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ACTION POINTS FOR COVID-19

Thank you for your recent letter to the Infectious Diseases Committee and we have had discussions and some documents are attached to be used as the basis for advice and action.
Please note that:
(a) The principles of personal good hygiene and social distancing have influenced our thinking.


(b) Coronavirus Hospital preparedness document should be obtained by the hosting hospitals (UCH Ibadan and any other hospital in Ghana)


(c) Temperature screening gadgets should be available in centres of examination like Abuja, Ibadan, Ghana as well as in Lagos WACP headquarters


(d) Institute of Pasteur Dakar has trained laboratory personnel from West African countries on diagnosis of coronavirus and other laboratory tests and all country members of WACP should link up with those laboratories in their countries


(e) The ECOWAS Ministers held a conference in Mid-February and communique has emphasized the importance of collaboration, coordination and cooperation in checking borders of travelling by air, land and seaports, each country member of the WACP should assess the communique


(f) For coordination of the response of WACP, we recommend that every member country should appoint a WACP link person as was done during the Ebola crisis and such persons most access and be conversant with WHO Africa region documents on coronavirus response in other to strengthen preparedness efforts in these countries, documents on technical guidance and seek the importance of vaccines and medicine developments


(g) Travel bans have so far been given by Ghana against public officers and it is important that the WACP secretariat should engage Ghanaian authorities in other to assist Ghanaian members, examiners and students.


The Committee will pursue researches that showed the effect of histocompatibility antigens that may be relevant to resistance in Africans

 

Thank you very much.

Prof. G.C. Onyemelukwe Chairman Infectious Disease Committee WACP
Dr Albert Akpalu Secretary General [secgen@wac-physicians.org/akpaluwacpsg@gmail.com]

 

PUBLIC HEALTH ADVISORY FROM THE WEST AFRICAN COLLEGE OF PHYSICIANS COMMITTEE ON INFECTIOUS DISEASES

Dear Examiners and Candidates WACP April 2020 Examinations,

Personal Protective Precautions for All Examiners and Candidates

In light of the ongoing COVID-19 outbreak in many countries, examiners and candidates should follow standard infection control recommendations and everyday preventive actions to prevent the spread of respiratory infections.

Reminders to all include the following information:

  • Face masks are in short supply globally and are being reserved for use by health workers and persons who are ill. The US Centers for Disease Control and Prevention does not recommend the use of facial masks for people who are well as a means to protect themselves from respiratory diseases. WACP will not supply face masks or gloves but examiners and candidates may bring and use their own items if they feel it necessary.

  • Avoid close personal contact such as handshakes, hugs, or kisses. Elbow or shoulder bumps are preferred if a greeting is desired.

  • Wash hands with soap and warm water regularly (with attention to between fingers and under fingernails), scrubbing for at least 20-30 seconds.

  • Use an alcohol-based hand sanitizer if soap and water are not available.

  • Avoid touching face, eyes, nose, and mouth.

  • Cover coughs or sneezes with a tissue, forearm/elbow, or shirt sleeve, and wash hands ASAP after a cough or sneeze; dispose of the used tissue immediately.

  • Food and drink for group breakfasts, coffee breaks, and afternoon lunch will be protected to the extent possible. If you touch an item, take it—do NOT put it back on the table.

  • Stay home if you are ill.


What to Do If You Have Symptoms (Cough and Fever):

  • If you have symptoms before the examination starts, do NOT come for the exams.

  • If you develop respiratory symptoms during the exams, you are asked to self-isolate to the extent possible.


Please contact any member of the WACP expert committee on infectious diseases via the SG or secretariat through email with any questions or concerns.


The WACP Expert Committee on infectious diseases,
Prof GC Onyemelukwe
Chairman


 

PREVENTING THE SPREAD OF COVID-19 DURING THE FORTHCOMING WACP EXAMINATIONS

Background

Coronaviruses are a large family of viruses which may cause illness in animals or humans.  In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). COVID-19 is the infectious disease caused by the most recently discovered coronavirus. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019. It is now present in all continents of the world (except Antarctica).

Transmission of the disease is through inhalation of respiratory droplets released by coughing or sneezing when an uninfected person is within 1-2 meters of an infected person. It could also be spread through contact of uninfected persons with surfaces and objects - such as desks, tables or telephones - contaminated with respiratory droplets from an infected person. Infection can be spread by asymptomatic, pre-symptomatic, and both mildly as well as moderately-severely ill persons. Persons older than 50 years of age are particularly vulnerable to severe illness, especially in the presence of medical co-morbidities.

Situation Report as at 10am CET, 11th March 2020

On the 30th of January 2020, it was declared a Public Health Emergency of International Concern and on the 11th of March 2020, it was declared a pandemic by the WHO. The global risk and regional risk are high. There are 12 African countries with reported confirmed cases. They include: Egypt, Algeria, Nigeria, Morocco, Senegal, Tunisia, Cameroon, South Africa, Togo, Democratic Republic of Congo, Cote D’Ivoire and Burkina Faso.

