KUALA LUMPUR: In about 72 hours, the public will know whether the Movement Control Order (MCO), enforced since March 18, will be further extended or not to curb the spread of Covid-19.
It was initially enforced until March 31, but extended to April 14 and this Friday (April 10), the government is expected to make the much awaited announcement on whether MCO will be further extended.
Many people are hoping the MCO, which enters its 22nd day today, will not be further extended so that they could return to their normal lives, but it will all depend on the Covid-19 situation in the country and the government will certainly not place the health of its people at stake.
For the record, Malaysia has recorded 69 Covid-19 sporadic cases (cases where the source of infection cannot be traced).
A total of 170 new Covid-19 cases , with one death, were as of noon yesterday, bringing the accumulated Covid-19 cases in the country to 3,963, with a total of 63 deaths.
We can all take pride that the country’s crime index has dropped by 70 per cent since enforcement of MCO, but the number of individuals who were caught for defying the MCO has increased to 6,451 people as of yesterday.
On public sanitation, Senior Minister (Security Cluster) Datuk Seri Ismail Sabri Yaakob said the government, through the Ministry of Housing and Local Government (KPKT), had conducted 666 sanitation operations in 79 zones, including all the 18 Red Zones.
The operation is important because there is another location placed under the Enhanced Movement Control Order (EMCO), namely the Malayan Mansion and Selangor Mansion buildings here.
Prior to that, the EMCO was enforced in three areas, namely Simpang Renggam, Kluang, Johor; Sungai Lui, Hulu Langat, Selangor, and City One Tower, Jalan Munshi Abdullah here.
Apart from efforts by the government, the public and corporate companies have also joined forces to help curb the Covid-19 outbreak, including by donating to the Covid-19 Fund, which has reached RM22.6 million.
Prime Minister Tan Sri Muhyiddin Yassin (pix), through a posting on his Facebook, stated that as of Monday (April 6), a total of RM5.68 million from the fund was channeled to the National Welfare Foundation (YKN) for purchase of daily necessities to be donated to those affected by the outbreak.
He said RM195,000 was also distributed to 39 next-of-kin of Covid-19 victims as ‘Bayaran Ihsan Kematian’.
The Covid-19 Fund was launched on March 11 as an effort by the government to help the people who are affected by the outbreak.
As such, Malaysia needs the cooperation and support of all the people during this MCO period to prevent Covid-19 from further spreading.
As citizens of the country, we should comply with the rules of MCO, to not spread fake news, including on social media and to appreciate the role of the frontline personnel in protecting the people’s lives and security in the country. –Bernama
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https://www.thesundaily.my/home/mco-extension-will-be-known-in-72-hours-DX2231467
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
Read More
https://www.who.int/news-room/detail/06-04-2020-virtual-press-conference-on-covid-19–06-april-2020
The Covid-19 pandemic underscores the urgent need to strengthen the global health workforce. A new report, The State of the World’s Nursing 2020, provides an in-depth look at the largest component of the health workforce. Findings identify important gaps in the nursing workforce and priority areas for investment in nursing education, jobs, and leadership to strengthen nursing around the world and improve health for all. Nurses account for more than half of all the world’s health workers, providing vital services throughout the health system. Historically, as well as today, nurses are at the forefront of fighting epidemics and pandemics that threaten health across the globe. Around the world they are demonstrating their compassion, bravery and courage as they respond to the COVID-19 pandemic: never before has their value been more clearly demonstrated.
‘Nurses are the backbone of any health system. Today, many nurses find themselves on the frontline in the battle against Covid-19,’ said Dr Tedros Adhanom Ghebreyesus, WHO Director General. ‘This report is a stark reminder of the unique role they play, and a wakeup call to ensure they get the support they need to keep the world healthy.’
The report, by the World Health Organization (WHO) in partnership with the International Council of Nurses (ICN) and Nursing Now, reveals that today, there are just under 28 million nurses worldwide. Between 2013 and 2018, nursing numbers increased by 4.7 million. But this still leaves a global shortfall of 5.9 million – with the greatest gaps found in countries in Africa, South East Asia and the WHO Eastern Mediterranean region as well as some parts of Latin America.
