mike Ryan and Dr Maria Van Kerkhove, who will be answering questions. We will  now open the floor.  I will  go to one question
    that I received by email this morning and I promised to answer; that’s Ankit Kumar from India Today. Ankit is asking; we have recently seen a spike in  cases caused through religious gatherings in India, in fact almost a third of new cases
    were linked to one gathering in India. We have also seen incidents of violence against health workers due to fear and misinformation. Is WHO concerned with these developments, what is WHO’s message to religious and community leaders and their
    followers?

    MR      First and foremost the idea of violence against health workers is driven by fear and it’s driven by misunderstanding but it’s  really  unacceptable. We ask everyone and every community to see our health workers
    as our heroes and to support them in every way we can.

    With regard to gatherings of any type, be they religious or be they for other  purposes,  there are always risks associated with such gatherings in the midst of a major epidemic. WHO has issued guidance on that. Many of these gatherings
    are now postponed or cancelled.  We’ve been working very, very closely with religious  and faith-based organisations  all  over the world including  groups  from the Islamic  tradition,  Christian 
    traditions  and others and continue to work through faith-based organisations to communicate  using  our  Epiwin platform.

    00:24:21

    We’re also continuing to develop guidance specifically  for the holy  month  of Ramadan and are working through our Eastern Mediterranean regional office to be able to advise governments and religious institutions on how best to manage
    the risks associated with such holy events.

    But it’s very important again; having COVID-19 is not anybody’s fault. Every case is a victim and every case needs to be  treated with sensitivity,  as the health workers who treat them so it’s very important that we’re not profiling COVID-19
    along  racial,  along  religious,  along ethnic lines. This is not helpful.

    TJ        Thank you very much. This was a question  from Ankit  Kumar from India  Today. Now we will go to journalists online. We will start with Jamie from Associated Press. Jamie, can you hear us?

    JA        Hi, yes. Can you hear me? TJ            Yes. Please go ahead.

    JA        Great, thank you very much. I wanted to ask you about… Over the weekend Dr Anthony Fauci mentioned that – if I understood it correctly – as much as 50% of transmission could be asymptomatic. Just aligned 
    with that, if  you could  give  us a little  bit  more  about what you’re thinking about the fact that some countries have said that this outbreak is more infectious than influenza. The CDC is saying that it’s up
    to three times more infectious than influenza so what do you have to say about that? Thanks.

    00:26:13

    MK      I’ll start and then perhaps Mike or DG would like to supplement. The modes of transmission and the way in which this virus is transmitted  are of significant  interest to all of us. What we are doing is working
    with member states, we’re working with everyone that’s affected by this, looking through the research and trying to understand  when most transmission is happening, when any transmission is happening.

    What we know from reports, what we know from published literature is that the predominant way in which transmission is occurring is amongst symptomatic individuals  and these are people that can be very early on in symptoms, even when they start
    to feel a little bit unwell. This is supported by some data that attempts to catch a virus from individuals who are symptomatic.

    We also know that it’s possible that people can transmit in the few days before they become symptomatic or in their pre-symptomatic  phase. There have been some studies  that have come out and we learned about this when we were on mission
    in China back in January or early February, that there are individuals that can shed virus one to three days before they develop symptoms.

    However it’s very important to note that even if you are pre-symptomatic or even if you don’t have any recognised symptoms you still have to transmit through  droplets,  you still  have to have these infectious particles that come out
    of your nose and your mouth. So while we know that that is possible we do not believe that it’s a major driver of transmission.

    00:27:42

    We’ve also seen modelling estimates that suggest that there’re large numbers of unrecognised transmission and I used unrecognised on purpose because I’m not saying asymptomatic. I’m saying that we may be missing people who are out there who are infected
    but we’re missing them because of current surveillance strategies. That is certainly possible in many parts of the globe.

    Whether or not those individuals are asymptomatic; we will have to wait until we see the results of serologic studies, which we hope we’ll be seeing in the coming days if not weeks.

    So what we can say is that most people are transmitting this virus while they are symptomatic.

    JA        Hi, Jamie. Just in addition because I think – I would never in any way contradict my good friend, Tony Fauci, such an eminent man. There are many different estimations of what might represent asymptomatic
    transmission or other infections in the community and we do know and everyone accepts that when the seroepidemiology studies do come online we will probably find more people who’ve been infected unknowingly; there’s no question of that.

    The thing we need to address in all of this is  very often the idea of  severity versus infection and there is a huge association  between the dose  of exposure  and the severity  of infection. We see this in many other
    infectious diseases so we also probably need to look  at who is getting sick and very sick and is the dose and the type of exposure they’re getting different to those who may be exposed and seroconverted in the community.

    00:29:26

    So it’s not just a matter of looking at how many people in the community are infected but are there specific elements  of exposure  that cause individuals  to have  a higher dose of exposure or a specific route of exposure 
    that causes more severe infection?  There is  also that concept of infectious dose when we talk about the different types of transmission. If somebody is exposed to a high dose from another individual directly or from a surface that’s
    heavily contaminated you can imagine the large dose.

    In other circumstances individual particles or virus particles potentially floating through  the air; it can be demonstrated that that may happen in certain circumstances, certainly in healthcare settings. But is that significant  in 
    terms of driving  infection,  is  that significant, does that produce an infectious dose that can successfully infect another individual?

    These are all very important things that still need to be studied. Again we’re only a number of weeks into this. I think we need to have the seroepi studies. I think  we need more information on what is the infectious  dose  and particularly 
    the relationship  between the dose  of exposure or infection and the severity of disease subsequently, which has been seen with many, many other diseases in the past including cholera, Ebola and others.

    TJ        Thank you very much, Mike and Maria. We will go now to our next question; that’s Kai Kupferschmidt. Kai, can you hear us?

    00:31:01

    KA      Yes, Tarik. Thanks a lot for taking my question. I wanted to ask about the global  push  to try and find a pre-exposure  prophylaxis  or a post-exposure  prophylaxis. I understand there’re
    several trials going on, most of them with chloroquine  or hydroxychloroquine.  I was just wondering whether you can speak a little bit to what role this could potentially play.

    Of course also there’re a lot of smaller studies going on. Is there any way to make sure that they all lead to results that can be proved in the end?

    MR      Maria can give you more detail but certainly one of the Solidarity trials – I think Solidarity 3 or 4 – we have one of the trials under design which will be a multi-centre study which will look at prophylaxis in healthcare workers to see whether there’s evidence that giving lower doses of drugs like chloroquine or hydroxychloroquine to healthcare workers would reduce their risk of becoming infected in a healthcare environment.

    Those studies are certainly underway and again there are a number of those studies underway in smaller studies around the world but again as WHO we’re trying  to bring  together  a larger set of collaborative studies that will give
    us the answers we need.

    In terms of post-exposure prophylaxis I don’t believe  we have at the moment  studies  planned but Maria can speak to that but there is certainly evidence for the use of – not proven  evidence of effectiveness but there are a number
    of studies underway and trials underway that use hyperimmune globulin  in  the treatment  of disease; in  other words  they use that purified plasma of recovered individuals to give an antibody boost to people who are
    suffering the disease.

