Medical doctors in Cross River State are accusing Governor Ben Ayade, and the Nigeria Centre for Disease Control (NCDC) of compromising on COVID-19 in the state.
Apparently irked by the alleged compromise, the state branch of the Nigerian Medical Association (NMA), says it is withdrawing its services from all medical facilities in the state because of hidden COVID-19 cases.
The accusation is coming as NCDC reports 544 new confirmed cases of the unyielding virus on Sunday which brings the country’s tally to 28, 711 in the last 24 hours.
While NCDC also announces 11 new deaths with the fatality figure now hitting 645 deaths across the country, it equally reports that 11,665 cases have been successfully treated and discharged from the different isolation centres and hospitals nationwide.
In spite of the damaging accusation from doctors in Cross River, of the 544 new confirmed COVID-19 cases and 11 deaths in Nigeria, NCDC still proudly says: “No new state has reported a case in the last 24 hours.’’
The 544 new cases are reported from 19 states of the federation with Lagos, the epicentre of the virus, still leading with 199 cases. Its total number of confirmed cases is now 11,244.
Ebonyi, in Eastern Nigeria, follows with 65 cases, Oyo – 47, Ondo – 46, Ogun – 31, Edo – 30, Abuja – 28, Katsina – 25, Plateau – 15, Bayelsa – 11, Kaduna – 10, Adamawa – 10, Akwa Ibom – eight, Gombe – seven Kano – four, Taraba – three, Rivers – two, Abia – two and Ekiti – one.
However, there are concerns about no specific guidelines on the most effective materials and designs for facemasks to minimise the spread of droplets from coughs or sneezes to mitigate the transmission of the rampaging COVID-19.
While there have been prior studies on how medical-grade masks perform, data on cloth-based coverings used by the vast majority of the general public are sparse.
In a letter addressed to the Minister of Health, Osagie Ehanire, and signed by the NMA Chairman, Agam Ayuk, on Sunday. The doctors bluntly pointed out that NCDC did not include Cross River in its daily COVID-19 updates. According to the protesting doctors, Cross River is the only state in Nigeria where no single case of COVID-19 has been officially confirmed, pointing out, ‘’five positive cases had their tests done at an NCDC-approved laboratory, but their results were not published in the agency’s situation report.’’
The doctors are, therefore, demanding an explanation from NCDC, why the five COVID-19 confirmed cases from University of Calabar Teaching Hospital (UCTH) carried out at the NCDC accredited Molecular Laboratory at Alex Ekwueme University Teaching Hospital, Abakaliki, Ebonyi State was not reflected in the daily situation report of NCDC long after results had been transmitted to UCTH since July 1, 2020.
The state branch of the NMA says it is demanding update of the NCDC situation report as a matter of urgent public health interest.
‘’The NCDC is put on notice that the Cross River State Government has abdicated her responsibility of contact tracing, treatment and care for the five confirmed cases which may not be unconnected with the delay in the publication of the results by NCDC”, NMA says.
In the meantime, research from Florida Atlantic University’s College of Engineering and Computer Science, just published in the journal Physics of Fluids, demonstrates through visualization of emulated coughs and sneezes, a method to assess the effectiveness of facemasks in obstructing droplets.
The rationale behind the recommendation for using masks or other face coverings is to reduce the risk of cross-infection via the transmission of respiratory droplets from infected to healthy individuals.
Researchers employed flow visualisation in a laboratory setting using a laser light sheet and a mixture of distilled water and glycerin to generate the synthetic fog that made up the content of a cough-jet.
They visualised droplets expelled from a mannequin’s mouth while simulating coughing and sneezing. They tested masks that are readily available to the general public, which does not draw away from the supply of medical-grade masks and respirators for healthcare workers.
They tested a single-layer bandana-style covering, a homemade mask that was stitched using two-layers of cotton quilting fabric consisting of 70 threads per inch, and a non-sterile cone-style mask that is available in most pharmacies.
By placing these various masks on the mannequin, they were able to map out the paths of droplets and demonstrate how differently they perform.
Results showed that loosely folded facemasks and bandana-style coverings provide minimal stopping-capability for the smallest aerosolized respiratory droplets. Well-fitted homemade masks with multiple layers of quilting fabric, and off-the-shelf cone style masks, proved to be the most effective in reducing droplet dispersal.
These masks were able to curtail the speed and range of the respiratory jets significantly, albeit with some leakage through the mask material and from small gaps along the edges.
Importantly, uncovered emulated coughs were able to travel noticeably farther than the currently recommended 6-foot distancing guideline. Without a mask, droplets travelled more than 8 feet; with a bandana, they travelled 3 feet, 7 inches; with a folded cotton handkerchief, they travelled 1 foot, 3 inches; with the stitched quilted cotton mask, they travelled 2.5 inches; and with the cone-style mask, droplets travelled about 8 inches.
“In addition to providing an initial indication of the effectiveness of protective equipment, the visuals used in our study can help convey to the general public the rationale behind social-distancing guidelines and recommendations for using facemasks”, says Siddhartha Verma, Ph.D., the lead author.
Verma, an assistant professor co-authored the paper with Manhar Dhanak, Ph.D., department chair, professor, and director of SeaTech; and John Frakenfeld, technical paraprofessional, all within FAU’s Department of Ocean and Mechanical Engineering.
“Promoting widespread awareness of effective preventive measures is crucial at this time as we are observing significant spikes in cases of COVID-19 infections in many states, especially Florida.”
When the mannequin was not fitted with a mask, they projected droplets much farther than the 6-foot distancing guidelines currently recommended by the United States Centers for Disease Control and Prevention.
The researchers observed droplets travelling up to 12 feet within approximately 50 seconds. Moreover, the tracer droplets remained suspended midair for up to three minutes in the quiescent environment.
These observations, in combination with other recent studies, suggest that current social-distancing guidelines may need to be updated to account for the aerosol-based transmission of pathogens.
Dhanak says, “we found that although the unobstructed turbulent jets were observed to travel up to 12 feet, a large majority of the ejected droplets fell to the ground by this point. Importantly, both the number and concentration of the droplets will decrease with increasing distance, which is the fundamental rationale behind social-distancing.”
The pathogen responsible for COVID-19 is found primarily in respiratory droplets that are expelled by infected individuals during coughing, sneezing, or even talking and breathing.
Apart from COVID-19, respiratory droplets also are the primary means of transmission for various other viral and bacterial illnesses, such as the common cold, influenza, tuberculosis, SARS (Severe Acute Respiratory Syndrome), and MERS (Middle East Respiratory Syndrome), to name a few.
These pathogens are enveloped within respiratory droplets, which may land on healthy individuals and result in direct transmission, or on inanimate objects, which can lead to infection when a healthy individual comes in contact with them.
Dean of FAU’s College of Engineering and Computer Science, Stella Batalama, PhD, says “our researchers have demonstrated how masks can significantly curtail the speed and range of the respiratory droplets and jets. Moreover, they have uncovered how emulated coughs can travel noticeably farther than the currently recommended six-foot distancing guideline.
“Their research outlines the procedure for setting up simple visualisation experiments using easily available materials, which may help healthcare professionals, medical researchers, and manufacturers in assessing the effectiveness of face masks and other personal protective equipment qualitatively.”