Revealingly, more than 80 per cent of the world’s nurses work in countries that are home to half of the world’s population. And one in every eight nurses practices in a country other than the one where they were born or trained. Ageing also threatens the nursing workforce: one out of six of the world’s nurses are expected to retire in the next 10 years.
To avert the global shortage, the report estimates that countries experiencing shortages need to increase the total number of nurse graduates by on average 8% per year, along with improved ability to be employed and retained in the health system. This would cost roughly USD 10 per capita (population) per year.
“Politicians understand the cost of educating and maintaining a professional nursing workforce, but only now are many of them recognizing their true value,” said ICN President Annette Kennedy. “Every penny invested in nursing raises the wellbeing of people and families in tangible ways that are clear for everyone to see. This report highlights the nursing contribution and confirms that investment in the nursing profession is a benefit to society, not a cost. The world needs millions more nurses, and we are calling on governments to do the right thing, invest in this wonderful profession and watch their populations benefit from the amazing work that only nurses can do.”
About 90 per cent of all nurses are female, yet few nurses are found in senior health leadership positions– the bulk of those positions are held by men. But when countries enable nurses to take a leadership role, for example by having a government chief nursing officer (or equivalent), and nursing leadership programmes, conditions for nurses improve.
“This report places much-needed data and evidence behind calls to strengthen nursing leadership, advance nursing practice, and educate the nursing workforce for the future,” said Lord Nigel Crisp, Co-Chair of Nursing Now. “The policy options reflect actions we believe all countries can take over the next ten years to ensure there are enough nurses in all countries, and that nurses use of the full extent of their education, training, and professional scope to enhance primary health care delivery and respond to health emergencies such as COVID-19. This must start with broad and intersectoral dialogue which positions the nursing evidence in the context of a country’s health system, health workforce, and health priorities.”
To equip the world with the nursing workforce it needs, WHO and its partners recommend that all countries:
increase funding to educate and employ more nurses;
strengthen capacity to collect, analyze and act on data about the health workforce;
monitor nurse mobility and migration and manage it responsibly and ethically;
educate and train nurses in the scientific, technological and sociological skills they need to drive progress in primary health care;
establish leadership positions including a government chief nurse and support leadership development among young nurses;
ensure that nurses in primary health care teams work to their full potential, for example in preventing and managing noncommunicable diseases;
improve working conditions including through safe staffing levels, fair salaries, and respecting rights to occupational health and safety;
modernize professional nursing regulation by harmonizing education and practice standards and using systems that can recognize and process nurses’ credentials globally; and
strengthen the role of nurses in care teams by bringing different sectors (health, education, immigration, finance and labour) together with nursing stakeholders for policy dialogue and workforce planning.
The report’s message is clear: governments need to invest in a massive acceleration of nursing education, creation of nursing jobs, and leadership. Without nurses, midwives, and other health workers, countries cannot win the battle against outbreaks,
or achieve universal health coverage and the Sustainable Development Goals.
Read More
https://www.who.int/news-room/detail/07-04-2020-who-and-partners-call-for-urgent-investment-in-nurses
After intense strain from the Nigerian public particularly from senior authorized practitioners and different outstanding residents, President Muhammadu Buhari on Monday introduced the signing into legislation of the COVID-19 Regulations.
Sections 2, Three and four of the Quarantine Act (CAP Q2 LFN 2004) conferred such powers on President Buhari.
It was the authorized framework wanted to implement the lockdown order in Lagos, Ogun and the FCT issued by Buhari on Sunday throughout a nationwide broadcast. The announcement was made on Monday evening by Special Adviser to President Buhari on Media and Publicity, Femi Adesina.
President Buhari had addressed Nigerians on the outbreak and continued unfold of Coronavirus 35 days after the nation’s first case was recorded.