    00:32:49

    Similar approaches have been used in post-exposure prophylaxis for other diseases but Maria may be aware of studies underway in that area.

    MK      Only to add that, as you mentioned, there are a number of smaller studies that are happening globally and across a large number of countries.  We have teams through  our science division and through GOARN,
    through the Global Outbreak Alert Network, who are pulling together  available  literature  on a number  of topics,  one  of which is  looking  at different types of therapeutics and drugs.

    The idea is until we can have a study that pulls together enough of a sample size to get these answers to these questions we’re trying  to evaluate  every piece of evidence  that is  published so that we can look at the way in
    which these studies were done, we can look at the strengths, we can look at the limitations so that can help guide us closer  towards an effective treatment for COVID-19.

    TJ        Thank you very much. The next question is from BFM Radio. Is is Kate who is with us?

    KT       Yes, hi. Good evening or good morning.  I’m from BFM Radio  Malaysia. My question is, many countries around the world have imposed lock-downs or some sort of restrictions on movement. I was wondering
    what WHO’s guidance would  be; what’s the sweet spot, the kind of data that governments need to consider before lifting or relaxing  some  of these lock- downs? Thank you very much.

    00:34:29

    MR      Thank you. It is a difficulty for governments right  now  because the lock-downs  in many situations are proving effective in dampening the flames of the epidemic  in  those countries but those
    lock-downs are also causing great economic hardship and everybody especially in the developing world needs to get to a more sustainable way of managing this epidemic and controlling COVID-19 without continuing to damage economic and social life.

    The transition strategy out  of lock-down  requires  a calibrated,  step-wise approach.  It would be probably very inadvisable just to lift a complete lock-down, all of the measures because lock-downs are a general term that
    include closure of schools, closure of  churches, stay-at- home orders, closure of workplaces. It’s a mixture of different things and I think each government needs to break out, what does our lock-down actually constitute, what are the elements
    of our lock-down, where is that happening in the country, do we now understand the epidemiology of the disease in each area in which we have an element of lock-down or shut- down.

    Then to chart the path out, you have to build strong public health capacity to take over from the lock-down. In other words the lock-down is pushing the disease down by putting people back in their homes, by separating communities. Once you raise
    the lock-down you have to have an alternative method to suppress the infection. The  way to do that is active  case finding, testing, isolation of cases, tracking of contacts, quarantining of contacts and strong community education and
    participation and ownership around normal physical distancing, hygiene and giving communities the power to control infection by in effect managing their own physical distance, managing their own capacities to support the response.

    00:36:32

    In that situation, if you’ve strong public health capacity, if you’ve got a community that’s mobilised and empowered and if you’ve strengthened your health system then you’re potentially in a position to start unlocking or unwinding the lock-down.
    The specific parameters you need to be looking at are on two sides.

    One is, it would be very inadvisable to lock down [sic] if the number  of cases coming  through the hospital is already at a level where your  occupancy of  beds is  nearly at 100%.  You need to be in a position where
    you now have free beds in your system so that you’re managing and coping with the caseload and that means you have some absorption capacity left.

    You need to look at things like the doubling  rate; how  many days does it  take for the  number of cases to double? You need to look at positivity rates; what proportion of all samples that we test are positive? You’ll see in
    somewhere like Korea two to 6% of the samples  they test are positive. Last week in New York 37% of tested samples were positive so you need to carefully look at what proportion of people you test are positive.

    00:37:45

    You need to look at the number of contacts that are generated per case and it goes on and on and WHO will be issuing guidance to countries that is a much more specific around the parameters they should be looking at. There are no absolutes here, there
    are no answers, there are no numbers that say if this number is this then you do that. That doesn’t exist but what we can do is offer countries very specific  measurements  that they need to look  at to chart the path out of lock-down.

    That step-wise approach of unlocking somewhat and then waiting to see; I think you need to say, we will stop doing this element of the shut-down  and then we will  wait and we will  look at the data and if that works we go to the next
    stage and the next stage. So a careful, calibrated, step-wise exit from lock-down with putting in place public health capacities, putting in place community capacity, building the capacity of the health system to cope should the disease bounce back up; that’s the safe path out of lock-down.

    We want to achieve it as quickly as possible and we want to avoid many countries going  into that circumstance and we still have many countries around the world who are not in a locked- down situation. In fact their epidemiology would suggest
    they can avoid the worst of this and we need to support them to avoid them going into that situation.

    The most damaging lock-downs are in many developing countries  where people  – as the  DG has said many times – can live from hand to mouth, not from pay cheque to pay cheque but from day to day and we have to find adaptive solutions
    around lock-down and around disease control in vulnerable periurban populations living in poverty,  in  poor  rural communities.  We have to find alternative, adapted ways to manage lock-downs or slow-downs or shut-downs in
    those situations.

    00:39:41

    TJ        Thank you very much. This was Kate from BFM Radio in Malaysia. Now we will  go to Nigeria to Natural Star and it’s Innocent. Innocent, can you hear us?

    IN        Thank you. Can you hear me?

    TJ        Not very well but we will try. Please go ahead.

    IN        Okay, thank you for taking my questions. I have two questions to ask. One; how will WHO assess African countries on what they’ve done concerning the lock-down and management of COVID-19?

    Then the second one; there’s news going around that vaccines are to be tested on Africans when they’re developed. How true is that and is there a window that’s in the nearer future when a vaccine will be developed for COVID-19? Thank you.

    Hello?

    TJ        Yes, we are just trying to make sure that we understood the question but we will try. MR     I think this is Nigeria. Is it?

    TJ        Yes.

    00:41:08

    MR      Maria may answer the question around vaccine development. With regard to our general assessment on lock-down – and the Director-General may wish to comment on this because he’s been speaking with many leaders in Africa
    and, I believe, spoke with  the whole of the African Union leadership and countries late last week so therefore is in a much better position than me to speak about that.

    We would characterise so far, Africa’s actually doing well in this response thus far. Countries have essential capacities for testing, many countries are taking strong action and want to really focus on finding cases and doing contact tracing and trying to stop this disease becoming much more extensive given the fact that health systems are not as strong in many countries. 

    They need support in that though, they need support in testing, they need support with protective gear and they need to be given the resources to be able to mount those types of responses so I would characterise that Africa has not suffered the worst
    of this pandemic so far. The worst of it can be avoided with very, very swift action to support those countries in Africa who really do want to take a comprehensive approach to this disease.

    With the many vulnerable  people  including  refugees and migrants  who live  in  those countries it is our responsibility to provide that support but, DG, you may wish to speak about your interactions with the African
    Union countries.

