Home-based treatment for COVID-19 patients

Following complaints of inadequate bed spaces to accommodate new cases of COVID-19 especially in Lagos isolation centres, the Nigeria Centre for Disease Control (NCDC) announced sometime in May that it was considering the option of treating coronavirus patients in their homes.

In his address at the Presidential Task Force (PTF) briefing on COVID-19 in Abuja, the Director General of the agency, Dr Chikwe Ihekweazu, said he was mindful of the fact that Lagos remains the worst-hit by the challenge of inadequate bed spaces, even though Kano and the Federal Capital Territory are currently struggling with similar problem.

He therefore, said there might be a need for a change of strategy and commencement of treating some patients at home.

Against this background, some states including Kwara, Katsina, Ondo, Borno, Gombe, Edo, Ekiti, Sokoto, Ogun, and Osun equivocally said they were not considering treating COVID-19 patients from their homes.

They separately affirmed they had enough bed spaces in their respective state isolation centres and the capacity to manage patients.

Nonetheless, the Coordinator of the Task Force Committee on COVID-19 in Kano state, Dr Tijjani Husain, said the state was looking critically at the national guidelines for home treatment before it would consider it.

Few weeks later, Dr. Ihekweazu announced that the PTF on COVID-19 could not go ahead with home treatment of COVID-19 patients once proposed by the agency.

“We want to prevent transmission; therefore, we want to institutionalise the treatment of everyone.

“We recognise that the circumstances that many Nigerians live in make home isolation difficult and sometimes, an impossible option for many people who live in very tight accommodation in family groups and communities”, he said.

The Lagos State Commissioner for Health, Prof Akin Abayomi, thereafter said at one of the regular press briefings held in Lagos, that the state had commenced plans to execute home-based treatment for mild and asymptomatic cases of COVID-19, while severe cases will be managed at the isolation centres.

With the daily increase in the number of positive cases occasioned by the increase in testing capacity, the commissioner expressed fears that the possibility of running short of bed spaces at isolation facilities cannot be ruled out; thus making it imperative to opt for home-based care for people who have mild symptoms or are asymptomatic to the infection.

According to Abayomi, COVID-19 patients who are asymptomatic qualify to be managed at home because most people in that category will naturally get well without any medical intervention.

“After all, if you are not feeling any symptom you may not know you have COVID-19, nothing happens to you and you may clear the virus after seven to 10 days”, he said; noting that the people they want to pay more attention to are the moderate to severe ones because they are not suitable for home-based care.

Prof Abayomi said patients receiving home-based care will be provided with a COVID-19 pack with which they can monitor their body temperature, measure their oxygen level and be given certain vitamins and pain-relieving drugs to manage themselves.

He further clarified that COVID-19 patients that would be managed from home are going to be monitored.

He said patients shall be contacted on phone and will also be visited.

Although Lagos and other states mulling home-based treatment for COVID-19 patients were or are under pressure to do so due to inadequate bed spaces, the reasons advanced by the PTF on COVID-19 for declining that option is also valid.

Managing COVID-19 patients in their homes put others at great risk because of the high tendency for unhindered transmission that would result from possible refusal by patients and family members to adhere to isolation protocols.

We advise Lagos and Kano states to take responsibility by finding means for scaling up their facilities at isolation centres.

Aside of the danger of free transmission and of private health facilities illegally becoming treatment centres, shifting isolation responsibility to citizens could also lead to some dangerous trends including self-medication and a resort to local herbalists.

The cost of expanding isolation centres is indeed a lesser ‘evil’ to the management of COVID-19 patients from home. Government has a duty to make citizens safe.