A flurry of criticisms over his silence and perceived lack of concern on the harm attributable to the pandemic had pushed him to talk.
Recall that earlier on Monday, Senior Advocate of Nigeria, Femi Falana, had mentioned that the lockdown order couldn’t be enforced besides it was backed by a legislation.
He mentioned, “No doubt, the President is empowered to undertake any measure deemed match to fight the damaging illness however such measure must be spelt out in a Regulation made pursuant to part 305 of the structure or beneath the Quarantine Act.
“Otherwise the presidential order on restriction of movement in the affected areas cannot be enforced by the police.”
Another lawyer, Inibehe Effiong, whereas reiterating Falana’s place, in truth vowed to problem the illegality of Buhari’s motion in court docket.
He mentioned, “After a deep reflection on President Muhammadu Buhari’s resolution to lock down all actions in Lagos, Ogun and Abuja by presidential fiat for 14 days, I’ve resolved to problem this unconstitutional motion in court docket.
“No accountable, democratic and civilised nation will throw its structure and legal guidelines into the dustbin in an effort to sort out a pandemic like COVID-19 the way in which President Buhari has carried out. Freedom of motion is a elementary proper assured by Section 41 of the structure.
“While it’s conceded that this proper just isn’t absolute, Section 45 of the structure is evident to the impact that freedom of motion can solely be taken away within the method allowed by a legislation that’s moderately justifiable in a democratic society. Buhari has not relied on any legislation.
“If Buhari is convinced that extraordinary measures are needed to contain Coronavirus, the proper action would have been for him to issue an instrument published in the official gazette of the government and make a proclamation of a state of emergency in Lagos, Ogun and Abuja.”
Also including his voice to the difficulty earlier on Monday, Nobel Laureate, Prof Wole Soyinka, mentioned that President Buhari had no constitutional backing to declare a complete lockdown of Lagos, Ogun and Abuja.
He mentioned, “The worst development I can conceive is to have a situation where rational measures for the containment of the Corona pandemic are rejected on account of their questionable genesis. “So, earlier than this turns into a behavior, a query: does President Buhari have the powers to shut down state borders? We need clear solutions. We should not in a struggle emergency. “We need to exercise collective vigilance, and not compromise the future by submitting to interventions that are not backed by law and constitution.”
However, earlier defending Buhari’s declaration of a lockdown in all three cities, Nigeria’s Attorney-General of the Federation, Abubakar Malami, mentioned that the President didn’t want any particular authorized framework to have the order enforced because the Quarantine Act already coated that.
Malami mentioned, “The appropriate place stays that the President acted rightfully beneath the powers conferred on him by the Quarantine Act 1990 CAP 384 LFN.
“Section 3 of the Act enables the President to declare any part of Nigeria as an infected area. Section 4 of the Act further empowers the President to make regulations to prevent the introduction, spread and transmission of any dangerous infectious disease.”
But with Buhari’s newest transfer on Monday, Malami now stands alone on the matter.
Enforcement of the order is now anticipated to begin in Lagos and FCT whereas it would take impact in Ogun from April 3.
KUALA LUMPUR: Ninety eight people had been dropped at courtroom in a number of states including senior residents for infringing the Movement Control Order (MCO) in addition to a girl who went viral for shouting at a policeman at a Covid-19 street block.
Most of the offences had been for failing to adjust to MCO by shifting from one contaminated place to a different and a few had been charged for obstructing civil servants from carrying their duties throughout MCO.
IN PAHANG, 11 people had been charged on the Kuantan Justice of the Peace’s courtroom including a Japanese senior citizen. Keiji Ando, 81, a retiree was caught taking photos in a leisure park right here throughout MCO and was fined RM1,000 or three months jail for violating the order.
The accused had moved from one contaminated space in Lorong Seri Teruntum right here to the leisure park in Taman Gelora, Tanjung Api, at 6.20pm on March 27.