    00:42:46

    MK      I’ll answer the question  around vaccines. What we can say is  that there are a number of vaccines that are in development and vaccines will be tested through clinical trials with all ethical considerations
    in place in whichever  populations  are under  study  with informed consent, with open and transparent communication. This is of the utmost importance, that not only do we have strong, robust  scientific  evidence 
    but  we ensure that all  of the studies  that are done are done with appropriate and the highest level of ethical considerations.

    One thing on the first question around Africa is that there are a number of countries in Africa right now which have very few cases and Mike has alluded to this in his earlier response.

    Some only have imported cases and there is an opportunity here, this  window  of opportunity that the DG has spoken about exists  in  many countries  still.  There is  an opportunity to prevent the worst from happening
    in a number of countries across Africa and across countries that are still seeing their first case; in some island countries.

    We need to support those governments, those countries, all of the people in those areas to prevent the worst from happening, to prevent these individual cases from becoming clusters, these clusters from becoming community transmission. I think that’s
    where we need to put  a lot of emphasis and support so that we can prevent countries  from reaching a point  where they need to put in these very restrictive movement restrictions.

    TAG    Thank you. Thank you for that question, my brother from Nigeria. On the situation, as Mike said, of course when you see the number of cases the African continent has the lowest number of cases so far but that doesn’t mean that
    the situation will not deteriorate. It may.

    00:45:06

    So Africa should do everything to prevent this situation from getting worse and that’s why African leaders are doing their best. I had a chance to participate in a meeting, a Leaders’ Coalition which was arranged or invited by the current Chairperson
    of the African Union, the President of South Africa, President Ramaphoza and many leaders from all corners of the continent have actually participated.

    The main agenda is to have a continental strategy and also make sure that that continental strategy helps the national strategy but in addition to a coalition of political leaders or the heads of state and government they have also agreed to have a coalition of business leaders. Business leaders in Africa are also getting together because Africa will need resources and one of the major problems that was identified during the discussion
    was especially shortage of equipment starting from medical equipment, PPE and test kits and so on.

    The leaders have agreed to look for concrete solutions to address the problem and they also believe that considering the number of cases we have in the continent testing cases, tracing contacts and isolating them, meaning using the comprehensive approach,
    will actually  help. They believe that lock-downs alone may not help or the physical distancing alone cannot help and they have agreed to do everything to follow the comprehensive approach.

    From WHO’s side we have been supporting and we increased, improved  the testing capacity in Africa significantly in the past two months and many countries in Africa have now testing capability although we may have a shortage of test kits but 
    we’re working  on that too and we’re finding different ways of addressing the gap.

    00:48:06

    But we will support the African Union, we will support the Africa CDC and also we will continue working through our WHO regional office in Congo Brazzaville and continue to support and fight the pandemic together.

    Then on the vaccines issue there was, I think, a comment last week from a couple of

    scientists who said the testing ground for the new vaccines will be Africa. To be honest,  I was so appalled and it was a time when I said, when we needed solidarity these kind of racist remarks actually would not help, it goes against the solidarity.

    Africa cannot and will not be a testing ground for any vaccine. We will follow all the rules to test any vaccine or therapeutics all over the world using exactly the same rules. Whether it’s

    in Europe, Africa or wherever we will use the same protocol and if there is a need to be tested elsewhere to treat human beings the same way, equally.

    The hangover from a colonial mentality has to stop — and WHO will  not  allow  this  to happen. It was a disgrace actually  and appalling  to hear during the 21st century from scientists that kind of remark and we condemn
    this in  the strongest  terms possible  but  we assure you  that this will not happen in Africa and will not happen elsewhere, in any country. Proper protocols will be followed and human beings will be treated as human
    beings because we’re all human beings.

    00:50:37

    Then after saying this the vaccine development; we’re addressing two issues and we will be announcing as soon as possible, hopefully during this week, a big initiative to accelerate the research and development and production of vaccines and also
    design mechanisms for equitable distribution of the vaccines.

    While we’re looking for vaccines, unless we break the barriers to equitable distribution of the products, whether it’s vaccines or therapeutics, we will have a problem, so we need to address the problem ahead of time, we need to address the problem
    of access or challenges to access ahead of time.

    That’s why we will put together a mechanism and we will appoint senior people from the North and South that will work out the details on how they can accelerate production but at the same time how they can ensure equitable distribution. Solidarity
    is very important here. When a vaccine or a medicine is ready we have to be able to deliver it all over the world.

    There should not be a divide between the haves and the have-nots.

    If we say solidarity, solidarity should be in its full form and I hope each and every individual, each and every human being will go for that kind of solidarity. I thank you.

    TJ        Thank you, Dr Tedros. We’ll take a couple more questions. We go to Yang from Xinhua news agency. Yang, can you hear us?

    00:52:58

    YA      Can I hear you?

    TJ        Yes, we can hear you. Please go ahead.

    YA      As World Health Day is approaching  what do you  have to say to the  front-line medical workers in China and around the world in  the global  anti-virus  efforts? This  question is
    for Dr Tedros. Thank you.

    TJ        If we understood well, the question is what is the message to health workers in China and around the world. Maybe you can repeat the question one more time, please.

    YA      Okay. As World Health Day is approaching what would you say and what message do you want to deliver to the front-line medical workers in China  and around the world  in  the global anti-virus effort?

    TAG    I think I have said it earlier;  as you  know,  this  is  the year of  the nurse and the midwife, 2020. We were ready to celebrate it in a big way and it was supposed to be the main event in our
    Assembly in mid-May. Unfortunately we’re in this situation but  we will  be launching a report tomorrow which is the first of its kind.  It’s a report on the  state of nursing. We will launch it tomorrow during the World Health
    Day.

    00:55:01

    But while launching that report, although it’s about nursing, we will celebrate all health workers, midwives, pharmacists, doctors, you name it. I think the world is now seeing the importance and the central role that health workers play. People,
    when they’re asked, of course, to choose they would say health first because it’s only when you’re healthy that you can aspire to anything, whether it’s wealth or fame or anything. It doesn’t matter if you’re not healthy.

    If you’re not healthy the first thing you ask for is to get back your health and our health workers are making sure that happens and they’re central and very important for any individual. So not only during COVID but during other times too health
    professionals are very important because they are safeguarding that very important aspect of life — that’s health.

    So we have to celebrate them every day. Of course during COVID we can see to what extent they’re sacrificing. We have lost many of them. They’re dying while  saving lives  so my message first is to the public at large; that each and every individual 
    should  recognise, whether it’s during normal times or pandemics like now, the role of health  professionals  and help them, protect them, really appreciate and respect what they are doing.

    To the health workers, although especially during this COVID pandemic you’re working in a difficult situation you should know that your work is the most blessed one, your work is something  special to the extent of losing  your  life 
    while  helping  others to live.  We respect you and appreciate you for that and we also believe in you and that you will do everything to control this pandemic.

    00:58:11

    But you should know that you have – and the world understands – the most important job. We can see the humility which is coming from some leaders because of this pandemic. I know they’re seeing, starting from their own lives, the whole world through 
    a different  prism  and they will also see your role.

