room089: I wouldn't blame first consultant hospital for any poor handling of the index case. Before the coming of patrick sawyer into Nigeria, no body knew all the symptoms of Ebola Virus Disease. And as we were made to know, the Liberian never helped matters: he absolved and exonerated himself from any ebola case; even when he was too sure that he had contracted the virus back home.

Any medical doctor in the endemic region ought to treat every fever, especially if you got a history of collapse in airport, like Ebola.

When we were in med school, during the Avian/ Swine flu epidemic. it was one of our questions during our finals exams, regarding a traveler with symptoms of FLU who recently visited Mexico, the answer was straight up Swine flu. The problem i think is most Doctors do not concern themselves with foreign affairs. Unfortunately, Ebola is not forgiving for such mistakes. As a doctor, you need to be very versatile and highly suspicious and have a high index of suspicion for such public health red flag diseases: HIV, Hepatitis, TB, now Ebola, etc. When you see such patients, you shouldn't miss diagnosis. You may not get a second chance.

PassingShot: Our number one failure was failing to restrict border crossings from those countries ravaged by the EVD

Then the failure of not screening anyone coming in from those affected countries before even entering the country.

If we had done any or both of the above, we may not be talking about Ebola in Nigeria. After all the scourge has been on since early this year.

We can block borders, but we need to help Liberia, Sierra Leone and Guinea handle the outbreak, else it will be counter productive if the disease keeps spreading and killing thousands.

less comments on this thread as most are trying to digest this particular 'Sauce'.

ceejayluv: Crying over spilt milk.. My condolences to the health workers that died.. Sincerely, I feel we were even lucky that it was a high profile personality that came in with the disease. I could imagine if it were some regional merchant or one of his boys that brought the virus via some remote border, thereby dying in some low brow clinic. The outcome is better imagined.
NB. With the way the virus is still ravaging Liberia et al and the number of internally displaced and refugees that may result, the hypothetical scenario I mentioned above is not so improbable in the near future.

Well said.

To even imagine that not much has been done in restricting inter-border movements between us and those affected countries is inexplicable.

We always play catch-up in Nigeria and never proactive.

gmyguy: We can block borders, but we need to help Liberia, Sierra Leone and Guinea handle the outbreak, else it will be counter productive if the disease keeps spreading and killing thousands.

No qualms with helping them but we surely first need to help ourselves first.

gmyguy:
Any medical doctor ought to treat every fever, especially if you got a history of collapse in airport, like Ebola.

When we were in med school, during the Avian/ Swine flu epidemic. it was one of our questions during our finals exams, regarding a traveler with symptoms of FLU who recently visited Mexico, the answer was straight up Swine flu. The problem i think is most Doctors do not concern themselves with foreign affairs. Unfortunately, Ebola is not forgiving for such mistakes. As a doctor, you need to be very versatile and highly suspicious and have a high index of suspicion for such public health red flag diseases: HIV, Hepatitis, TB, now Ebola, etc. When you see such patients, you shouldn't miss diagnosis. You may not get a second chance.

You are right bro, thanks for the insight. I think I will go with you, doc.

Sincere9gerian:
My point is that the diagnosis from day one would have been Ebola until proven otherwise. If that was done, it would have reduced the number of contacts within the hospital to only healthcare workers who saw him on day one. Those who attended to him on day one would have gone home only after serious de-contamination.

If you still dont agree with me, compare the situation in Nigeria with other countries with similar imported cases of Ebola. How many of such countries have you heard primary contacts, secondary contacts, bla bla bla? Lets stop making excuses for our failures.

EVD could have been queried or put as a major differential, but not necessarily as d first diagnosis. If u make such a diagnosis in any clinical exam, you would fail woefully esp if it ends up being wrong.
Sawyer was wicked cos he failed to volunteer that necessary information. Of course, he did that cos he was a biological terrorist, so denying his contact was part of his plans of spreading the virus.
However, like you wrote, the ministry of health failed in being proactive early enough. If sensitization campaigns had started going on since Ebola outbreak overtook Liberia, Guinea and Sierra Leone, reminding Nigerians especially health workers of the possibility of the virus being imported via air, water or land, and advising them to be on their guard, I'm sure things would not have gone this bad.
So to a large extent, I agree with your write up. It is very typical of Africans for bad things to always catch us unawares. It's well.

u just de look for attention

I agree with the Op,despite the similarities in symptoms,Patrick sawyer coming for a high risk area is enough to be isolated immediately he was hospitalized, to reduce contact with people.

