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Friday, April 26, 2024
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COVID-19

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Resident doctors in the country have commenced an indefinite nationwide strike following the expiration of the 14-day ultimatum issued to the Federal Government.

Among the demands of the doctors are immediate implementation of the revised hazard allowance and payment of the COVID-19 inducement allowance as “agreed by government and healthcare workers” three months ago. They also want an immediate payment of all arrears owed doctors in federal and state tertiary health institutions, arising from consequential adjustment of the national minimum wage.

Meanwhile, there is fear that the industrial action may worsen the poor doctor-to-patient ratio and increase the number of deaths due to coronavirus infection, although Sokombo said doctors treating Covid-19 patients were not going on strike immediately.

Several studies have shown that frequent healthcare workers’ strikes result in the closure of public healthcare institutions, thereby preventing Nigerians’ access to quality health services.

It was gathered that the resident doctors, who are the ‘militant arm’ of the Nigerian Medical Association (NMA), the umbrella body of all doctors in Nigeria, represent about 40 per cent of physicians in the country.

Contrary to the World Health Organisation (WHO) recommendation of 1:600 doctor-patient ratio, Nigeria currently has one doctor attending to 6,000 patients.

According to the NMA, there are 72,000 registered Nigerian doctors with over 50 percent practicing outside the country. Consequently, there are less than 40,000 doctors in an estimated population of 196 million.

This means that with the number of resident doctors in Nigeria put at about 16,000 (that is 40 per cent of 40,000), it will leave the country with just 24,000 doctors, including consultants and those in private practice. The situation will further reduce the country’s doctor-to-patient ratio from 1:6,000 to 1: 10,000.

Indeed, Nigeria is still far from the recommendations of the WHO on the required number of medical personnel to cater efficiently for its teeming population. However, figures from the Federal Government differ: the ratio of doctor-to-patient is 1: 2,753, which translates to 36.6 medical doctors per 100,000 persons.

Figures from the Federal Ministry of Health (FMoH) indicate that 74,543 medical doctors are registered with the Medical and Dental Council of Nigeria (MDCN) as at March 4, 2020.

The National Universities Commission (NUC) had in January 2020 said Nigeria needed about 300,000 medical doctors to meet the doctor-patient-ratio of 1:600 recommended by the WHO.

The Executive Secretary, NUC, Prof. Abubakar Rasheed, said the current “doctor-patient ratio in the country stands at 1: 3,500.”

According to him, the nation’s medical schools produce about 3,000 doctors yearly and this is not enough to achieve the WHO standards to deliver on health care services.

President of the National Association of Resident Doctors (NARD), Dr. Aliyu Sokomba, who announced commencement of the strike at a press conference yesterday in Abuja, said NARD’s members attending to Covid-19 patients at designated treatment and isolation centres were exempted from the strike for two weeks after which, if their demands were not met, they would also be co-opted to join the industrial action.

He explained that the exemption was in recognition of the intervention of the speaker of the House of Representatives, the chairman of the House Committee on Health Services and other stakeholders as well as a demonstration of NARD’s goodwill to Nigerians.

Meanwhile, there is fear that the industrial action may worsen the poor doctor-to-patient ratio and increase the number of deaths due to coronavirus infection, although Sokombo said doctors treating Covid-19 patients were not going on strike immediately.

Several studies have shown that frequent healthcare workers’ strikes result in the closure of public healthcare institutions, thereby preventing Nigerians’ access to quality health services.

It was gathered that the resident doctors, who are the ‘militant arm’ of the Nigerian Medical Association (NMA), the umbrella body of all doctors in Nigeria, represent about 40 per cent of physicians in the country.

Contrary to the World Health Organisation (WHO) recommendation of 1:600 doctor-patient ratio, Nigeria currently has one doctor attending to 6,000 patients.

According to the NMA, there are 72,000 registered Nigerian doctors with over 50 percent practicing outside the country. Consequently, there are less than 40,000 doctors in an estimated population of 196 million.

This means that with the number of resident doctors in Nigeria put at about 16,000 (that is 40 per cent of 40,000), it will leave the country with just 24,000 doctors, including consultants and those in private practice. The situation will further reduce the country’s doctor-to-patient ratio from 1:6,000 to 1: 10,000.