    But the most important is not the recognition from the public or from leaders but the internal commitment and passion you have and believing that you’re doing the most blessed thing  and you have all our respect and appreciation and we believe in 
    you,  that together  we will  finish this pandemic. All the respect and appreciation we have to you, the greatest respect and appreciation ever. Thank you.

    TJ        Thank you very much, Dr Tedros. I think this important message will be heard from everyone and we will  conclude  this  press briefing with these important  words from Dr Tedros. We will
    have an audio file available in the minutes to come and we invite you for our next briefing on Wednesday. Thank you.

    TAG    [Inaudible] and see you on Wednesday – tomorrow actually for the launch. Yes, see you tomorrow.

    01:00:18

    Virtual Press Conference on COVID-19- 06 April 2020
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    https://www.who.int/news-room/detail/06-04-2020-virtual-press-conference-on-covid-19–06-april-2020

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  • National Ethics Committees and COVID-19

    National Ethics Committees and COVID-19

    On
    Monday April 6, WHO will host a digital assembly to facilitate communication,
    collaboration and alternate between National Ethics Committees from across the
    world to assist international locations reply to the moral challenges offered by
    COVID-19. This assembly will likely be chaired by Hugh Whittall from the Nuffield
    Council on Bioethics.

    Related sources

    A selection of work addressing the COVID-19 pandemic

    National Ethics Committees and COVID-19
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    https://www.who.int/news-room/detail/04-04-2020-national-ethics-committees-and-covid-19

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  • WHO and UNICEF to partner on pandemic response through COVID-19 Solidarity Response Fund

    WHO and UNICEF as we speak introduced an settlement to work collectively on COVID-19 response, through the historic COVID-19 Solidarity Response Fund powered by the United Nations Foundation and Swiss Philanthropy Foundation.  

    The COVID-19 Solidarity Response Fund has been arrange to facilitate an unprecedented world response by supporting the WHO Strategic Preparedness and Response Plan. As a part of the settlement, an preliminary portion of the cash from
    the Fund – which presently stands at greater than $127 million – will circulate to UNICEF for its work with susceptible kids and communities everywhere in the world.

    “COVID-19 is an unprecedented pandemic requiring extraordinary global solidarity to urgently respond,” stated Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “I’m happy that UNICEF joined the Solidarity
    Response Fund. With their in depth expertise each in fundraising and in implementing programmes, this partnership will assist us to work collectively carefully to save lives.”

    The cash collected through the fund can be used, amongst others, to practice and equip communities and health-care staff to forestall, detect and deal with COVID-19. It will assist international locations broaden their health-care capability and mitigate its social impression, particularly
    on girls, kids and susceptible social teams. And it should speed up analysis and improvement of therapies and preventive vaccines.

    As a key partner on this joined-up effort, UNICEF will lead emergency efforts to guarantee households and communities in probably the most susceptible international locations are totally engaged within the response and have entry to water, sanitation and hygiene and different an infection prevention
    and management measures. UNICEF may even guarantee kids, caretakers, and frontline responders corresponding to social staff, academics and healthcare staff are supported through evidence-based steering through its huge group outreach and nation
    packages.

    “This is an extraordinary emergency that demands an extraordinary response, and we need all-hands on deck—individuals, corporations, foundations, governments and other organizations around the world,” stated UNICEF Executive Director Henrietta
    Fore. “UNICEF is happy to be a part of the Solidarity Response Fund. It will bolster our efforts to strengthen well being and sanitation techniques and assist shield probably the most susceptible households from knock-on impacts of COVID-19 on already overstretched well being
    techniques.”

    Funds raised can be spent in alignment with the worldwide response plan, and the place wants are biggest. At the path of WHO management, it’s anticipated that sources will go immediately towards:

    • WHO, for its work to monitor the unfold of the virus, assess gaps and wants, equip frontline well being staff with private protecting gear, guarantee lab and testing instruments can be found in international locations around the globe, and maintain communities
      and frontline responders knowledgeable with the most recent technical steering.
    • UNICEF, to guarantee kids and households around the globe are outfitted with all of the evidence-based data and newest WHO steering in addition to domestically related data to shield themselves from the unfold of COVID-19; to assist
      susceptible international locations by offering entry to water, sanitation and hygiene, and primary an infection prevention and management measures; and to present entry to look after susceptible households and kids.
    • CEPI, the Coalition for Epidemic Preparedness Innovations, a key partner main the financing for analysis and improvement for novel vaccines to fight COVID-19, working carefully with WHO.

    The COVID-19 Solidarity Response Fund was arrange at WHO’s request by the UN Foundation and Swiss Philanthropy Foundation and launched three weeks in the past. It is the one manner for people and organizations to contribute immediately to WHO’s
    world efforts to deal with the pandemic. To date the fund has $127 million raised or dedicated from greater than 219,000 people from everywhere in the world plus greater than 90 world corporations and organizations. The partnership can be an amazing
    demonstration of solidarity throughout UN organizations in coordinating, partnering and supporting one another in coping with the instant and longer-term impression of the pandemic. 

    “There has never been a more urgent need for global cooperation,” stated Elizabeth Cousens, President & CEO of the UN Foundation. “The COVID-19 pandemic reveals us that all of us can play a component to cease the unfold. The unimaginable
    generosity proven to the COVID-19 Solidarity Response Fund from around the globe will assist WHO, UNICEF, CEPI and companions speed up their lifesaving work, particularly to assist probably the most susceptible communities and velocity the event of a
    vaccine.”

    ###

    Notes to editors

    About UNICEF

    UNICEF works in a few of the world’s hardest locations, to attain the world’s most deprived kids. Across greater than 190 international locations and territories, we work for each little one, in every single place, to construct a greater world for everybody.

    About WHO

    WHO is the United Nations’ specialised company for well being. It is an inter-governmental group and works in collaboration with its Member States often through the Ministries of Health. The World Health
    Organization is accountable for offering management on world well being issues, shaping the well being analysis agenda, setting norms and requirements, articulating evidence-based coverage choices, offering technical assist to international locations and monitoring
    and assessing well being tendencies. Learn extra at www.who.int.

    About the United Nations Foundation

    The UN Foundation brings collectively concepts, folks, and sources to assist the United Nations drive world progress and deal with pressing issues. Our hallmark is to collaborate for lasting change and innovate to handle humanity’s biggest challenges.
    Learn extra at www.unfoundation.org.

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  • Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem 1

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem 2


    A lot of legal issues are bound to arise as an aftermath of the outbreak of Coronavirus otherwise referred to as COVID-19.  There is therefore a need to shed light on some of the issues that may arise and how to navigate them. This article will x-ray the rights of patients, the rights of health workers and the basic minimum obligations of the government.

