The world has become a different place from what we knew it to be in the last few months of 2019. Ever since then, the greater percentage of humanity has lived under one form of physical and social restriction or the other. The lives of many have been upended and the frills of personal travel, of personal mobility have been replaced by an increase in cargo traffic everywhere in the world. With all of that, there have been rising prices of goods and services and many people have lost their jobs. Worse still, nearly 5.5 million people have died from this pandemic from around the world according to official figures from among more than 285 million infections.
In reality, the fatality figure is likely to be about two times as much. This is nearly as many people as the number of combatants who died by violence in the Second World War; the toll in human suffering has truly been substantial. In Nigeria, the arrival of the Omicron variant has seen a significant increase in the number of confirmed cases and an official death toll of about 3,000 souls. The mortality figure is certainly more than that but it shows how disruptive the whole saga of this pandemic has become to ordinary patterns of living.
Clearly, there is little appetite today across the world for governments to institute the kind of punishing lockdowns many people around the world experienced in early 2020. As Pastor E.O. Adeboye of the Redeemed Christian Church of God said at some point, the world cannot simply continue to remain on holiday. Therefore, a fresh approach was required of mankind in the control of this pandemic.
And then Omicron came along, with its unique capabilities; it is far more infectious than all the previous variants of Covid-19 but it is also the most likely to cause mild disease. Typically, it is acknowledged to cause a dry cough with an itchy throat, muscle pain and fatigue. Features associated with earlier variants like shortness of breath, fever and headache are not prominent in this new variant. All of that may be good news in some ways, especially for the African continent that has thus far suffered much less than all the other continents by way of the number of infections and the death rate. It is also a continent plagued by vaccine hesitancy, vaccine unavailability, official corruption and poor healthcare infrastructure. This mild variant of the original could be a positive development for Africa and the world.
In the face of challenges as outlined above, African nations, particularly those in sub-Saharan Africa, may have found an ally in Omicron. First, Botswana and South Africa did sterling epidemiological work in quickly identifying it as a variant of concern, but the rest of the world sadly responded in typical fashion by banning travel between the number of countries that had identified the Omicron variant with certain European and North-American countries. Since vaccines are largely not available in many of these countries or are not trusted by the citizens who do not even practice any of the recommended protocols for stopping the spread of Covid-19, perhaps the people should be allowed to go about their normal business unhindered, knowing full well that the virus would spread but that not many people would die. In this way, the respective countries could rapidly gain the herd immunity that has proved elusive by way of immunisation and redirect this pandemic into a seasonal infection. So far, the figures coming out of more reliable African countries show that while infections have dramatically gone up, fatalities are rare.
This pattern of high infection rates and low death numbers are seen also in Europe and North America, not to mention major countries such as India and China. In Nigeria, Covid protocols have existed largely in the halls of government. People, who are too hungry and impoverished, simply do not care about wearing masks and washing their hands many times a day. Except for a few instances of personal knowledge of Covid-19 victims, many people see this whole affair as a scam. By flouting all the protocols, therefore, Nigerians have largely got away unscathed. So why not lift all the restraints and allow the dynamics of nature to determine the course of things? This is more now like throwing up our hands in despair but it is a belief rooted in contemporary scientific thought for people to live free of any further regulation in their bid to get their lives back. These restrictions can be kept in place for the elderly, children and those individuals with pre-existing health conditions of hypertension, obesity, diabetes and heart disease. If people do not want to take the vaccine, let them have a form of the disease that is guaranteed to pursue a mild course. In that way, nature would have helped achieve what vaccines to be procured at a huge cost have largely failed in doing.
While scientists must have their own way of deciding when a pandemic has come to an end, it should be noted that people have become used to living with this particular disease, especially in the more developed countries of the world where awareness is always more. As we now see, even a massive surge of this Omicron infection from around the world has not resulted in the kind of wild panic we saw at the beginning of the pandemic. It may also mean that the disease as a whole, probably now poses less of a risk to human lives with this new, milder strain. There is also the likelihood that even after Omicron, there will be other variants. However, viruses are most dangerous when they get into a population that has never previously been exposed to them. Because of that, the outcome for many people will be more terrible than for those who suffer later exposure. We have seen that with the current pandemic; we have seen it too with Lassa fever, Dengue fever and other diseases. In the main, a great many people have lost their initial fear of Covid and that on its own may signal the beginning of the end of the pandemic.