Indeed, Nigeria is still far from the recommendations of the WHO on the required number of medical personnel to cater efficiently for its teeming population. However, figures from the Federal Government differ: the ratio of doctor-to-patient is 1: 2,753, which translates to 36.6 medical doctors per 100,000 persons.

Figures from the Federal Ministry of Health (FMoH) indicate that 74,543 medical doctors are registered with the Medical and Dental Council of Nigeria (MDCN) as at March 4, 2020.

The National Universities Commission (NUC) had in January 2020 said Nigeria needed about 300,000 medical doctors to meet the doctor-patient-ratio of 1:600 recommended by the WHO.

The Executive Secretary, NUC, Prof. Abubakar Rasheed, said the current “doctor-patient ratio in the country stands at 1: 3,500.”

According to him, the nation’s medical schools produce about 3,000 doctors yearly and this is not enough to achieve the WHO standards to deliver on health care services.

Sokomba faulted the non-payment of the Covid-19 hazard inducement allowance to all health workers across the country in spite of repeated promises by government. He alleged insincerity of officials of the executive arm of government in paying the outstanding salary shortfall of 2014, 2015 and 2016 under the guise of appealing the decision of the National Industrial Court.

The NARD president expressed concern over the plight of members of the association in state hospitals such as the non- domestication and non-implementation of the Medical Residency Training Act, the non-implementation of appropriate salary structure, non-payment of salaries, and recently, the slashing of salaries of doctors and other healthcare workers by Kaduna and Kogi states.

Sokomba decried the sorry state of the healthcare delivery system in the country which, according to him, is characterized by perpetual unavailability of personnel protective equipment for workers in the hospitals with the attendant increase in infection rates and unnecessary suffering of patients and their relatives following the use of obsolete equipment, machines and technology.

NARD urged the governments to provide adequate personal protective equipment for all healthcare workers, ensure universal implementation of the Medical Residency Training Act in all federal and state hospitals and ensure pay parity among doctors of equal cadre.

The association advocated provision of funding for medical residency training in the 2021 Appropriation Bill even as it called for stoppage and immediate refund of all illegal, unjust and callous cut in salaries of its members by Kaduna and other states.

“We will continue to appreciate President Muhammadu Buhari for his commitment to the welfare of Nigerians. We appeal that he calls relevant agents/agencies to order from deliberately creating chaos to destabilize his administration. We appeal to our fellow lovely Nigerians to bear with us and understand this as a battle to save the almost dead health sector.

“NEC noted the commitment of the National Assembly to implementing the Medical Residency Training Act by ensuring inclusion of the residency funding into the reviewed 2020 budget.”

In a similar development, there is fear of scarcity of pharmaceutical products, especially those needed during this COVID-19 pandemic, as pharmacists in the country are planning to down tools in 14 days.

The Pharmaceutical Society of Nigeria (PSN) yesterday petitioned President Buhari over the appointment of A. T. Mora as chairman of the Pharmacists Council of Nigeria (PCN), instead of Alhaji Yaro Budah whom it recommended to the minister for the position, threatening to go on an indefinite strike in two weeks if the decision was not reversed.

The PSN, in the petition titled “Rejection of A. T. Mora as Chairman Pharmacists Council of Nigeria (PCN)”, urged the Federal Government to indefinitely suspend or cancel the inauguration of the PCN governing council with Mora as chairman.

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Oyo State has recorded 68 new cases of COVID-19, the latest figures released by the Nigeria Centre for Disease Control (NCDC) have revealed.

In the figures released on Monday night, the 68 cases in Oyo were among the new 573 recorded in 20 states.

The News Agency of Nigeria (NAN) reports that the latest figure in Oyo has brought the total COVID-19 cases in the state to 575.

Gov. Seyi Makinde, had, on Monday directed all categories of workers to resume work on June 22 as well as the resumption of classes for primary six pupils, Junior Secondary School III and Senior Secondary School III students on June 29.

He also announced the relaxation of the curfew imposed on the state as the curfew will now run between 10 p.m. and 4 a.m. against the earlier period of between 8 p.m. and 5 a.m.