Meanwhile, 9 people including an Indonesian man, Utama Yuliandes, 25, and a Myanmar nationwide, Shamsul Alam Boshir Ahmad, 32, in addition to an area lady, 40 had been fined between RM800 to RM1,000 or three months jail for defying MCO.
They pleaded responsible to committing the offence between March 26 and 31 at a number of areas within the city.
IN SELANGOR, gross sales supervisor Tong Poh Kim, 44, pleaded not responsible to 2 offences of yelling at a policeman and obstructing him at a Covid-19 street block operation.
For the primary cost, Tong was accused of insulting Corporal Izuan Hasim Nor Hamzah by calling him an fool at 9.40am on March 31 at Persiaran Surian right here beneath Section 14 of the Minor Offences Act 1955 which carries a most positive of RM100 upon conviction.
She was additionally accused of obstructing Cpl Izuan from carrying his duties on the similar place and time beneath Section 186 of the Penal Code.
The courtroom allowed Tong to go on bail at RM4,000 for the 2 expenses in a single surety and set May 20 for point out.
IN KUALA LUMPUR, 10 males had been introduced to 2 courts for violating MCO. At the Selayang Justice of the Peace’s courtroom, 9 males including two senior residents pleaded responsible for infringing the MCO by intentionally gathering at an contaminated space with out legitimate causes. Six males had been every fined RM850 or 15 days jail whereas three extra had been fined RM900 or a month’s jail.
All the accused aged between 20 and 61 had been nabbed at separate areas in Tasik Taman Bersatu, Rawang and Bandar Tasik Puteri, Gombak between 10.15 am and 12.45 am on March 31 and April 1.
At the Ampang Justice of the Peace’s courtroom, shoe manufacturing unit employee, Okay. Dorai Nathan, 26, was fined RM5,500 or seven months jail after pleading responsible to 3 expenses including violating MCO in Taman Cheras Indah, at 2pm on March 26.
He was additionally charged with obstructing Cpl Amar Rusdi from finishing up his obligation other than fleeing from the street block on the similar place and time.
IN PENANG, 50 males aged between their 20’s and 50’s had been fined RM1,000 or a month’s jail by the Butterworth Justice of the Peace’s courtroom and classes courtroom for breaching the MCO.
They had been charged for popping out of their home for issues not supplied beneath Regulation 3(1) of the Prevention and Control of Infectious Diseases (Measures throughout the Infected Local Areas) Regulations 2020 in Seberang Perai Utara between March 30 and April 2.
Among their offences had been loitering, fishing, gathering in addition to being detained for failing to offer legitimate causes or allow.
IN PERAK, 15 people had been dropped at the Ipoh Justice of the Peace’s courtroom for violating MCO. Thirty people aged between 18 and 34 pleaded responsible and had been fined RM1,000 or three months jail every whereas two extra accused aged 21 and 23 pleaded not responsible.
All of them including a girl had been held at a number of areas amongst them Taman Beringin, Bandar Seri Botani, Jalan Wing Onn and Taman Hock Lee on March 31.
IN NEGRI SEMBILAN, 11 people including three underaged youngsters had been charged at two Justice of the Peace’s courtroom right here for failing to adjust to MCO.
At the Port Dickson Justice of the Peace’s courtroom, T. Paandi Bakaran, 24 and two male juveniles aged 16 and 19 pleaded responsible.
Paandi Bakaran was sentenced to 10 days in jail and fined RM900 in lieu 20 days jail for breaching the MCO. He dedicated the offence on the Port Dickson-Lukut junction at 8.25 pm on March 31.
The courtroom set May 19 for point out of the 2 juveniles earlier than sentencing.
The 19-year-old juvenile was fined RM4,000 or three months jail for the offence beneath Section 186 of the Penal Code. They dedicated the offences at Kilometre 11 Jalan Lukut-Sepang at 9.10pm on April 1.
At the Tampin Justice of the Peace’s courtroom, seven males and a girl aged 20 and 43 and a 19-year-old youth had been charged for violating MCO and for obstructing the obligation of a civil servant.