Today, in the most prominent cities of the West, many people are even willing to put themselves in some danger by going out of their homes for a drink with friends, for a party or two (a friend attended four parties last weekend) and also for sometimes throwing some caution to the wind to experience some personal freedom. For the great proportion of the populace, two years of constantly wearing masks at work, in public transportation and at all times of the day has taken a toll. Omicron may turn out to confer some degree of immunity against other strains of Covid in those people it infects, nobody knows for sure just like some future strain could yet turn out to be as infectious as Omicron and as deadly as Delta, if we are unlucky. However, the spirit of freedom in man is infinitely unquenchable. People have simply grown weary of this pandemic be it in Nigeria or elsewhere and there is a strong desire to now move forward. What was sustainable then, for a few months, cannot endure for several years now. It is nice to recall the unbelievable images in the early months of 2020 when the entire world had various populations withdraw from social life, work and even family to help slow the spread of a dangerous virus.
Starting from the early days of this pandemic, the experts and the common folks disagreed strongly about how to respond to this fast-moving pandemic. There were contentious arguments about just how much social distancing and physical separation were necessary to halt the spread of a relentless virus. We saw the powerful effect of strong government mandates in communist China as against the government interventions in freer societies. In the democratic nations of India, Brazil, The United States, The United Kingdom, France, Spain and Italy, we saw the havoc caused by adherence to arguments about the freedom of choice. In the rest of the world, absolute denial about the existence of Covid led to mixed results. What, therefore, seems likely is that with Omicron on the rampage or the advent of a new variant, we are likely to see a world by the end of 2022 looking more like the autumn of 2019, the last few months of that year before news of alarm about a new kind of deadly pneumonia filtered out from the Chinese city of Wuhan.
Questions and answers
Dear doctor, I want to appreciate your good work that makes me a regular reader of Sunday PUNCH. My son, who is one and a half years old, has been coughing and also picked up some unsanitary materials into his mouth. His stomach is now swollen, protruding with associated fever and vomiting. He looks fatigued and this morning, also passed out something that looked quite grotesque and stony. He has been on malaria drugs before now. We took him to the hospital where he was given two injections but he is not better in my view. What do we do? 0813xxxxxxx
Thank you very much for your words of appreciation. You did well by taking him to a hospital for treatment but if his tummy is the way you have described it, he needs to be attended to by a paediatrician. He may have developed a serious infection arising from the things he has swallowed and would need specialist care in a proper hospital where such professionals are found. Alternatively, you could have your hospital arrange for a paediatrician to visit and advise or make his input.
Dear doctor, I have read many of your articles in Sunday PUNCH. I do not know what is wrong with me in my private parts. But I have a bit of pain there and feel uncomfortable. There is no discharge which has increased my confusion about the whole thing. What should I do? Thank you very much. 0802xxxxxxx
Thank you very much for keeping a date with us every Sunday. A sensation like the one you just described has to be due to some infection with associated inflammation. There may be no discharge now but that could change in a few days because it is reasonable to say that the disease condition you have got is still evolving. It is wise to seek an audience with your doctor. Get a proper examination done including swabs and the result obtained will surely guide the treatment you will get. That treatment will have to be shared with your husband or partner as the case may be to avoid a situation where he might re-infect you after completing your treatment. This must be the case even if he has no symptoms.
Dear doctor, my son is four years old and he has been coughing and sneezing so badly over the last five weeks. It is bad when he is sleeping and sometimes he breathes with his mouth open, maybe because the nose gets blocked. He can cough and cough continuously for up to three minutes and then his eyes will turn red and he will start vomiting. We have been to different hospitals and he has been on antibiotics almost the entire period from when the problem first started but there is no improvement. He has used Zinnat; Ampiclox; Fleming and Amoksiclav and none of them is cheap. What do you advise us to do? This is so confusing please. 0802xxxxxxx
Depending on where you live, the attention of a paediatrician is important for your son’s well-being. The problem here is probably that of empirical treatment for your son. In other words, no definite diagnosis has been made. In order to reach that status, your son would need to have at least a chest X-ray done. This helps not just to make a probable cause more treatable but also to help exclude some overlooked condition that could be responsible for so much coughing. By this, it is indicated that the coughing your son is suffering may not necessarily be due to a chest infection and so antibiotics alone may not be the solution.
