Recall that the Cross River State government had announced the deployment of rapid diagnostic test (RDT) kits for massive screening of persons at border communities and "areas of interest" in the state.
The state Commissioner for Health, Dr Betta Edu stated this in a press briefing on Monday, June 22 during an update on the effort of the state's Covid-19 Response Task Force in containing the virus.
AMLSN in a press statement signed by its Chairman, Benedict Ndem and Secretary Dennis Ekpo, said the RDT kits comes with both positive and negative controls which, apart from not being validated by relevant authorities, comes with risk of infection.
The statement reads in full:
A Press Release By The Association Of Medical Laboratory Scientists of Nigeria, Cross River State Branch Concerning The Update On COVID-19 By The State Task ForceAMLSN in a press statement signed by its Chairman, Benedict Ndem and Secretary Dennis Ekpo, said the RDT kits comes with both positive and negative controls which, apart from not being validated by relevant authorities, comes with risk of infection.
The statement reads in full:
Preamble
The Cross River State Branch of the Association of Medical Laboratory Scientists of Nigeria is compelled to issue this Press Release, following recent events in Cross River State,: a Video, which went viral, showing the Honourable Commissioner for Information and an Update on the State’s response on COVID-19 by the State Task Force, presented by the Honourable Commissioner for Health. As a body of Healthcare Professionals, saddled with the professional duty of Medical Laboratory Diagnosis (including COVID-19 testing), we are obligated to take more than a passing interest in the following developments:
The Viral video
The Honourable Commissioner for Information is seen alleging that the Federal Ministry of Health is planning to import COVID-19 into Cross River State, through a planned COVID-19 training at the Nigerian Navy Reference Hospital, Calabar. We consider this a serious allegation with grave implications being that it is coming from the Official Image-maker and mouth piece of the State Government. The allegation is capable of throwing spanners in the works in the efforts to increase testing for COVID-19 and fight against the pandemic. As Professionals, we have a responsibility to inform the public without bias and/or prejudice.
We are aware that the NCDC National Testing Strategy has 4 prongs as elucidated in the document: ‘National Strategy to Scale up Access to Coronavirus Disease Testing in Nigeria’, published on April 15, 2020. Prongs 1 and 2 have been achieved and no Laboratory in Cross River State was included. Prong 3 involves "The re-purposing of point-of-care Tuberculosis Testing GeneXpert Laboratories for COVID-19 testing". The target is to re-purpose one GeneXpert Laboratory in each of the 36 States and FCT and is expected to increase the country's testing capacity by 1,300 tests per day.
The Nigerian Navy Reference Hospital Calabar, was selected in Cross River State by NCDC and National TB and Leprosy Control Programme for Prong 3 of the National Testing Strategy. The purported hands-on training is part of capacity development in preparation for possible activation of the project. These capacity development activities should not and cannot translate to importing of COVID-19 into Cross River State. So far, there are 37 approved Laboratories, in the NCDC Laboratory Network, spread across different States of the Federation, and trainings were conducted for Medical laboratory personnel before they were activated. There was no report of importation of COVID-19 as a result of these trainings which are usually conducted in controlled environments. Why should the case of Cross River State be different? One who lives in a glass house should not throw stones.
The State COVID-19 Task Force might have already imported the virus into the State; for according to its report, the Task Force claimed to have performed COVID-19 screening using RDT Kits. These kits, as we know, come with both positive and negative controls!
2. Testing of COVID-19 in Cross River State.
The level of COVID-19 testing in Cross River State is abysmally low and of serious concern. Records from NCDC indicate that as at 10th June 2020, only 9 COVID-19 screening tests had been conducted for the State. The disparity between number of samples collected and actual test performed raises more questions than answers. On the other hand, the State has conducted test using RDT Kits, as reported in the CRS COVID-19 update. The Medical Laboratory Science Council of Nigeria (MLSCN), in May 2020, made public its validation of COVID-19 RDT Kits in Nigeria. The MLSCN revealed that no single RDT Kit in the country was able to meet up with 95% level of sensitivity and specificity. It was on this strength, that the NCDC placed an embargo on the use of RDT Kits to test for Coronavirus. The consequence of the use of RDT kits with less than the required sensitivity and specificity, is their inability to pick true positive and true negative cases when in use. This scenario leads to high levels of false positive and false negative results.
If this was used for screening at the point of entry as reported, then somebody should be held accountable for putting the lives of Cross Riverians at risk. The gold standard for testing for COVID-19 remains RT-PCR, for now. We want to appeal to the COVID-19 State Task Force, and by extension, Cross River State Ministry of Health, to stop risking the lives of Citizens by screening for Coronavirus using non-validated and non-certified test kits.
The statement, ‘the public must know that testing for COVID-19 does not work magic as we are made to think’, encapsulates the Task Force’s prejudice against testing. It can then be inferred that testing is not a priority for Cross River State Government. For the purpose of disabusing the minds of the general public, testing remains the gateway in and out of the Coronavirus pandemic. For, it is through testing, that one’s status is determined and in the event of being infected with the virus, it is also testing that determines the response to treatment, as well as when one is rid of the virus. For standard practice, a patient must test negative before he is discharged. It is therefore worrisome to note that patients in the Isolation Centres in Cross River State are subjected to blind treatment in the twenty-first century. We are calling on the NCDC to investigate the claims of the procedure of management in Cross River State Isolation Centres.
3. General laxity
We have observed an increased laxity among members of the public towards adherence to personal safety guidelines as advocated by the NCDC. This may be due, largely, to the continuous bombarding of the public psyche with zero status of the State by various Agents of Government. We are calling on all residents of the State, to take responsibility for their health by ensuring that they comply with the NCDC guidelines of use of face mask, conscious physical and social distancing, general and personal hygiene, including regular washing of hands and use of hand sanitizers.
4. Signs of community transmission
The transmission of Coronavirus is presently suspected to be at the community level across the country. Hospitals and Clinics in Calabar Metropolis are currently reporting high cases of patients with flu-like symptoms, with loss of taste/smell. This is causing heightened fears among the populace and worry among Care-givers. This further raises doubt on the ‘zero status’ of the State. This underscores the urgent need for testing. Testing remains the only empirical way of determining if these are cases of COVID-19, or other ailments altogether.
5. Production of PPE by Government
The efforts of the State Government in the production of PPE is worthy of commendation. Proper standardization and sustained production will ensure the availability of PPE. This will go a long way in boosting the morale of health-care workers in the State; apart from generating the much needed revenue for the State.
Conclusion
It is said that when two elephants fight, the grass suffers. The current flexing of muscles between the Cross River State Ministry of Health and NCDC, has dire consequences on the health of the poor residents of the State. There are no international or local awards or laurels for zero status of COVID-19 pandemic. We are therefore joining other health professionals, and all well-meaning Cross Riverians, to send an SOS to the relevant authorities to by-pass bureaucracy and activate a Testing Centre in Cross River State, without further delay. We pray the government of Cross River State to remember that it has a responsibility to protect the lives and property of the Citizens of the State.
NDEM, BENEDICT N. DENNIS EKPO E.
Branch Chairman Branch Secretary
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