Makinde said that the decision was taken by the state COVID-19 task force headed by him and further announced opening up of Mosques and Churches, which were to operate at 25 per cent capacity.

Some residents have expressed fear over the upsurge in the number of COVID-19 cases in the, especially with the decision of the government to reopen schools and offices.

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The coronavirus, COVID-19 is the Pandemic currently ravaging the world. Being a Virus, treatment has been elusive. There have been various treatments that have been proposed including hydroxychloroquine and chloroquine and there have been many pros and cons including endorsements by some individuals, groups and Regulating body.

My own candid opinion is that hydroxychloroquine or chloroquine should not be considered as a first-line drug, at the moment. In the eighties and nineties, there were publications on fatalities from chloroquine therapy, including some experimental studies by my group in Lagos. These were few reports, which were probably not considered then to be significant, as some deaths may have been ascribed to the malaria infection rather than as a possible side effect of chloroquine. In some of the reports, the administration of chloroquine resulted in deaths in some children and adults, especially from injections. Some of these fatalities were probably accentuated by the fever. In many cases, death was by cardiac arrest. In our experiments, we showed that chloroquine caused a fall in blood pressure, electrocardiogram (ECG) abnormalities that can lead to cardiac arrest and death. It is possible that some fatalities were occurring with chloroquine administration then, but were not appreciated because it was so widely used for treating malaria and no one thought that it might be dangerous, which may be part of its side effects.

More recent studies in the year 2020 have indicated that hydroxychloroquine causes derangements of heart activity and rhythm-causing irregularities in a heartbeat which can be fatal and this may even be worsened by the use of Azithromycin. It is, therefore, being advocated that an ECG should accompany its use. This has led the American College of cardiologists to recommend the stopping of its use in COVID-19 patients. Recently on May 22, 2020, the Lancet published a report of a large-scale study, though now retracted, suggesting hydroxychloroquine may not be effective. However recent reports also doubt the usefulness of the drug in the treatment of COVID-19.

However one’s belief is that it is not wise, at the moment, to allow for the therapeutic use of hydroxychloroquine. There must be proper clinical and randomised drug trial and well-controlled to prove or disprove the effectiveness of the drug, which is not the case as at now. This assertion also applies to the use of the antiviral drug, Remdesvir. It is when we collate all these data that we can give a verdict. But for now, it is my humble suggestion that it is a drug that must be used with caution under supervision, not ‘Off the Counter’ pending the verdict from the several on-going clinical trials worldwide. The extent of the Covid-19 is a big worry and so we should hasten the trials of all the candidate therapy, also bearing in mind the need to provide safety guidelines while conducting the trials.

*Soga Sofola is a Fellow of the Nigerian Academy of Science (FAS) and Emeritus Professor of Physiology, College of Medicine University of Lagos

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The novel coronavirus (COVID-19), a respiratory infection which according to the World Health Organisation (WHO), causes fever, tiredness, sore throat and in severe cases, shortness of breath and respiratory difficulty, is the most challenging health issue the world has experienced in the past few decades.

WHO and other global public institutions have confirmed that the severity of COVID-19 infection is heavily linked with the overall state of the body’s immune system, a reason why people with pre-existing health challenges are said to be most vulnerable to the contagion.

It is, therefore, not surprising that since earlier this year when WHO declared COVID-19 a global pandemic, people are now increasingly mindful of the state of their immune system.

For instance, the shopping lists of households across different parts of the world, including Nigeria, have revealed changes remarkably. CNN reported that the United States retail sales of orange juice jumped about 38 percent in the four weeks ending on March 28 when compared to the same period last year. Also, the Florida Department of Citrus disclosed that there was a spike in demand for 100% orange juice within the same period. The department forecasts a considerable increase in the short-term demand for the commodity.

Just like in the United States, there has been surplus demand for fruit juices in every other part of the world. During the five weeks the Federal Capital Territory, Lagos and Ogun were on lockdown, shops and supermarkets had run out of orange fruit juice stock in the first two or three weeks of the restriction.