    The Code of Medical Ethics in Nigeria 2008 lists acts that constitute professional negligence. Rule 29.4 of the Code outlines some of these acts as follows:-

    a)      Failure to attend promptly to a patient requiring urgent attention when the practitioner was in a position to do so;

    b)     Manifesting incompetence in the assessment of a patient;

    c)      Making an incorrect diagnosis particularly when the clinical features were so glaring that no reasonable skillful practitioner could have failed to notice them; 

    d)     Failure to advise, or proffering wrong advice to  a patient on the risk involved in a particular operation or course of treatment, especially if such an operation or course of treatment is likely to result in serious side effects like deformity or loss of organ, or function;

    e)      Failure to obtain the informed consent of the patient before proceeding on any surgical procedure or course of treatment when such consent was necessary; 

    f)       Making a mistake in treatment e.g. amputation of the wrong limb, carelessness that results in the termination of a pregnancy, prescribing the wrong drug, or dosage in error for a correctly diagnosed ailment, etc;

    g)     Failure to refer, or transfer a patient in good time, when such a referral or transfer was necessary;

    h)     Failure to do anything that ought reasonably to have been done under any circumstance for the good of the patient;

    i)       Failure to see a patient as often as his medical condition warrants or to make appropriate comments in the case notes of the practitioner’s observations and prescribed treatment during such visits. It also includes failure to communicate with the patient or with his relatives as may be necessary with regards to any developments, progress or prognosis in the patient’s condition.

     

    Rule 11.2 of the 2008 Code of Medical Ethics in Nigeria provides that, “A physician shall preserve absolute confidentiality on all he knows about his patient even after the patient has died.”

                 Rule 44 of the Code of Medical Ethics has extensive provisions on Confidentiality and when disclosure of information can be made. The Rule provides in part that:

    “Disclosure of information on the patient by the doctor can only be made following an informed consent of the patient in writing. It is clear that the ethic covers even such information as induced abortion, venereal disease, attempted suicide, concealed birth and drug dependence but would exclude situations in which a discretionary breach of confidentiality is necessary to protect the patient or the community from danger and this must be made clear to the patient at the time of the confidential disclosure. Where statutory notification of disease is involved, the consent of the patient is not required.”            

                Confidentiality: To Disclose Identity Of Covid-19 Patients Or Not To Disclose?

    COVID-19 is an infectious disease caused by a newly discovered coronavirus. Most people infected with the COVID-19 will experience mild to moderate respiratory illness and recover without requiring special treatment.  Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.[1]

    The Federal Ministry of Health confirmed the first case of COVID-19 in Nigeria on the 27th of February 2020. It is the case of an Italian citizen who works in Nigeria and returned from Milan, Italy to Lagos, Nigeria on the 25th of February 2020. In reaction to the report, the social was divided between those who want the name of the Italian disclosed and those that preferred it remains confidential. The outcry was even more when the Chief of Staff to the President tested positive according to reports from various media houses[2], but the Minister of Health decided to keep mute on the identity of the President’s aide who contacted the virus, citing confidentiality.

    It will ordinarily be wrong to disclose the medical status of someone infected with COVID-19, for instancethe case of the Italian who was the index case. However in view of the proviso to Rule 44 of the Code of Medical Ethics 2008 which provides that a discretionary breach of confidentiality is necessary in order to protect the community from danger, I am of the view that the test results of popular figures who hold strategic offices like the Chief of Staff to the President or a Governor must be disclosed to guaranty public safety. This is necessary in view of the countless number of people from all works of life they come in contact with on a daily basis.  It will be correct to have made their status public in the overriding interest of the public, since it will enable those who have come in contact with them isolate, just like we have seen in the cases of the British Prime Minister, the Bauchi State Govenor, Prince Charles, the First Lady of Canada and many more. We must commend those who announced their status in public themselves-it is the best thing to do in the interest of humanity

    The World Health Organization (WHO) provides additional guidelines for the management of coronavirus patients specifically.[3]

    Health workers should:

    •follow established occupational safety and health procedures, avoid exposing others to health and safety risks and participate in employer-provided occupational safety and health training; 

    •use provided protocols to assess, triage and treat patients; 

    •treat patients with respect, compassion and dignity; 

    •maintain patient confidentiality; 

    •swiftly follow established public health reporting procedures of suspect and confirmed cases; 

    •provide or reinforce accurate infection prevention and control and public health information, including to concerned people who have neither symptoms nor risk;

    •put on, use, take off and dispose of personal protective equipment properly;

    •self-monitor for signs of illness and self-isolate or report illness to managers, if it occurs; 

    •advise management if they are experiencing signs of undue stress or mental health challenges that require support interventions; and 

    •report  to  their  immediate  supervisor  any  situation  which  they  have  reasonable  justification  to  believe presents an imminent and serious danger to life or health.

     

    Doctors and health workers in Nigeria must endeavor to digest the guidelines in the Code of Medical Ethics as well as the WHO Guidelines for management of Coronavirus victims and ensure they work strictly by their provisions. A breach of these duties have dire consequences. 

    Options Available To Covid-19 Patients Who Are Victims Of Medical Negligence

    A Coronavirus patient who has suffered medical negligence has a number of options:

    1. He could file a complaint with the regulatory body (e.g. the Medical and Dental Council of Nigeria, in the cases involving a Doctor). The Doctor will in the first instance be investigated by the Medical and Dental Practitioners Investigation Panel, after which he will be tried by the Medical and Dental Practitioners Disciplinary Tribunal. If found culpable,  the Doctor may be warned, suspended from practicing for a period not exceeding 6 months or in very serious cases, have his name can be removed from the Register of Medical Practitioners. The Medical and Dental Practitioners’ Disciplinary Tribunal does not award monetary damages.

    2. A suit can be filed against the Medical Doctor, the Hospital, Agency or Government in the High Court for Medical Negligence and monetary damages will be awarded if the Defendant(s) are found culpable.

          3.  If there is an element of Crime, a report could be made to the Police who would conduct Criminal Investigation and where the investigation reveals gross negligence, recklessness or wanton disregard for life of the victim, the police can prosecute or forward the case file to the office of the Attorney General of the State for possible prosecution in deserving cases.  

    A Need To Do More For Doctors And Other Professionals In The Health Sector

    Health workers are at the front line of any outbreak response and as such are exposed to hazards that put them at risk of infection with an outbreak pathogen (in this case COVID-19). Hazards include pathogen exposure, long working  hours,  psychological  distress,  fatigue,  occupational  burnout,  stigma,  and  physical  and  psychological violence. 

    During the outbreak of Ebola more than 500 health care workers died in Guinea, Liberia and Sierra-Leone alone. We also lost some of our finest doctors and health workers to the disease in Nigeria, the most prominent being Dr. Stella Adadevoh, who is credited with having curbed a wider spread of the Ebola virus in Nigeria by placing the index patient, Patrick Sawyer, in quarantine despite pressures from the Liberian  government. As we speak, The coronavirus is waging a war of attrition against health care workers throughout the world, but nowhere is it winning more battles at the moment than in Italy and in Spain, where protective equipment and tests have been in severely short supply for weeks. In Spain 13.6% (6500) of those affected with the coronavirus are health workers and in Italy 10% (7400) of those affected with the virus are health workers. [4] In New York dozens of health workers have been affected with the virus, while hundreds are in quarantine.[5] According to reports filtering in as the time of concluding this article, three health workers have been infected with COVID-19 in Abuja, Nigeria.[6]

    Human Rights Watch research into health system collapse in Hungary and Venezuela suggests the nations’ mismanaged, underfunded, and understaffed public healthcare system is poorly equipped to handle a COVID-19 outbreak. Patients and medical experts described a lack of basic hygiene protocol, lack of isolation rooms, and a shortage of health professionals, doctors and nurses, and medical supplies in general.

