– Says Infectious Disease Scientist, Dr. Dougbeh Chris Nyan
Liberia’s Infectious Disease Scientist, Dr. Dougbeh Chris Nyan, says the country’s three positive coronavirus cases may be an under-representation of the actual number of infectious persons since there is far less testing being conducted for the coronavirus.
Dr. Nyan says while Liberia 3 positive cases after about three weeks are cautiously welcoming, the true number of cases can only be determined if massive testing is carried out since research has shown that there are lots of people who can be infected (silent carriers) and do not show symptoms.
“Government’s announcement of still having only 3 positive cases after about three weeks is cautiously welcoming, but raises serious public health questions,” Dr. Nyan added. “With far less testing for COVID-19 conducted in the population during the last three-week period, I think the three positive cases is an under-representation of the actual number and rate of COVID-19 infections in the Liberian population. This may be due to a shortage of COVID-19 testing kits that most African countries are presently faced with.”
According to Dr. Nyan, COVID-19, “which we also call SARS-CoV-2, tricks the body not to show symptoms in some infected persons; therefore, any further delay in massive testing means a continual increase of asymptomatic cases, which will complicate efforts to stop the spread of the disease.
“I believe that there are plenty of infected asymptomatic carriers of the virus that are not yet tested due to the apparent lack of mass testing in Liberia,” Dr. Nyan, who is a Liberian based in the USA, said. “Once we begin to conduct mass testing, that number will exponentially increase drastically from 3 cases upward. This is the same pattern we are now observing in other countries like the US, Spain, Turkey, and South Africa. Therefore, there is a need for more testing so that we are not under the illusion that Liberia has only three positive cases. In the Bible, it is stated that Seek and ye shall find. The more we test, the more we will find.”
Dr. Nyan’s remarks about Liberia’s cases came a few days after health authorities disclosed that they have identified at least 390 contacts including 40 health workers to have come in contact with the three existing cases, which constitute “low and high-risk contacts.”
Out of the 390 contacts so far, health authorities have said 45 are of high-risk cases including a one suspected case.
“As of this morning, we had 390 contacts; of that number, 45 are high-risk. What we usually do is to go after our high-risk cases; after testing, 24 of those cases are negative after the first test. Once you are negative after the second test you are off the list and you are allowed to self-quarantine from home. Whether we have covered all the contacts is a tricky question to answer because it determines whether the person is saying the truth,” said Dr. Mosoka Fallah, Director General-designate for the National Public Health Institute of Liberia last week during his confirmation hearing at the Liberian Senate.
According to Dr. Fallah, the country has only twenty thousand test kits and more are expected from friendly governments to facilitate testing of suspected cases and traced contacts, and that the government of President George Weah has made available only US$750,000 out of US$3 million that health authority requested in late January to combat the virus.
Howerver, according to Dr. Nyan, the Liberian government should be disappointed in itself for making promises to the Liberian people that it is not kept or fulfilled, which, according to him, is putting people’s lives at risk.
Dr. Nyan added that it is time that the government stood up and stopped its continuous dependence on donations all of the time, “as we do not even know the quality and accuracy of COVID-19 testing kits being donated to our country in Africa.”
“It is unfortunate that the government has yet to make available the full $3 million promised to the NPHIL to combat the COVID-19 Pandemic. This makes the work of the NPHIL very difficult to perform and this puts the health of the population at risk of a pervasive COVID-19 pandemic. I hope President George Weah will do something about this urgently. The government has to make healthcare a priority, because there may be another infectious disease outbreak a few years from now after the present COVID-19 Pandemic,” Dr. Nyan said.
Dr. Nyan added that the current Pandemic the country is faced with could have been properly addressed with monies that disappeared from the government without a trace of proper accountability.
He said: “So when the people demonstrate and say ‘Bring Back Our Money,’ fighting this COVID-19 pandemic is exactly what some of the missing LD$16 billion and US$25 million could have been used for. Some of that money could have been used to train enough public health personnel and healthcare workers to produce our own diagnostic testing kits, to conduct our own medical research, to provide medications and equipment like ventilators in the hospitals and clinics, and to provide other basic social needs of the impoverished people of Liberia.”
Meanwhile, Dr. Nyan has expressed his disappointment in some pastors who have been violating the social–distancing order by organizing large prayer gatherings in Monrovia. He said the gatherings were a perfect recipe for person-to-person transmission of the COVID-19 in the population and it shows a weakness in the public awareness of the COVID-19 pandemic.
“Hence, more needs to be done to educate the public about the pandemic by public service announcements on all radios in the country, organized community engagements, and rigorous enforcement of the stay-at-home orders as well as restrictions on internal travels. Everyone needs to stay in place for at least three to four weeks for the public health personnel to carry on the work monitoring, contact-tracing, mass testing for COVID-19 infection, isolation, quarantine, and treatment if needed for some patients,” he said.
In a related development, Dr. Nyan said the pending gasoline shortage in the country if not addressed sooner, will be a major problem in the government’s efforts to combating the COVID-19 Pandemic.
“It will make it difficult to operate the ambulances that are needed to transport patients; it will hinder the movement of healthcare workers and public health personnel,” Dr. Nyan said. “If we have well-enforced social-distancing orders in place, we should not be too worried about long queues at the petrol stations.”