In fact, less than a week into the lockdown, my favorite 100% Real Orange Fruit Juice, which would have made the stay-at-home less boring for me, had rapidly been purchased off the shelves in Lagos. The scramble for unavailable raw fruits in the open markets started in earnest. That the restriction on movement cut off a large chunk of the supplies did not help matters.

This major spike in the demand for pure fruit juice, especially the orange category, could be attributed to the immune-boosting power of orange juice. Peter McCaffery, a professor of biochemistry at the University of Aberdeen, said vitamin C, which is contained in orange juice, helps to strengthen the immune system to fight off bacteria and virus infections like the one the world is currently grappling with.

There are still relatively very few studies on the effect of nutrition on the human immune system. Yet, Harvard Medical School in its Harvard Health Publishing says deficiency in zinc, iron, copper, folic acid, Vitamin A, B6, C (which is contained in large quantity in fruit juice) and E have negative impacts on immune responses. Fruit juice contains the vital micronutrients needed to boost immunity.

However, fruit juice intake is just one of the ways to boost one’s immune system. There are several other things one can do to achieve this – adequate sleep, thorough cooking of meat, maintaining good hygiene, moderate intake of alcohol and regular exercise.

There are lots of herbal mixtures on the shelves of local stores with labels containing ‘support immunity’, ‘immune booster’ etc. So far, there is no evidence that such substances can strengthen immunity.

Regular exercise is an essential component of healthy living. It improves cardiovascular function, helps control body weight, removes toxins in the body, increases blood circulation and lowers blood pressure. The result of these is a strengthened immune system that protects the body against infections and diseases. Regular exercise is most valuable when one shuns junk food and sticks to healthy eating habits and balanced diet.

Individuals are often advised to ‘eat well’ as protection against the risk of infection. This advice has become even more relevant since the outbreak of COVID-19. What is missing in this counsel is the real definition of ‘eating well’. It is good to fill your stomach, but at best, that may only give you energy. What about ‘going green’?

Fruits are also an awesome option, but you also need to be sure you are not eating trouble. You really might not know how many hands must have touched the mango or apple you want to eat. Pure fruit juice contains the same nutritional value as raw fruit. So, if you can find a pack of trusted and healthily-processed 100% fruit juice on the store shelf, you will be making a smarter choice considering the prevailing health challenge.

*Malomo is a nutritionist

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The Coronavirus disease (COVID-19); soaring forex and inflation rates; ban on export of products from China and India; ban on international flights, which has increased freight costs associated with importation of Active Pharmaceutical Ingredients (APIs), excipients and finished products are among factors that have pushed up prices of essential and prescription drugs, and medical/pharmaceutical products lately.

Other factors, which have contributed to this include slow uptake of the Central Bank of Nigeria’s (CBN) N100b stimulus package, and bottlenecks and disruptions in worldwide supply value chain.

A market survey has shown that the price of essential and prescription drugs, and medical/pharmaceutical products have gone up between December 2019 and June 2020. For instance, surgical facemask, which stood at N50 in December 2019 is now N500; disposable gloves (x 100) moved from N500 to N1, 500; Amoxicillin Clavulanic Acid (625mg) moved from N85/tablet to N142, and cough expectorant jumped from N250 per bottle to N400.

Also, antimalarial- Artemether- Lumefantrine tabs D/S (x6) moved from N400 to N600; Artemether Lumefantrine (x24) jumped from N500 to N700; average bottle of blood tonic (per bottle) moved from N350 to over N500, while an anti hypertensive drug, Methyl dopa tablets (x10) is now N300 as against N200, and Metformin (anti diabetes) x14 now goes for N250 from N200.

According to medical experts, Personal Protective Equipment (PPE), especially facemasks, which jumped to about N400/N500 depending on the location remains one of the worst affected medical essentials.

The experts, who expressed deep concerns over the slow uptake of the CBN’s N100b intervention fund said only four companies have so far received a total of N10b, just as outstanding applications were been processed. The funds are meant for capacity expansion and working capital at single-digit interest rate.

The National Chairman, Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN), Dr. Kingsley Chiedu Amibor, who also admitted that prices of essential medicines have skyrocketed since the outbreak of COVID-19, blamed the development on difficulties encountered in importing finished products from China.