    The situation is not too different in Nigeria at the moment and except something drastic is done we might be witnessing a devastating effect of the pandemic. Nigeria’s, public health capacity has been diminished by large scale public sector corruption. Medical personnel lack surgical masks and local supplies have been diverted and shipped to other markets partly due to corruption. Many states are ill-prepared to combat the impeding surge in patients. A senior health worker with a government hospital in Abuja, in an interview with Sahara Reporters, lamented the lack of quality Personal Protective Equipment for them, adding that government must invest in the protection of health workers at the frontline of the battle against the virus. He said, “The unfortunate thing is that the government is not providing us with what to work with. It is sad that our PPE are not up to the world standard and can be penetrated by viruses. Some of us (health workers) have to use our personal funds to purchase gloves as we do not trust the ones government supplied. Nigerians should please remember us in their prayers and government should provide us with what we really need to work.” [7]

    There was report that in Bauchi State a Coronavirus patient rejected the isolation centre at the Bauchi Specialist Hospital and went back home while describing it as “too dirty”.[8]  

    It is disappointing to hear that the hazard allowance for doctors and health workers is N5,000 per month in Nigeria. The amount is very paltry compared to the risks and the attendant emotional and psychological stress suffered by the health-care workers (HWCs) particularly during monumental outbreaks like this. Unfortunately, when a patient is mismanaged, these doctors and health workers bear the burden of paying huge compensation and sometimes losing their jobs. More importantly, the brain-drain in the health sector is monumental, almost all my friends who are doctors, work abroad. Unfortunately, there are concerted efforts by the US Government to engage foreign Doctors to further fortify its health work force as COVID-19 ravages. Many young Nigerian doctors are already considering the offers because the Nigerian government has paid little attention to their welfare and the welfare of the general health workforce. To stop the exodus of our doctors, who are already in short supply, the government must act fast by improving their welfare packages in line with acceptable international standards.

    The psychological needs of doctors and health workers are also often ignored. Unsafe working conditions contribute to health worker attrition in many countries due to work-related illness and injury and the resulting fear of health workers of occupational infection, including from HIV and Tuberculosis. The 2006 World Health Report – Working Together for Health reported on a severe health workforce crisis in fifty-seven countries, most of them in Africa and Asia. [9]

    Protecting the occupational health of health workers is critical to having an adequate workforce of trained and healthy health personnel. Governments at the Federal and State levels are urged to do more by complying fully with the World Health Organization’s guidelines regarding the Rights of Health Workers while combating COVID-19. Some of the rights are:

    ·         assume overall responsibility to ensure that all necessary preventive and protective measures are taken to minimize occupational safety and health risks;

    ·         provide information, instruction and training on occupational safety and health, including; Refresher training on infection prevention and control(IPC); and Use, putting on, taking off and disposal of personal protective equipment(PPE);

    ·         provide adequate IPC and PPE supplies (masks, gloves, goggles, gowns, hand sanitizer, soap and water, cleaning supplies) in sufficient quantity to healthcare or other staff caring for suspected or confirmed COVID-19 patients, such that workers do not incur expenses for occupational safety and health requirements;

    ·         not be required to return to a work situation where there is continuing orserious danger to life or health, until the employer has taken any necessary remedial action;

    ·         allow workers to exercise the right to remove themselves from a work situation that they have reasonable justification to believe presents an imminent and serious danger to their life or health. When a health worker exercises this right, they shall be protected from any undue consequences; 

    ·         honour the right to compensation, rehabilitation and curative services if infected with COVID-19 following exposure in the workplace. This would be considered occupational exposure and resulting illness would be considered an occupational disease,

    ·         provide access to mental health and counselling resources; and 

    ·         enable co-operation between management and workers and/or their representatives. Etc.

    In conclusion, professional care givers for COVID-19 patients should uphold four basic principles formulated by Beauchamp and Childress in their book ‘Principles of Biomedical Ethics’ in order to protect themselves from liability for negligence. The four basic principles are autonomy, beneficence, non-maleficence and justice.

    Autonomy: People have the right to control what happens to their bodies. This principle simply means that an informed, competent adult patient can refuse or accept treatments, drugs, and surgeries according to their wishes. People have the right to control what happens to their bodies because they are free and rational. And these decisions must be respected by everyone, even if those decisions aren’t in the best interest of the patient.

    Beneficence: All healthcare providers must strive to improve their patient’s health, to do the most good for the patient in every situation. But what is good for one patient may not be good for another, so each situation should be considered individually. And other values that might conflict with beneficence may need to be considered.

    Non-maleficence: “First, do no harm” is the bedrock of medical ethics. In every situation, healthcare providers should avoid causing harm to their patients. You should also be aware of the doctrine of double effect, where a treatment intended for good unintentionally causes harm. This doctrine helps you make difficult decisions about whether actions with double effects can be undertaken.

    Justice: The fourth principle demands that you should try to be as fair as possible when offering treatments to patients and allocating scarce medical resources. You should be able to justify your actions in every situation. For instance, it will amount to a professional misconduct for a Health-care Worker to remove a poor man from the ventilator because a Senator was rushed in. 

    Ahmed Adetola-Kazeem is a partner in Adetola-Kazeem Legal Practice and specializes in Medical and Health Law

    Email: aadetolakazeem@gmail.com;aadetolakazeem@gaklp.com

    [1] https://www.who.int/health-topics/coronavirus#tab=tab_1(Accessed on the 28th of March 2020)

    [2] https://businessday.ng/coronavirus/article/abba-kyari-tests-positive-for-coronavirus-buhari-negative/

    https://www.channelstv.com/2020/03/24/buharis-chief-of-staff-abba-kyari-reportedly-tests-positive-for-coronavirus/ (Accessed on the 28th of March 2020)

    [3] Coronavirus Disease (Covid-19) Outbreak: Rights, Roles and Responsibilities Of Health workers, Including Key Considerations For Occupational Safety And Health”. https://www.who.int/docs/default-source/coronaviruse/who-rights-roles-respon-hw-covid-19.pdf?sfvrsn=bcabd401_0   (Accessed on the 26th of March 2020)

    [4] https://abcnews.go.com/Health/wireStory/collapsing-virus-pummels-medics-spain-italy-69789413 (Accessed on 26th March 2020)

    [5] https://www.washingtonpost.com/health/covid-19-hits-doctors-nurses-emts-threatening-health-system/2020/03/17/f21147e8-67aa-11ea-b313-df458622c2cc_story.html (Accessed on 28th of March 2020)