They had been fined between RM300 to RM1,000 in addition to jailed between 14 days to a month.
One of the accused, M. Thanaselan, 47, was nonetheless not current in the course of the continuing and a warrant of arrest had being issued towards him by the courtroom. — Bernama
Read More
https://www.thesundaily.my/local/mco-violations-98-including-senior-citizens-juveniles-charged-LJ2209863
There was commotion within the Nyanya space of Abuja on Thursday as some policemen engaged a bunch of Air Force personnel in a faceoff.
Trouble began when two younger Air Force officers drove in opposition to site visitors through the ongoing lockdown of town occasioned by the outbreak and continued unfold of Coronavirus however had been stopped by the monitoring crew of the Federal Capital Territory administration.
The enforcement crew directed the 2 males to show again and observe the precise manner however they declined.
According to an eyewitness, “The Air Force officers started insulting the police commander, Azeez Idowu.”
This infuriated the policemen and different officers on the crew, who made try to arrest the Air Force personnel.
The state of affairs escalated when a detachment of Air Force officers arrived the scene to rescue their colleagues however had been resisted.
This led to a different spherical of shouting match, creating panic within the space.
Normalcy nevertheless, returned when a senior Air Force officer on the crew requested the 2 males to apologise to the police commander.
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
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)
A senior Nigerian Army officer, Maj. Gen. Olusegun Adeniyi, who headed Operation LAFIYA DOLE and spearheaded the fight against Boko Haram terrorists in the country’s North-East region, has reacted to his redeployment to the Nigerian Army Resource Centre as Senior Research Fellow by Chief of Army Staff, Lt Gen Tukur Yusuf Buratai.
The redeployment of Adeniyi and over 50 senior officers was announced in a statement on Tuesday.
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.
In the viral video, Adeniyi was seen standing together with his men on the battle field and lamenting how the terrorists shelled their positions with heavy artillery and mortar bombs during an ambush where they recorded heavy casualty.
He disclosed that they lost several soldiers during the mission due to wrong intelligence provided by military authorities.
Reacting shortly after his redeployment on Tuesday, Adeniyi disclosed that the viral video was leaked by his orderly and his friend.
In a message to some of his soldiers, he said that he had no regret over the leaked video because he served well and defended Nigeria’s territory with commitment.
He said, “I am posted and also a happy man. Nobody should send any long pitiable message to me.
“I have not failed, nor led irresponsibly. I have demanded your best which you gave.
“Video meant for ASA leaked by my orderly and his friend could not have been helped. For even that there is nothing to be bitter about.
“We all had fun fighting Boko Haram together. God bless you.”
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.
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.
“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.”
KUCHING: The Yang di-Pertua Negeri of Sarawak, Tun Abdul Taib Mahmud (pix) donates various equipment and essential items, worth RM120,500 to the Sarawak General Hospital (HUS) today, to help in the treatment of Covid-19 patients.
The contribution was handed over by his senior private secretary Datuk Mustapa Han to HUS director Dr Ngian Hie Ung and Anaesthesiology and Intensive Care department head Dr Teo Shu Ching, in a brief ceremony at the Yang di-Pertua Negeri’s office here.
In a statement issued by Astana Negeri Sarawak, the donation included one unit of Portable Ultrasound Linear Probe, anti DVT equipment (5), fibre optic scope (2), and syringe pump (2) for the hospital’s intensive care unit (ICU).
The Governor also donated 700 food packs and mineral water to Sarawak Police Operations Room, to be distributed to police, Armed Forces a well as People’s Volunteer Corps (RELA) personnel who are carrying out roadblocks during Movement Control Order (MCO).
He also urged Sarawakians to cooperate with the government by adhering to MCO, which was extended to April 14, to enable frontliners focus on their duties to curb the Covid-19 outbreak. –Bernama
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https://www.thesundaily.my/local/covid-19-sarawak-yang-di-pertua-negeri-donates-rm120500-to-hus-AM2196543