Amibor said India placed a ban on export of APIs from their country at the onset of the Coronavirus outbreak. “These factors seriously affected our capacity to produce locally, as well as import finished products.”

He added that as far back as last year, the Pharmaceutical Society of Nigeria (PSN) had warned of drug insecurity in the country, and now the society has been vindicated by current developments.

He, however, said the COVID-19 pandemic is not solely to blame for the rising cost of pharmaceuticals products, noting that the exchange rate of the naira has been a source of concern to pharmaceutical importers because by the time they are able to source foreign exchange and bring in the finished products, the final cost to the consumers would have gone quite high.

He said this is why the PSN has been asking for import waivers for pharmaceuticals to make the prices competitive. “Unfortunately, that has not been the case,” the pharmacist said, adding, “to answer your question directly, the lockdown and difficulties in importation of pharmaceuticals brought scarcity and price increase with it.”

Regarding access to the intervention funds made available by the CBN, Amibor said few pharmaceutical companies have accessed the funds as at today. “Some others have collected offer letters and are waiting for disbursement of funds. The bulk majority are still at negotiation stage,” he said.

He further explained that: “The CBN intervention fund is meant for the development of the pharmaceutical industry, a special fund for manufacturers to expand their facilities. The fund is not for importation of COVID-19 products, but to cushion the impact of the pandemic on the industry.”
Commenting on the rise in prices, the President, Pharmaceutical Society of Nigeria (PSN), Mazi Sam Ohuabunwa said it was inescapable for the cost of drugs to rise.

“First, is the fact that inflation is rising, this phenomenon pushes up the prices of most products and services in any economy. That is why the primary role of the CBN is to keep inflation down,” he said.

“Secondly, the break in global supply chain occasioned by COVID-19 lockdown in China, India, UK and elsewhere has led to supply gaps for raw materials and finished pharmaceuticals. This in turn creates scarcity and in any economy scarcity leads to price increases.”

Ohuabunwa said the money being provided by CBN for the pharmaceutical and healthcare industry cannot immediately translate to improved product supply as much of the money is for industrial capacity output enhancement.

He said even if the money is released today, it would take some time for it to be used to build factories or buy equipment and install and then begin to produce. “Only perhaps working capital for raw materials importation will benefit the economy in, maybe three months time. Otherwise the impact will begin to kick in six months to one year at the earliest. And yet only very few of those who applied for the CBN loan have received approval,” he said.

The PSN President said despite the best effort of the industry to ramp up production and minimise supply gaps, there will inevitably be some supply gaps that will create shortages and scarcities, resulting in normal market upward price adjustments.

Specifically, a former President of PSN, Olumide Akintayo said the major issues promoting rising costs of essential and prescription drugs, and medical/pharmaceutical products include high forex rates; ban of export of products from China and India, and the ban on international flights, among others.

He said even though increased freight costs associated with importation of APIs, and excipients and finished products are also contributory factors, the CBN’s intervention funds, which about N10.5b has so far been released would, to a reasonable extent, help in addressing challenges in the sector that require urgent attention.

The Chairman, Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN), and CEO/MD of Fidson Healthcare Plc, Dr. Fidelis Ayebae reiterated that: “Like other commodities, prices of medical essentials have gone up across board, and this is due to bottlenecks and disruptions in worldwide supply value chain. It is also due to the unavailability of forex and CBN’s devaluation. Of course, you also know that inflation is rising and companies are trying to recoup those costs. So, it is increase across board by about 12 per cent. The CBN provided N100b as intervention fund, but only four companies have received a total of N10b and outstanding applications are been processed. The funds are meant for capacity expansion and working capital at single-digit interest rate.”

The pharmacist, who said that countries were beginning to open up and import raw materials and packaging materials among others, added that the CBN’s intervention, coupled with the availability of forex would be very helpful in easing the price increases.

Ayebae expressed optimism that things can only get better, but sufficient supply was required quickly to make this happen, adding that the stimuli would ensure that manufacturing remains stable while only minimal job losses would be recorded, “otherwise it would have been worse.”