The authority really messed up big time.

How was he cleared to board a plane remains a mystery to mem

Allohrandy: I don't think the hospital knew Mr Patrick was from Liberia when he first arrived at the hospital. Like you said, Mr Patrick might have deliberately withheld information to the doctors and nurses. The symptoms of Ebola is similar to any other fever

Did he just walk from the airport to the hospital alone? Were there no airport staff with him, shouldn't that be a reason why questions should've been asked?

Some one came from Liberia, a country afflicted by ebola since early this year and our doctors didn't deem it fit to be careful? Haba!! Sincere9gerian is on point yet again, a masterpiece.
I love this sincere dude, politics should not be everything, he's a doctur and he showed his pedigree with the above.

Nothing good will ever come out of Nigeria. I know how we handle things in this part of the world.

hey insincere are u broke or u ve been fired,as ur Jonathan how he spoil the health sector those pathetic questions

Sincere9gerian:
I heard that aspect of the story too (that Mr Sawyer denied having any contact with people with Ebola disease) but I still insist that a history of acute fever PLUS recent arrival from Liberia was sufficient to make a diagnosis of Ebola UNTIL PROVEN OTHERWISE.

good thread, i think the failure started at the airport.
Btw finally you agree with my thread.

www.nairaland.com/1851308/gejs-incompetence-kill-us-all

you people dont get the picture, the West wants to get rid of you, they see you as beast of burden

Sincere9gerian: Nigeria was free of Ebola until the late Patrick Sawyer, the Liberian-American, imported Ebola into Nigeria on July 20. Mr Sawyer was reported to have been terribly ill on his flight and was rushed to the First Consultant Hospital Obalende, Lagos, where he was diagnosed as having Ebola. He died on July 24.

From that single imported case of Ebola, Nigeria has had, till date, 14 confirmed cases of Ebola (including the 2 cases confirmed today out of the secondary contacts), out of which 5 deaths [including the index (imported) case] was recorded. 5 confirmed cases of Ebola made full recovery and have been discharged while up to 213 contacts are on follow up.

Few days ago, Nigeria’s Health Minister, Prof Onyebuchi Chukwu described the way Nigeria has managed the imported case of Ebola so far as a "success story". With all due respect, I beg to disagree with the Prof. I think we FAILED and I will point out the different levels of failure below.

1. The index case of Ebola was already sick when he arrived the Lagos Airport on July 20. If the Port Health Authorities were alive to their duties on that fateful day, perhaps the late Sawyer would have been quarantined immediately, especially since there was already a widely reported ongoing epidemic of Ebola in Liberia since March this year. Therefore, the Port Health Authority FAILED at this level.

2. Late Patrick Sawyer was rushed to First Consultant Hospital, Lagos, on arrival. It was reported that Sawyer was initially assessed and treated for malaria, hepatitis, etc. The assessment and diagnosis of Ebola came later. The junior and senior doctors that managed Sawyer at the First Consultant Hospital FAILED at this level. With history of acute fever (plus other symptoms) and recent arrival from Liberia, the diagnosis at presentation ought to have been ebola viral disease (EVD) UNTIL PROVEN OTHERWISE.

However, the hospital should be commended for making the diagnosis of EVD eventually and alerting the Lagos health authorities. Otherwise, things could have been worse.

3. The failure of the the First Consultant Hospital to make the diagnosis of ebola promptly can also be linked to failure of the state and federal health authorities to sensitize the private and public hospitals on the possibility of ebola outbreak in Nigeria considering the fact that neighbouring west African countries have been battling with ebola epidemic since March this year. The state and federal health authorities FAILED in this respect.

4. The other level of failure is the way we have managed the primary contacts of the index case. I believe that the primary contacts ought to have been categorized into high risk and low risk contacts. The low risk contacts will include, for instance, all those that flew in the same aircraft with Mr Sawyer. The high risk contacts should include the person who sat next to Mr Sawyer in the aircraft, those who helped him all the way to the Lagos hospital and all the health workers that took care of him when his condition was still unknown. All those who fall into the high risk group ought to have been quarantined compulsorily immediately because they are at high risk of EVB. On the other hand, those who fall into the low risk group can be followed up at their homes since they are at low risk of developing EVD.