Among the above-listed countries, 3 chapters of the WACP have confirmed cases – Nigeria (2 cases, 2 days since the last reported case), Senegal (4 cases, 6 days since the last reported case) and Cote D’Ivoire (1 case); all of which are imported cases only and no deaths.

Preventing the spread of COVID-19 during the WACP April 2020 exams would require the following:

  • Prior to commencement of the exams, a list (including biodata and travel history in the past 2 weeks) of all college officials, administrative staff of the college, examiners and exam candidates that would be visiting the various member countries should be sent ahead to the receiving country.

 

  • Persons who have been designated to travel to other member states to conduct or take exams, should at least two weeks before departure, be educated on monitoring themselves and reporting any influenza-like illness or SARS-like symptoms up until the day of departure, particularly if the person has had a history of recent travel to places having local transmission of COVID-19 or has had a history of contact with any confirmed case of COVID-19. Such an individual should be advised to refrain from travelling and be kept for surveillance purpose.

 

  • Health talks on prevention and control of COVID-19 should be given before and after the commencement of the exams.

  • The college should ensure that there are adequate facilities available at all exam locations and hotels used by the examiners and candidates – alcohol-based hand rubs, hand wash stations for handwashing. Where there is no running water available, veronica buckets and soaps should be provided and strategically placed.

 

  • Alcohol-based hand rubs should be provided for all examiners, candidates and exam officials.

  • All exam officials, examiners and candidates should ensure regular and thorough handwashing with soap and water or an alcohol-based hand rub.

 

  • All exam locations, hotels and meeting halls should be kept clean and hygienic. Surfaces such as door handles, seats, desks, tables, telephones should be regularly disinfected.

  • IEC materials on the required precautions should be posted at strategic locations and leaflets shared to all candidates, examiners and exam officials.

 

  • Screening of exam officials, examiners and candidates at both the venues and the hotels should be instituted to identify those with fever.

  • Maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing or sneezing.

 

  • Avoid touching the eyes, nose and mouth.

  • Ensure good respiratory hygiene at all times (Cover your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately and wash hands thereafter).

 

  • Persons who feel unwell should stay at home. If there is fever, cough and difficulty in breathing, please contact the Faculty Chair.

 

  • Keep up to date on the latest COVID-19 hotspots (cities or local areas where COVID-19 is spreading widely).

  • WHO advises rational use of medical masks to avoid unnecessary wastage of precious resources and mis-use of masks. Only wear a mask if you are ill with COVID-19 symptoms (especially coughing) or looking after someone who may have COVID-19. Disposable face mask can only be used once.

 

Considerations for examinations holding as scheduled

  • Only 3 chapters have reported confirmed cases – Nigeria, Cote D’Ivoire and Senegal.

  • Within the 3 chapters that have confirmed cases, there has been no local or community transmission reported.

  • There has also been no deaths in those countries with the cases in Nigeria said to be clinically stable at the designated treatment facility for COVID-19.

  • Considering the above reasons, the risk in West Africa can be said to be low.

  • Although events have been cancelled in some countries, it has been due primarily to the fact that there is ongoing local transmission in such countries.

 

Considerations for postponement of the examinations

The case for deferment of the exams until the situation is clearer, more certain or resolved should not be dismissed but should be kept in view.  This is because:

  • More countries are coming up with travel restrictions.

  • Some persons are asymptomatic carriers and potential transmitters of COVID-19.

  • Some examiners may have to travel from affected countries with travel restrictions.

  • Some countries in the sub region already have cases, and there is the risk of its spreading owing to the transmission dynamics of the virus.

  • COVID-19 is more severe in the elderly and those above 50 years of age as well as in persons with medical co-morbidities. A significant, if not substantial, number of examiners might belong to these categories.

 

In view of the above, it is advised that a critical analysis of the considerations for and against the exams holding as scheduled should be done.

Conclusion

The COVID-19 pandemic is still fraught with several unknowns. However, the basics as it relates to transmission and preventive measures are known and can be used to protect individuals and populations. Early identification of cases (suspect or confirmed) and contacts is key. Common preventive measures such as regular handwashing, good respiratory hygiene and self-monitoring for symptoms are beneficial. Member chapters should also closely monitor the COVID-19 situation in their countries and globally as this can help influence further actions.

WACP Expert Committee on Infectious Diseases

Prof. G. Onyemelukwe – Faculty of Internal Medicine, WACP /ABUTH Zaria – Chairman
Prof. George Akpede – Faculty of Paediatrics, WACP /ISTH Irrua - Secretary
Prof. S. Gevao – Faculty of Pathology, WACP / University of Sierra Leone, Freetown
Prof. Victor Imen – Faculty of Family Medicine /LUTH Lagos
Prof. Danny Asogun - Faculty of Community Health, WACP /ISTH Irrua
Dr. Stephen B. Kennedy- Faculty of Community Health/ Liberia