Dear doctor, my son is four years old and snores a lot when sleeping. Sometimes, even when he is awake he still snores. He often breathes with his mouth open and I know that this is not normal. I am worried about it as well as the implications but my husband keeps saying that he will outgrow it. I don’t know whether that is wise. Please let me have your opinion because I have taken him to a hospital a few times in the last two years but nothing has changed much even after giving him a few drugs prescribed by the doctors. 0807xxxxxxx
Good day to you. The discomfort your son experiences properly falls within the ambit of the ENT surgeon. A snoring child is such an uncommon phenomenon that your doctors should have referred him as soon as they examined him. However, they can furnish you now with a referral to an ENT surgeon depending on where you live and he can then get a proper assessment which will include X-rays and more. After that, you will be advised about the most appropriate treatment for him which can include an operation.
Dear doctor, I have been suffering from typhoid over the past six months. There is no kind of treatment I have not taken including taking a bed in the hospital to wash off the bacteria (my doctor said it was caused by bacteria) and many types of medicines such as Augmentin; Ciprotab; Zinnat and even Chloramphenicol. I still continue to have this typhoid. Does it not have any cure? 0803xxxxxxx
Thank you very much for your question. Typhoid does have a cure but it also diagnosed too easily and far too much. Perhaps all you have got are some high titres obtained by the standard Widal reaction which is not alone to determine that you have typhoid. Ideally, such a test should be done regularly over several days to show a pattern of a steady increase in titres before such a diagnosis can be made. In addition, a full blood count is important where the presence of a relatively low count for a white blood component almost always clinches the diagnosis. These must be taken together with other features like initial constipation, abdominal pain, fever, headaches and the progressive passage of diarrhoea whose stools would resemble pea-soup (a dark brown kind of stool) associated with nightmares and nearly absent sleep. If these are not present, then you not only do not have typhoid but may now be suffering from the effects of too much antibiotics in your system.
Dear doctor, this is the sad story of the untimely death of two gynaecologists at the Dalhatu Araf Specialist Hospital recently (Dr Victor Nwatu and Dr Esa Oga). Dr Nwatu is a new fellow (O&G) of the West African College of Surgeons (April 2021) while Dr Oga was employed in 2017 as a consultant obstetrician and gynaecologist at DASH. The case was that of a woman with severe PPH for whom Dr Nwatu had earlier done uterine artery ligation for the patient. However, the bleeding persisted and Dr Oga had to perform hysterectomy (assisted by Dr Nwatu). The plan to perform hysterectomy was discussed at the morning meeting (as a case of uterine atony) but little concern was placed on the surgical presentation of Lassa fever. Eventually, the patient died. Both surgeons later became ill. Dr Victor travelled back to his family at Abuja from Lafia and was managed as a case of malaria. He eventually died on December 5, 2021 at the age of 43 and survived by his wife and four children. This prompted a review of the corpse and the diagnosis of Lassa fever was confirmed on December 6, 2021. The lead surgeon, Dr Oga was also confirmed to be Lassa positive and died on December 14, 2021. Even as we strive to save lives; let’s continue to remember that doctors’ (as well as other health workers) lives matter by ensuring and insisting on adequate protection from all workplace threats and dangers. May the soul of Drs. Oga and Nwatu rest in peace and may the good Lord continue to protect us. Please keep staying safe. You are covered by the blood of Jesus. You will not be a victim of your job in Jesus name. 0802xxxxxxx
Thank you very much for your prayers. They are sincerely appreciated. There is not much healthcare practitioners can do at the present time to deal with some of these problems which the recurrent lack of critical safety materials have often made clear. Safety equipment is simply not adequate; patients are too many and the skilled hands are few and getting fewer. Virtually all of the healthcare professionals lost to Covid-19 died also from not having the right materials to protect themselves. This is a country in which politicians, including those at the local government level, award themselves wardrobe allowances. It is a huge moral issue. Your contribution is much appreciated.
Dear doctor, excellent article on white tongue in babies. Please what is a PSA? 0802xxxxxxx
Thank you for your question and your comment too. PSA means Prostate-Specific Antigen, a laboratory test that measures the amount of that protein found in the blood. It is specifically made by the prostate gland hence its utility in determining the presence of certain conditions in the prostate gland. The amount may therefore be higher in men who have prostate cancer, benign prostatic hyperplasia and inflammation of the prostate. There is a scale by which these figures are interpreted and these go a long way to make a diagnosis.
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