    [6] http://saharareporters.com/2020/03/28/exclusive-two-nurses-one-doctor-infected-coronavirus-abuja-hospital

    [7] Supra

    [8] https://www.dailytrust.com.ng/coronavirus-patient-rejects-bauchi-isolation-centre-returns-home.html (Accessed on 28th March 2020)

    [9] https://www.who.int/occupational_health/topics/hcworkers/en/(Accessed on 26th March 2020)

     

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  • Group Hails Army Commander, Adeniyi, For Bravery, Patriotism In Boko Haram Fight After Removal By Buratai

    Group Hails Army Commander, Adeniyi, For Bravery, Patriotism In Boko Haram Fight After Removal By Buratai

    Group Hails Army Commander, Adeniyi, For Bravery, Patriotism In Boko Haram Fight After Removal By Buratai 3

    Group Hails Army Commander, Adeniyi, For Bravery, Patriotism In Boko Haram Fight After Removal By Buratai 4


     

    Concerned Nigerians, a civil society group, has commended Major General Olusegun Adeniyi for revealing challenges faced by troops fighting Boko Haram in Nigeria’s North-East.

    SaharaReporters had earlier reported that Adeniyi was removed as commander of Operation LAFIYA DOLE for revealing in a viral video that troops fighting Boko Haram terrorists lacked weapons and credible intelligence to execute their mission. 

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    Group Hails Army Commander, Adeniyi, For Bravery, Patriotism In Boko Haram Fight After Removal By Buratai 5

    Breaking News

    BREAKING: Nigerian Army Removes General In Viral Video Asking For Weapons To Fight Boko Haram


    The rights group in a statement by Convener, Deji Adeyanju, on Tuesday, said it was obvious Adeniyi was vilified for saying the truth and looking out for the safety of his men on the battlefield.

    The statement reads, “We are greatly impressed with Major-General Adeniyi and his men for their unwavering patriotism, steadfastness and gallantry in fighting against these enemies of humanity. 
    “We want to assure Major-General Adeniyi that Nigerian people look up to him and the boys, their devotion to duty, integrity and sense of honour and commitment to each other in the fight against Boko Haram is well appreciated and noted.”

    Adeyanju called on the Nigerian Government to launch a thorough investigation into the welfare of troops fighting Boko Haram terrorists as well as investing in tools for efficient intelligence gathering. 

     

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  • Nigerian Army Redeploys Senior Officers In Major Shake-up

    Nigerian Army Redeploys Senior Officers In Major Shake-up

    Nigerian Army Redeploys Senior Officers In Major Shake-up 6

    Nigerian Army Redeploys Senior Officers In Major Shake-up 7


     

    As earlier reported by SaharaReporters, the Nigerian Army has announced the redeployment of senior officers, claiming that the move was in a bid to add freshness into the war against terrorism in the country.

    The posting, which was approved by the Chief of Army Staff, Lt Gen Tukur Yusuf Buratai, led to the removal of Maj. Gen. Olusegun Adeniyi as Theatre Command Operation LAFIYA DOLE, the group fighting Boko Haram terrorists in the North-East region of the country.

    Adeniyi, who spoke out against the lack of weapons and accurate intelligence to fight terrorists in the region in a video that went viral a few days ago, was moved to the Nigerian Army Resource Centre as Senior Research Fellow after his outburst embarrassed the military authorities. 

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    Breaking News

    BREAKING: Nigerian Army Removes General In Viral Video Asking For Weapons To Fight Boko Haram


    In a statement on Tuesday, Acting Director Army Public Relations, Col. Sagir Musa, said, “The major highlight of the posting includes the posting and appointment of Maj Gen ACC Agundu from Special Task Force, Operation SAFE HAVEN, Jos, to Nigerian Army Resource Centre (NARC), Abuja, as Senior Research Fellow, Major General HI Bature from Defence Headquarters (DHQ), Defence Liaison Office, National Assembly Abuja, to Army Headquarters, Department of Civil Military Affairs and appointed Chief of Civil-Military Affairs, Maj Gen UM Mohammed from Nigerian Army Property Limited (NAPL) to the Office of the Chief of Army Staff and appointed Special Adviser Nigerian Army University Biu/Deputy Chairman Board of Trustees NAPL, while the erstwhile Special Adviser Nigerian Army University Biu Maj Gen CC Okonkwo now redeployed to STF Operation SAFE HAVEN Jos  and appointed Commander, Maj Gen F Yahaya from Headquarters 1 Division Kaduna to Headquarters.

    “Theatre Command Operation LAFIYA DOLE (OPLD) Maiduguri and appointed Commander, while Maj Gen OG Adeniyi is redeployed from Headquarters Theatre Command OPLD Maiduguri to NARC as Senior Research Fellow, Maj Gen S Idris from Sector 2 OPLD Damaturu- Yobe State redeployed to DHQ Abuja and appointed Director Liaison. 

    “Others affected include – Maj General AA Adesope from Office of the Chief of Army Staff Directorate of Audit and Financial Management to NAPL and appointed Group Managing Director, Maj Gen MG Ali from Headquarters Theatre Command OPLD Maiduguri to Headquarters 4 Special Forces Command Doma, Nasarawa State as Commander while the erstwhile Chief of Civil-Military Affairs AHQ Abuja Maj Gen US Mohammed has been redeployed to 1 Division Kaduna and appointed General Officer Commanding. 

    “Similarly, Brig Gen HI Daniel from the Defunct  Army Special Forces Command Maiduguri to Headquarters Training and Doctrine Command Minna and appointed Director Army Training Support, Brig Gen BE Onyeuko is to remain in DHQ Abuja as Acting Director Defence Media Operation, Brig Gen NM Jega from Training and Doctrine Command Minna to Infantry Corps Centre Jaji and appointed Chief of Staff, Brig Gen LA Araba from Nigerian Army Welfare Limited by Guaranty Abuja now redeployed to Sector 2 OPLD Damaturu, Yobe State as Ag Commander, Brig Gen VO Ita from DHQ, Abuja to Headquarters 402 Special Forces Brigade Azare and appointed Commander while Brig Gen JAL Jimoh from Sector 3 Artillery Brigade OPLD Monguno to Headquarters 31 Brigade Minna and appointed Commander and Brig Gen GTO Ajetunmobi has been redeployed from 31 Brigade Minna to Nigeria Army Welfare Limited by Guaranty, Abuja as Executive Director Operation. 