“You are aware that we have been clamouring for access to finance to members – we advocated for N300b in 2018 at nine per cent rate for members.

Now, the Federal Government, through the CBN rolled out an intervention fund of N100b to the healthcare sector, which is a laudable initiative, close to what we have been advocating for at five per cent rate.

“My worry here is whether the lending banks are on the same page with the CBN, as this is a rare opportunity to develop the Nigerian pharmaceutical manufacturing sector, which is very critical, not only in closing the gap in access to medicine, but also to ensure economic growth and sustainable development. For us as a country not to miss out on this opportunity, lending banks should look at the local manufacturing sector, which is a long-term capital intensive investment from the perspective of building a socially inclusive pharmaceutical sector, not from absolute capitalist perspective in lending.

“The intelligence we are gathering is that these loans will end up in the hands of importers whom their returns on investment cannot be compared to that of local manufacturers – of which the reasons are obvious. I therefore urge the lending banks to ensure that they reduce the many administrative bottlenecks that will hinder members from accessing these funds. Members look forward to use these funds to repurpose their facilities to meet international qualification and standards, expand their product lines, upgrade their machineries, and build new factories.”

He continued: “Access to forex, as you are aware, is core to our members, as much as repurposing our facilities, putting up new production lines, purchase of new machineries for facility expansion, purchase of raw materials, and upgrading of our facilities to meet WHO certification. These involve huge forex, as they are all import-dependent. In view of this, a special consideration for the sector on access to forex will support the utilisation of the intervention funds in achieving its intended goal.

“Policy inconsistency could be a potential threat to the proposed CBN intervention, example; giving a blanket waiver on finished pharmaceutical products imported into the Nigerian market. If the many clamours, from drug marketers as being peddled in the media, are granted, the aim of the CBN’s intervention will be defeated. In addition, Nigeria will become a dumping ground for pharmaceuticals and these in turn will lead to underutilisation of the capacity that the group has developed over the years towards achieving self-sufficiency and attaining medicine security.

The Fidson Healthcare Plc boss said, in 2016, the government of President Muhammadu Buhari, instituted a 20 percent – on Import Adjustment Tax (IAT) for categories of finished essential medicines, amongst which is antimalarial-commodities for which incontrovertible evidence suggests that local pharmaceutical manufacturing companies have excess capacity for its production.

He said this landmark policy supported the sector to scale up capacity in production of these essential products.

The pharmacist, however, said it should be noted that any reversal of these policy in any way will destroy all the capacity the sector has developed overtime, and in addition, accessing the CBN intervention will be counterproductive as the good intention would be defeated.

Ayebae lamented that member-companies were being owed by Ministries Departments and Agencies (MDAs) in the last 10 years and the total amount runs into billions of naira.

“As you are aware some member companies have gone under due to these bad debts owed by the government institutions. It would be a great relief to members if these debts are recovered. Going forward, these institutions should faithfully buy from us, not only buy from us as stipulated by Executive Order 003, but also pay us timely,” he said.

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As at May 21, globally 5,209,860 were COVID-19 positive, 2,092,757 had recovered while 334,878 persons were pronounced dead. In Africa, there were 101,684 positive cases, 40,588people have recovered with 3,115 deaths. Nigeria has 7,016 positive cases, 1,907 had recovered while 211 people have died of the virus. One major precaution that is often repeated in campaigns against the virus is the need to be hygiene conscious, reason citizens were told to regularly wash or sanitise their hands aside maintaining social distance and wearing facemasks.

But is there a place for good diet and nutrition in the management of COVID-19 spread and treatment according to experts. They have argued that malnutrition severely weakens immunity, increasing people’s chances of getting ill, staying ill, and dying because of illness

President, Federation of African Nutrition Societies and the immediate past President, Nutrition Society of Nigeria, Professor Ngozi Nnam stated that though diet is not a risk factor in contracting Coronavirus, diet can help in curbing it, as it plays a significant role in helping individual’s recovery process.

According to her, healthy diet is very important at this time, because consuming diet rich in food nutrients will boost the immunity. “COVID-19 is a virus, with no vaccine to treat it at present, so we are relying on body immunity to fight and kill it. Some people after testing positive will receive care and days after, they will test negative, it is because their body immunity is high. Yet, some people that went to the isolation centre with them will still be receiving treatment, ten days after they are still positive.

