COVID-19: understanding isolation, lockdown and stigmatization (2)

COVID-19 is spread from person to person and cannot infect others unless droplets of relevant body fluids from the patient comes in direct or indirect contact with others through the eyes, nose and mouth. Locking down simply aims at restricting movement of persons to limit the capacity of the virus to be spread from person to person directly or indirectly. Simply put, lockdowns stop the virus from moving using the human carrier. In most cases, lockdowns also enable health officials to execute seamless contact tracing and community case search within a period. In that period, it is likely for those at the early stage of the virus infection to develop symptoms or generate enough measurable antibodies that can be determined through molecular testing or screening techniques.

Again, lockdowns are not intended to punish anyone but comes with other socio-economic challenges, especially in countries like ours with poor power infrastructure and weak social safety nets. The consideration is usually one that determines whether the people can reasonably be kept inside without being attacked by "hunger virusÔÇØ which on its own is capable of lowering their capacity to fight COVID-19 infection with their immune system, or not. It is for this reason that Governments distribute palliative food and medical items to those considered most vulnerable to hunger during lockdowns.

It is strongly advised that folks obey guidelines related to isolation and lockdown for their own good. It is better to be alive and healthy than to be sickly or dead. Only the living and healthy can work and enjoy life.

Finally, many do not understand how COVID-19 death records are compiled and, hence, expect that those who die speculatively of the infection should be listed as victims of the disease.

Samples for COVID-19 tests must be collected while the patient was alive through nose and mouth, or within 2 hours of death. If such samples return positive results, the person is counted as a COVID-19 patient or deemed dead from COVID-19. Where samples are not taken directly from a person alive or shortly after death there will be no official record of death from COVID-19 regardless of later emergence of circumstantial evidence pointing in that direction.

Where the medical authorities and public health managers suspect that someone may have died of COVID-19, but lack the required empirical proof, the next option will be to test those around the person within the final 14 days of his/her life on earth and use that to obtain only circumstantial evidence required for public health protection purposes. Such circumstantial evidence should not lead to the declaration of cause of death as COVID-19 but is enough to warrant issuance of public health alert to prevent further spreading of the disease. It is always the duty of governments and health authorities to do the needful during health emergencies to protect the public through sensitization and careful information management within existing applicable legal and medical protocols.

Once more, such public health alerts are not meant to stigmatize the dead or their surviving relations but strictly to protect the living from avoidable secondary infection.

In any case, there is no justifiable reason for anyone to be stigmatized for contracting COVID-19 as the disease is neither sexually transmitted nor some form of divine punishment for any wrong done by the person. Our reality in Nigeria is that stigmatization has actually worked against early detection and control of the disease as people are afraid to come forward for testing and clinical management while prefering to die in silence or go on self medication which might be harmful and also lead to spreading of the disease to others.

Until those who contract the disease within our state freely come out to discuss their experiences, stigmatization will likely continue. Many people have recovered from COVID-19 after being managed at various isolation facilities and in some states like Abia, there is zero fatality with recoveries of up to 20 patients. If those who made the recoveries discuss their experiences with the virus others will become more empathetic and, indeed, stop stigmatizing them for doing no wrong known to society. This will also encourage others with symptoms of the disease to freely and willingly submit themselves for testing.

Thank you for reading, take responsibility for your protection.

By John Okiyi Kalu

Abia State Commissioner for Information
14/06/2020