This strategy has the following benefits:
- since we cannot quarantine all the primary contacts because of logistic challenges, those at high risk, who are few, can be quarantined.
- high risk individuals who develop EVD while on quarantine will not transfer the disease to secondary contacts. That way, secondary contacts will be minimal or zero. If this strategy was adopted, the 213 secondary contacts that are currently on follow up and the 2 confirmed cases of EVD among secondary contacts would not have arisen.



The above suggested strategy is better than the strategy adopted by Nigeria's health authorities, which is simply to follow up all contacts from home. This has led to what looks like a cascade of 213 secondary contacts and 2 confirmed cases of EBV among the secondary contacts. And God forbid, if we continue this way, we will soon be talking of tertiary contacts, quaternary contacts, and so on, with resultant ballooning morbidity and mortality.

In conclusion, if we have this level of mortality and morbidity from a single imported case of Ebola, just imagine what will happen if, God forbid, we have infiltration of several Ebola cases into Nigeria.

Note: this article is a critique of the system, and does not necessarily suggest the author would have done better than the various actors under the same circumstance.

WORD!!!
+1000

Most people complain about bad treatment in the hands of Nigerian doctors. Doctors need to have continuous on going education to keep them abreast of treating not just the common malaria and respiratory infections. Exotic diseases like Ebola, will easily be missed because the casual onlooker will easily miss the diagnosis and casually assume it to be malaria or URTi. You can't even blame NNPC for missing the diagnosis at their facility, but perhaps you should. Because, if you actually take a detailed history, instead of breezing through your evaluation casually, a mistake most of us make, we miss very unusual conditions like this.

The FG scrapping its residency program is not the best move, as it will leave many Doctors hanging in the need for continuous education. I think the reverse ought to have been the way forward. Let's forget all these salary issue. I am sure everybody who is a patient, even when the doctor himself does become a patient, will want to be attended by a specialist. This is also one of the problems.

Mind you, the first physician to attend to emergency patients are usually medical officers or residents. Of what benefit, is it, when he/ she fails to make a diagnosis?. In this instance, several staff would eventually get infected before a consultant comes along to make the correct diagnosis.

Mynd44:


Patrick Sawyer was a medical terrorist, claiming the health officials failed in their jobs is complete silliness.

Finito!

Well for now the situation is under control. I belive it is best that until a cure is discovered

In the End we are all Nigerians looking for Johns Hopkins School of Public Health JHSPH
ways to make our country Better , this well written article by the OP goes to show that GEJ supporters are not robots but objective people . In that Name that is greater than any other name Nigeria will overcome Ebola !God bless Nigeria

Their is a need to prepare for worst case scenario what if like OP side we have a hundred ebola ppl from liberia find there way into the north or south.

Are we preapring our systems for worst case scenario..

This is a very serious matter and this is the only way the diesase can be contained.

This dicussion needs to be raised to ppl in govt if u know any

With all due respect to the topic under discussion,I find it hard to agree with a lot of the issues raised,it is a common saying in medicine that common things occur commonly,meaning a man walks into your clinic complaining of fever and body aches,the first thing your mind goes to is the commonest cause of this symptoms,ie malaria etc, having treated for this and with the patient denying any history of contact with a known Ebola victim,the hospital took the next logical step in patient management,which is to send samples for investigation..it is very easy on the benefit of hindsight to sit on your high horse and dish out comments and condemnations on what is and should have been,having gone through the steps the hospital took,as a medical professional myself,I commend the hospital's work ethics,keeping in mind the environment we live in..If there's any blame to be apportioned leave it at the feet of a government that prefers to be reactive instead of proactive in the management of issues where her citizens are concerned...

kolawaxxy:

IS NOW A CRIME 2 B OBJECTIVE,IN OBSERVATION? everybody can not be jajanweed,dat are blind with hatred,greed& one way politics AS FAR AS AM CONCERN THIS IS CONSTRUCTIVE CRITISM

Sincere9gerian: Nigeria was free of Ebola until the late Patrick Sawyer, the Liberian-American, imported Ebola into Nigeria on July 20. Mr Sawyer was reported to have been terribly ill on his flight and was rushed to the First Consultant Hospital Obalende, Lagos, where he was diagnosed as having Ebola. He died on July 24.

From that single imported case of Ebola, Nigeria has had, till date, 14 confirmed cases of Ebola (including the 2 cases confirmed today out of the secondary contacts), out of which 5 deaths [including the index (imported) case] was recorded. 5 confirmed cases of Ebola made full recovery and have been discharged while up to 213 contacts are on follow up.