“The treatment they are getting is not for the virus, the treatment is to take care of the manifestations, as a result of the virus attacking the body system. So, the virus would be suppressed, if the individual’s immune system is high, because the individual has the ability to fight back the virus.

“The implication is that we should be taking adequate diet rich in nutrients that can help boost our immune system. And such nutrients are Vitamin A, B complex, D and E, because vitamins are good at boosting the immune system. And the foods that are rich in these vitamins are within reach. We have fruits and vegetable, which are often neglected in meals. So, at this time, we need to take a lot of fruits and vegetable, including avocado peer. Then, the normal legumes and cereals; all help us to grow well; rice, beans, yam very important with vegetable.”

The nutritionist, nonetheless, said Nigerians should not wrongly believe that with high immune system, they cannot contract Coronavirus, good nutrition only helps to weaken the virus when it enters the body, as the high immune system will suppress and not allow it to thrive.

The professor of nutrition noted that taking unhealthy diet would lead to malnutrition, which makes the body immunity to be very low, and if such a person gets infected with COVID-19, the virus will continue to thrive and multiply in the body system, with the system unable to fight and kill it.

“And the likelihood of recovery will be longer, and the person is likely to develop complications as a result of COVID-19. The numbers that are being announced is not the actual number of people that are infected with COVID-19, the number is much higher, because many people are infected without knowing, their immune system is suppressing it and there will be no manifestation of symptoms sometimes till they recover. Some may even have mild manifestation, but because they are not very sure they have it, they do not call the Nigeria Centre for Disease Control (NCDC) officials, yet they will recover, because their immune system has suppressed the virus, so that is the place of nutrition.

“Mind you, we have avenues for all these nutrients, like vitamin D, just coming out during the early morning sun, the skin will synthesize enough Vitamin D from the sunlight. You don’t need money for that, just stay in the sun during mid-day for 30 minutes.”

Nnam said as the country continues to battle the pandemic, it is important government and all stakeholders step up nutrition advice to get people informed about healthy eating.

She noted that some Nigerians do not feed well, not necessarily because they do not have money to buy food to feed well, but because they are not well informed. “They do not buy food that they can combined for adequate diet. Some will buy expensive food, thinking it will give adequate diet; it might not necessarily be, so people need to be informed.

“Some people say it might be difficult for the poor to eat adequate diet, no, because not all nutritious foods are expensive. The rains are here; vegetables are cheaper in the market now. And some of the foods are still within the reach of the poor because most of the locally available foods are rich in these nutrients; the protein foods- beans and crayfish are good components,” Nnam said.

Dr Patience Ikeme Ogbuli, a nutritionist, said “By healthy nutrition, we mean adequate consumption of fresh fruits and vegetables, nuts, protein of high biological value, and reasonable daily calorie, less consumptions of sweet foods and beverages, and adequate intake of water daily.  Safe and healthy practices that will help build immune health include limited alcohol and tobacco consumption, possibly total cut off tobacco, daily exercises, adequate sleep and less stressful lifestyle.

“It is rather unfortunate that it took COVID-19 pandemic to expose the poor immune health of Nigerians. The majority of Nigerians due to insufficient finances, power failure, excessively long working hours, and lack of access to fresh fruits and vegetables depend on vendor and street foods for daily subsistence. Indomie, bread, high carbohydrate foods and snack, and sugary beverages, and low protein foods are the mainstay nutrition in Nigeria. It cannot be a mistake that hunger, malnutrition and poor unhygienic environments will kill many Nigerians before COVID-19 may find them to finish the job.

“It behooves the stakeholders of our nation to consider the pandemic of hunger, starvation, and filthy environment and attack it more aggressively than the pandemic of COVID-19. The former has killed and will continue to kill more Nigerians than COVID-19.”

