By Jeph Ajobaju, Chief Copy Editor
Abuja has threatened to sack doctors on strike over lack of equipment to handle coronavirus in Nigeria, which now has 455 deaths, in contrast to the United Kingdom where dexamethasone has been deployed against the pandemic.
The National Association of Resident Doctors (NARD) announced the start of a nationwide “indefinite strike” on Monday in a communique issued at the end of their ‘virtual extraordinary National Executive Council (NEC) meeting’.
NARD President, Aliyu Sokombo, said doctors are on strike over unpaid salaries, non-payment of hazard allowance, and a lack of Personal Protective Equipment (PPE) in hospitals among several other reasons.
NARD explored several other options before arriving at their decision, he said.
In the UK, however, dexamethasone has been found to be a life-saving treatment for seriously-ill hospital patients with coronavirus and is being used across the UK from today, following breakthrough results in a trial.
Dexamethasone – a cheap, widely-available steroid – was shown to reduce deaths among patients on ventilators and on oxygen, the BBC reports.
The UK’s chief medical officers say it should be used “with immediate effect”. And there are no issues with supplies of the medicine in the UK.
How dexamethasone works
An “urgent” letter the UK’s four chief medical officers wrote to clinicians in the National Health Service (NHS) said dexamethasone had “a clear place in the management of hospitalised patients with Covid-19”.
Health Secretary Matt Hancock told the House of Commons that 240,000 doses of the drug are “in stock and on order”.
“It is not by any means a cure but it is the best news we have had,” he added.
It comes as the UK government announced a further 184 people have died with coronavirus across all settings in the UK, taking the total to 42,153.
Major breakthrough
The anti-inflammatory drug was tested as part of the world’s biggest trial of existing treatments to see if they could also work against coronavirus.
In the trial, led by a team from Oxford University, about 2,000 hospital patients were given dexamethasone and compared with more than 4,000 who were not.
For patients on ventilators, it cut the risk of death from 40 per cent to 28 per cent. For patients needing oxygen, it cut the risk of death from 25 per cent to 20 per cent.
The researchers said this was equivalent to one life being saved for every eight patients on a ventilator and one life being saved for every 20-25 being treated with oxygen.
Home a week after taking dexamethasone
Marium Zumeer, an 18-year-old from Bradford who was given the drug as part of the trial, said it had been “life-saving”.
She was admitted to hospital after 10 days of being extremely unwell, and after beginning a course of the drug she was told she would hopefully be home in a week.
“And a week later I did come home,” Zumeer told the BBC.
On Monday, 385 people with Covid-19 were on mechanical ventilation in hospitals in the UK with hundreds more likely to be on oxygen support.
They could all be candidates for receiving dexamethasone.
The drug works by dampening down the reaction of the body’s immune system to on Covid-19, which can often be more harmful than the virus itself.
Chief investigator Prof Peter Horby said it was “the only drug so far that has been shown to reduce mortality – and it reduces it significantly”.
“It’s a major breakthrough,” he added.
However, it should not be used to treat anyone with coronavirus who is not in hospital. Its use is still being studied in children.
Dexamethasone is already used to reduce inflammation in a range of other conditions, including arthritis, asthma and some skin conditions.
The drug is also widely available around the world.
Sack threat to doctors
Striking doctors in Nigerian public hospitals are demanding better benefits, including the provision of more protective equipment, as they battle the coronavirus, NARD said.
NARD said those treating COVID-19 patients will stay on the job but gave the government two weeks to meet the demands or else they would also walk out.
But on Wednesday, the government threatened to sack the doctors after they told the government to make “alternative arrangements” for patient care.
“The resident doctors have told us that they are not returning to work very soon until certain conditions are met and they cannot keep extending the goal post any time they like,” Sahara Reporters quoted Labour and Employment Minister, Chris Ngige as saying.
“Those who report to work will be taken as those who are still in service and the [attendance] register will be closed at 12 noon and by then we will know who want to still be in service,” Ngige warned.
Resident doctors are those who have graduated from medical school and are training as specialist consultants. They are pivotal to frontline healthcare in Nigeria as they dominate the emergency wards in its hospitals.
Strikes are common in Nigeria’s public health system, with clinicians frequently seeking pay rises and improvements to under-funded infrastructure to meet the rising burden of healthcare in a country of 200 million people, according to Reuters.
“If the government fails to meet our minimum demands within two weeks, the resident doctors working in (COVID-19) isolation centres will automatically join the strike,” Sokomba said in a statement.
The resident doctors are seeking a COVID-19 pay supplement in addition to life insurance for doctors and more funds in the federal budget for their training, among other demands.
The union has complained about inadequate protective equipment to treat coronavirus patients and has said that 10 doctors have died so far from the highly infectious respiratory disease.
At the latest count, Nigeria has 17,148 confirmed cases of the virus and 455 deaths. Lagos, Africa’s biggest city of 20 million inhabitants, has the most cases of 7,461 and 107 deaths.
Last month, doctors in Lagos staged a one-day strike over what they described as police harassment of health workers trying to move through the city to treat patients during a coronavirus curfew.
Meeting doctors’ demands
Ngige had promised on Tuesday the government would implement the demands of the doctors in stages.
He said no conclusions were reached at that day’s meeting, noting that the doctors have gone for consultations with their members and “they would get back to government after 24 hours.”
“They said that they haven’t seen any tangible thing from government and that their accounts were yet to be credited.
“But I told them that the federal government has paid N2 billion to health workers across board in 14 teaching hospitals and Federal Medical Centres as of Monday,” Ngige disclosed said.
He said the government has started paying the new hazard allowances to all categories of frontline health workers involved in COVID-19 treatment in batches.
“There are about 43 or 52 teaching hospitals and Federal Medical Centres in the country and we are paying them in batches. By Wednesday, the amount paid out would have hit N4 billion.”
Health Minister Osagie Ehanire told reporters government officials were holding talks with NARD, saying the strike at a time of the pandemic may lead to loss of lives.
He urged the doctors to show empathy by calling off the strike, and pledged that the government will do anything to protect the lives of Nigerians.
“We are ready to protect the lives of Nigerians; we are not going to allow our hospitals to fallow,” he told journalists.
Ehanire claimed that Nigeria is the first country in the world where doctors went on strike during a global pandemic.