Few days ago, Nigeria’s Health Minister, Prof Onyebuchi Chukwu described the way Nigeria has managed the imported case of Ebola so far as a "success story". With all due respect, I beg to disagree with the Prof. I think we FAILED and I will point out the different levels of failure below.

1. The index case of Ebola was already sick when he arrived the Lagos Airport on July 20. If the Port Health Authorities were alive to their duties on that fateful day, perhaps the late Sawyer would have been quarantined immediately, especially since there was already a widely reported ongoing epidemic of Ebola in Liberia since March this year. Therefore, the Port Health Authority FAILED at this level.

2. Late Patrick Sawyer was rushed to First Consultant Hospital, Lagos, on arrival. It was reported that Sawyer was initially assessed and treated for malaria, hepatitis, etc. The assessment and diagnosis of Ebola came later. The junior and senior doctors that managed Sawyer at the First Consultant Hospital FAILED at this level. With history of acute fever (plus other symptoms) and recent arrival from Liberia, the diagnosis at presentation ought to have been ebola viral disease (EVD) UNTIL PROVEN OTHERWISE.

However, the hospital should be commended for making the diagnosis of EVD eventually and alerting the Lagos health authorities. Otherwise, things could have been worse.

3. The failure of the the First Consultant Hospital to make the diagnosis of ebola promptly can also be linked to failure of the state and federal health authorities to sensitize the private and public hospitals on the possibility of ebola outbreak in Nigeria considering the fact that neighbouring west African countries have been battling with ebola epidemic since March this year. The state and federal health authorities FAILED in this respect.

4. The other level of failure is the way we have managed the primary contacts of the index case. I believe that the primary contacts ought to have been categorized into high risk and low risk contacts. The low risk contacts will include, for instance, all those that flew in the same aircraft with Mr Sawyer. The high risk contacts should include the person who sat next to Mr Sawyer in the aircraft, those who helped him all the way to the Lagos hospital and all the health workers that took care of him when his condition was still unknown. All those who fall into the high risk group ought to have been quarantined compulsorily immediately because they are at high risk of EVB. On the other hand, those who fall into the low risk group can be followed up at their homes since they are at low risk of developing EVD.

This strategy has the following benefits:
- since we cannot quarantine all the primary contacts because of logistic challenges, those at high risk, who are few, can be quarantined.
- high risk individuals who develop EVD while on quarantine will not transfer the disease to secondary contacts. That way, secondary contacts will be minimal or zero. If this strategy was adopted, the 213 secondary contacts that are currently on follow up and the 2 confirmed cases of EVD among secondary contacts would not have arisen.



The above suggested strategy is better than the strategy adopted by Nigeria's health authorities, which is simply to follow up all contacts from home. This has led to what looks like a cascade of 213 secondary contacts and 2 confirmed cases of EBV among the secondary contacts. And God forbid, if we continue this way, we will soon be talking of tertiary contacts, quaternary contacts, and so on, with resultant ballooning morbidity and mortality.

In conclusion, if we have this level of mortality and morbidity from a single imported case of Ebola, just imagine what will happen if, God forbid, we have infiltration of several Ebola cases into Nigeria.

Note: this article is a critique of the system, and does not necessarily suggest the author would have done better than the various actors under the same circumstance.

.Good talk. We all desire for ideal society(textbook society).We should be real to where we are.The writer forgot to know that Liberian authority that allowed the man to travel is to be questioned.LAgos and Federal govt did a good job by the awareness about the virus and how it was generally managed.

kolawaxxy: They finally succeded in hacking into insincere9igerian's account

My friend, I was shocked. I had to double check his profile to make sure it was the same person speaking this intelligently.

Op is 100% correct. Patrick should have been screened and dictated at the airport. but hey, nothing was put in place to check the import of the virus from the countries affected. Minister of health and Aviation failed big time, they are just acting behind time not proactive. And yes, the consultant hospital acted out of ignorant too. Even under emergency, the medical/travel history and ID of sawyer were not something to have overlooked. His passport alone showing a liberian citizen would have flash the red signal that its not save. Rather Every body attended to him at the clinic like a normal person not until the result of ebola test was out. You don't treat patients from ebola ridden country base on trust, because he said he had no contact with ebola patient doesn't mean he can be trusted given that the virus is raving where he is coming from. In fact there are so many loopholes more especially from the ministers. Bwt, patric sawyer was a devil in human skin.