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    Nigerian Army Redeploys Senior Officers In Major Shake-up 9

    Boko Haram

    How Boko Haram Terrorists Dealt Us Heavy Blow –Nigerian Army Commander


    “Others are – Brig Gen LG Lepdung from Headquarters Infantry Corps Centre Jaji to DHQ Abuja and appointed Deputy Director Procurement (Logistics), Brig Gen MO Ihanuwaze to remain in Office of the Chief of Army Staff Directorate of Audit and Financial Management as Acting Director, Brig Gen EC Obi – Osang from the defunct Headquarters 707 Special Forces’ Brigade Makurdi to Headquarters 401 Special Forces’ Brigade Makurdi as Commander while Brig Gen GM Mutkut is redeployed from the Defunct Nigerian Army Amphibious Command OPLD Baga to Headquarters 403 Amphibious Brigade Baga and appointed Commander and Brig Gen JR Lar from Nigerian Army School of Artillery Kachia to Sector 3 Artillery Brigade OPLD Monguno as Commander.

    “Also, Colonel DJ Abdullahi from the defunct Headquarters Nigerian Army Special Forces’ Command Maiduguri to Headquarters 4 Special Forces’ Command Doma Nasarawa State and appointed Acting Chief of Staff, Colonel EC Emere from Nigerian Army Archives to Nigerian Military School Zaria as Deputy Commandant and Col MO Agi is to remain in Headquarters Nigerian Army Armour Corps Bauchi as Acting Chief of Staff among others.

    “All the postings and appointments take effect from the 1st of April 2020. 

    “While wishing all the officers well in their respective appointments, the Chief of Army Staff enjoins them to take their new responsibilities/appointments seriously and discharge all duties professionally with utmost loyalty to the Nation and the Service.” 

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  • WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic

    WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic

    The COVID-19 pandemic is straining health systems worldwide. The rapidly increasing demand on health facilities and health care workers threatens to leave some health systems overstretched and unable to operate effectively.

    Previous outbreaks have demonstrated that when health systems are overwhelmed, mortality from vaccine-preventable and other treatable conditions can also increase dramatically. During the 2014-2015 Ebola outbreak, the increased number of deaths caused
    by measles, malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola
    [1,2]. 

    “The best defense against any outbreak is a
    strong health system,” stressed WHO Director-General Tedros Adhanom Ghebreyesus.
    “COVID-19 is revealing how fragile many of the world’s health systems and
    services are, forcing countries to make difficult choices on how to best meet
    the needs of their people.”

    To help countries navigate through these challenges, the World Health Organization (WHO) has updated operational planning guidelines in balancing the demands of responding directly to COVID-19 while maintaining essential health service delivery, and mitigating
    the risk of system collapse. This includes a set of targeted immediate actions that countries should consider at national, regional, and local level to reorganize and maintain access to high-quality essential health services for all.

    Countries should identify essential services that will be prioritized in their efforts to maintain continuity of service delivery and make strategic shifts to ensure that increasingly limited resources provide maximum benefit for the population. They
    also need to comply with the highest standard in precautions, especially in hygiene practices, and the provision of adequate supplies including personal protective equipment This requires robust planning and coordinated actions between governments
    and health facilities and their managers.

    Some examples of essential services include: routine vaccination; reproductive health services including care during pregnancy and childbirth; care of young infants and older adults; management of mental health conditions as well as noncommunicable diseases
    and infectious diseases like HIV, malaria and TB; critical inpatient therapies; management of emergency health conditions; auxiliary services like basic diagnostic imaging, laboratory services, and blood bank services, among others.

    Well-organized and prepared health systems can continue to provide equitable access to essential service delivery throughout an emergency, limiting direct mortality and avoiding increased indirect mortality. 
     

    The guidelines stress the importance of keeping up-to-date information. This requires frequent transparent communications with the public, and strong community engagements so the public   can maintain trust in the system to safely meet their
    essential needs and to control infection risk in health facilities. This will help ensure that people continue to seek care when appropriate, and adhere to public health advice.


    1. Elston, J. W. T., Cartwright, C., Ndumbi, P., & Wright, J. (2017). The health impact of the 2014–15 Ebola outbreak. Public Health, 143, 60-70.

    2. Parpia, A. S., Ndeffo-Mbah, M. L., Wenzel, N. S., & Galvani, A. P. (2016). Effects of response to 2014–2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. Emerging infectious diseases, 22(3), 433.

     

    For interviews please contact:  Tarik Jasarevic

    To access the full guidance please visit: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/maintaining-essential-health-services-and-systems

    For further information and guidance on COVID-19 please visit: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

     

     

    WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic
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  • How Boko Haram Terrorists Dealt Us Heavy Blow –Nigerian Army Commander

    How Boko Haram Terrorists Dealt Us Heavy Blow –Nigerian Army Commander

    How Boko Haram Terrorists Dealt Us Heavy Blow –Nigerian Army Commander 10

    How Boko Haram Terrorists Dealt Us Heavy Blow –Nigerian Army Commander 11


    Olusegun Adeniyi, Commander of Operation Lafiya Dole, a group of Nigerian soldiers deployed to the North-East region to combat Boko Haram terrorists and other insurgent groups, has revealed how they recorded heavy casualty during a recent encounter with the hoodlums.

    In a video making the rounds on the Internet, Adeniyi could be seen standing together with his men on the battle field and lamenting how the terrorists shelled their positions with heavy artillery and mortar bombs. 

    According to him, they lost several soldiers during the mission due to wrong intelligence provided by military authorities.

    He added that they lacked necessary weapons to face the firepower of the terrorists.

    Speaking in the widely-circulated video, Adeniyi said, “We have been met with very strong resistance – from more than pockets of Boko Haram. From every flank not less than 15 gun trucks were facing us.  

    “I’m standing here with Sector 2 Commander; the armed helicopter has just come to hover our air, the instruction I gave them was that anything they see moving they should engage because most of my gun trucks are not moving. Like I said earlier, the three battalions are fighting as deployed — nobody is running.

    “But what we have here, I will give you some estimates. Boko Haram has fired more than a hundred mortar bombs at us; they have fired 80 to a hundred RPGs at us; in addition to eight to 10 gun trucks firing at us from all sides. We have not run, and the soldiers are not misbehaving or disobeying orders.

    “We have casualties. I will come and see you in person on what we need to do. But we are not running.

    “We lost about 20 MRAP tires here. We have changed close to 250 Hilux tires due to the terrain.

    “This is what we are facing in the Timbuktu triangle. We are not running, we are fighting as a system to curtail the situation.”

    Several wounded soldiers could be seen crying in the video while bodies of their colleagues was scattered all over location.

    Recall that Boko Haram recently ambushed troops in Borno and killed more than 50 soldiers during that attack.

    An unspecified number of military personnel, who participated in that mission, remain missing and unaccounted for till this day.

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  • Can debt-burdened millennials afford to invest?

    Can debt-burdened millennials afford to invest?

    In this episode, Joel and Maria talk with a trio of millennials about their individual challenges around saving and investing and share their advice on balancing short- and long-term priorities to stay on track.
    Can debt-burdened millennials afford to invest?
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  • Webcast replay and transcript: Women and investing

    Webcast replay and transcript: Women and investing

    In this webcast, 3 Vanguard investing experts share their perspectives on the unique challenges women investors face
    Webcast replay and transcript: Women and investing
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