On availability of advice on nutrition advice, Ogbuli said advice would make sense if the people have good chance of adhering to the advice. Rather, she said government should improve food supply and make them affordable. “We have enough people in the nation to do the job of nutrition education. It takes job restoration, improvement in job creation, and improved wages to begin to heal the nation.” She said that it is the responsibility of all stakeholders to change the picture of the pathetic nutritional status of many Nigerians, not just that of government alone.

On her part, a Clinical Nutritionist, Funmilola Wunmi Ijiwola stated that healthy food doesn’t necessarily mean expensive, as the key point in achieving healthy diet is knowing the right quantity and quality of nutrients to be included in a meal. She advised Nigerians to eat seasonal foods, which are cheaper. “Beans with sweet potato and grated crayfish cooked with palm oil makes an adequate diet. Also, eating avocado pear with bread and vegetable, which is now in season, are rich in fatty acid and protein. Using fruits in season as snacks also contributes to healthy eating and good health status.”

She noted that malnutrition causes a general imbalance of nutrient composition in the body, it’s either low nutrient, which is deficiency or too much nutrient, which is excess. “If their is an imbalance, the body doesn’t function well and the malfunction will eventually lead to symptoms that can be corrected with adequate diet or lead to a permanent damage of some organs or system in the body.”

Ijiwola also implored government to step up advocacy for good nutrition, because food is the first ‘drugs’ to make the body function well and ensure good health. “If our food intake is taken care of, there won’t be need for treatment of disease conditions. Good nutrition is the perfect description of prevention is better than cure”

Dr Abimbola Odusote, also a nutritionist stated that a virus as COVID-19 attacks the body and the body fights back to overcome it, so if the body is not healthy and the immunity is not strong, the virus would overwhelm the person.

“A person can build his immune system through what he feeds his body. It cam also be through rest, reduction of stress, adequate exercise, sunlight and fresh air. This is the time to up our micronutrients, eat lots of fruits, vegetables and remove the junk foods. Those giving out palliatives should consider what are in the packs- are they packaged processed foods? Why not consider adding fresh fruits and vegetables to the packs? We have lots of fruits rotting away that can be put to good use.”

Odusote said it is important that people learn what foods to buy with little money, which is why nutrition advice at this time is important.

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Bald men may be at higher risk of suffering from severe COVID-19 symptoms, emerging evidence suggests.  

The link is so strong that some researchers are suggesting baldness should be considered a risk factor called the “Gabrin sign,” after the first physician to die of COVID-19 in the United States, Dr. Frank Gabrin, who was bald. 

The lead author of the key study behind the association, Professor Carlos Wambier of Brown University, said, “We really think that baldness is a perfect predictor of severity.”

Since the beginning of the outbreak in Wuhan, China, in January, data has shown that men are more likely to die after getting Coronavirus. In the UK, a report this week from Public Health England found that working-age males were twice as likely as females to die after being diagnosed with COVID-19.

Until recently, scientists had been at a loss as to why this might be pointing to factors such as lifestyle, smoking and immune system differences between the sexes.

But increasingly, they believe it could be because male sex hormones like testosterone may play a part, not only in hair loss, but also in boosting Coronavirus’ ability to attack cells.

This raises the possibility that treatments suppressing these hormones, such as those used for baldness, as well as diseases like prostate cancer, could be used to slow the virus down, giving patients time to fight it off.  “We think androgens or male hormones are definitely the gateway for the virus to enter our cells,” said Wambier. 

As well as the trial being discussed, using baldness drugs in the US, a separate trial has been launched by Matthew Rettig, an oncologist at UC Los Angeles, in 200 veterans in Los Angeles, Seattle and New York, using prostate cancer drugs. 

The trials follow two small studies in Spain led by Wambier, which found that a disproportionately high number of men with male pattern baldness were admitted to hospital with COVID-19.

In one study, 79 per cent of the men suffering from COVID-19 in three Madrid hospitals were bald. The study of 122 patients, published in the Journal of the American Academy of Dermatology followed an earlier piece of work among 41 patients in Spanish hospitals, which found 71 per cent were bald. The background rate of baldness in white men of a similar age to the patients studied is between 31 and 53 per cent. A similar correlation was found in the study among smaller numbers of women with hair loss linked to androgens. 

Other scientists said more work needed to be done, but were excited by the potential link. 

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