Beync: Op is 100% correct. Patrick should have been screened and dictated at the airport. but hey, nothing was put in place to check the import of the virus from the countries affected. Minister of health and Aviation failed big time, they are just acting behind time not proactive. And yes, the consultant hospital acted out of ignorant too. Even under emergency, the medical/travel history and ID of sawyer were not something to have overlooked. His passport alone showing a liberian citizen would have flash the red signal that its not save. Rather Every body attended to him at the clinic like a normal person not until the result of ebola test was out. You don't treat patients from ebola ridden country base on trust, because he said he had no contact with ebola patient doesn't mean he can be trusted given that the virus is raving where he is coming from. In fact there are so many loopholes more especially from the ministers.

They know they were at fault, the miserable people. That's why they started campaigning against a dead man and claiming he was a terrorist. Apparently, he managed to outwit an entire country. -_-

I am calling on all wise people on this forum to attend and discuss their views on Ebola .

I have a list people who I consider may be wise on this subject.

My list is by no means exhaustive but when they arrive they may list their own list of wise people.

I am calling the following people:

Litmus, mannycrown, Firefire, Fresia01, ak4God, mojeer678,


https://www.youtube.com/watch?v=AUvxsqcsWoc


https://www.youtube.com/watch?v=sBRvNJ5rEJM

For me the white man is over-hyping the Ebola out break if it existed at all - definitely there is propaganda about the deadliness of Ebola, it may surprise many that there is at least one disease more deadly than they claim ebola is.

Why do you think Ebola propaganda is being propelled by the white man?

Why do you think they want to panic us and make us fearful of Ebola.?

What do you think about the theory that they want to panic us into accepting dangerous experimental vaccines (and probably other unrelated dangerous medical tests) to be used on Nigerian / West African population.

Do you know it is almost impossible to find somebody who has been filmed suffering from the symptoms of Ebola?
It makes you wonder if the disease exists at all.

Why are is WHO creating hysteria for Ebola and not Rabies? Is it because Ebola is for discrediting Africa only?

I saw this video where Liberian president was on CNN saying that there has been 47 deaths in Liberia and that 28 of those has been medical staff. As she was saying this CNN was flashing up that 730 deaths in the West African region.


https://www.youtube.com/watch?v=4IGx66evPmk

It struck me that CNN or W.H.O. are exaggerating the deaths because if as we are told that Liberia is one of the major epicentres of the Ebola, then surely its share of the 730 deaths should be in the region of at least 200 deaths instead of 47 deaths.

But even more surprising is the part that she said 28 of the deaths were medical staff, meaning only 19 patients have died in Liberia.

So a major epicentre of the illness has only recorded 19 deaths ?

Then she reveals that her people are resisting authorities .. W.T. .? what does it mean? is it that Liberians were not aware of the epidemic until the USA medical mission told them?

What do you think?

Researcher talks about a case of how epidemic hoaxes are used to sell dangerous vaccines

https://www.youtube.com/watch?v=PK_7ZrYlOs8

Ebola vaccine share stocks rise on back of epidemic propaganda

https://www.youtube.com/watch?v=4dqxZr_iY6c

Some ground rules:
Please can we refrain from throwing insults if you disagree with somebody else.

Beync: Bwt, patric sawyer was a devil in human skin.

See, now I had to take back my like because you edited to add this part.

Someone ban GenBuhari.

Always derailing. Get your own thread instead of copy-pasting in everyone else's! This has got to be the 10th time I've seen your stúpid post! And it's freaking long as hell.

A little mathematics to boot..
According to the article on Ebola found on Wikipedia page, it has a fatality rate of 65-90%.
In Nigeria, out of 14 cases, 5 recovered fully while only 5 have been confirmed dead. This means the fatality rate in Nigeria now is [(5/14) * 100 ] less than 36%.
They have managed to keep the fatality rate less than the perceived level. I think that is commendable.
Not to say everyone can rest on their oars now, but they have tried in expunging the fear.

MissMeiya:

See, now I had to take back my like because you edited to add this part.

lol. But it's true nau. Why do you think he denied having contact with ebola patient when his sister just died of the virus. I also learnt that he got in contact with the said deceased sister as against medical advice given to him.

hmm