Monrovia – Language barriers, lack of simple logistics and a community resistant to the existence of the deadly Coronavirus pandemic is complicating the efforts to trace those coming in contact with suspected cases of the COVID-19.
According to the latest situation report compiled by the National Public Health Institute, contact tracing, case investigators and body management teams lack essentials like chlorine, examination gloves, hand sanitizers, hand washing bucket, rain boots and thermo-flash for response.
The lack vehicles and internet in certain parts of the country like Grand Kru is even making it difficult for tracers and medical workers.
“We recommend to NPHIL, MOH and Partners to provide the following to intensity response activities: Gasoline, fuel, stroke & engine oil and Training such as: contact tracing, case investigation and body management • Internet services at the EOC • Chlorine, examination gloves, hand sanitizers, hand washing bucket, rain boots, thermoflash etc,” the Grand Kru County Health Team, National Supervisor & Partner (WHO) documented on April 12.
Serious Situation in Grand Kru
As of April 12, 2020, no additional contact had been identified in the county although twenty-eight contacts have been identified and line-listed.
Of that number, 22 are reported to be Chinese, six Liberians and at least twelve (12) are currently under observation. Thirteen of the contacts line-listed are high risk while fifteen (15) are low risk, according to the report.
Six of the thirteen high risk contacts are reported to be under observation.
According to the report, on April 7, 2020, the NPHIL notified the Grand Kru County Health Team about a confirmed COVID-19 case, a 56-year-old male who died in Monrovia on April 5, 2020 after travelling from Grand Kru (Forpoh) within a week and was tested positive.
Immediately upon receiving this notification, the report notes, a team was conveyed to investigate with the aim of verifying the information, identifying contacts, line listing, establishing the source of infection and implement public health measures.
The report notes that a patient with severe acute respiratory infection (fever, cough, and requiring admission to hospital), and with no other etiology that fully explained the clinical presentation and a history of travel to or residence in affected countries during the 14 days prior to symptom onset.
The team sought to find out whether the patient showed any acute respiratory illness or at least one of the following during the 14 days prior to symptom onset: a) Contact with a confirmed or probable case of COVID-19 infection, or b) Worked in or attended a health care facility where patients with confirmed or probable COVID-19 acute respiratory disease patients were being treated.
It was determined that the suspect case for whom testing for COVID-19 was conducted, was inconclusive and tested positive using a pan coronavirus assay and without laboratory evidence of other respiratory pathogens.
The county case management team collected fourteen samples on April 10. Of that number, seven were Ghanaian travelers, and six were Chinese, who were listed as high-risk contacts.
Six of the thirteen high risk contacts are reported to be under observation. According to the report, on April 7, 2020, the NPHIL notified the Grand Kru County Health Team about a confirmed COVID-19 case, a 56-year-old male who died in Monrovia on April 5, 2020 after travelling from Grand Kru (Forpoh) within a week and was tested positive.
Swab was collected from a dead corpse and sent to the lab for confirmation. Six came back negative and one (1) will be repeated while seven are still pending.
To date, twenty-eight contacts have been line-listed and active contact tracing is ongoing in the affected communities in the county.
NIMBA – Traveler for US Dies
In Nimba, there is to date, one suspected case of COVID-19 reported on April 12, 2020 and there have been no new confirmed case reported since 8 April 2020.
Cumulatively, according to the situation report, about 109 contacts have been line-listed from eight communities while thirteen contacts exclusive of the 109 cumulative contacts were line-listed from the suspected case.
Of the five high-risk contacts in quarantine, two are health workers and three others who came in contact with the suspected case are being monitored.
Some 93 contacts are being monitored today and three specimens collected and sent to the County Incident Management Team which is coordinating and collaborating response efforts at all tiers of service delivery.
The suspected case is that of a 42-year-old Liberian male, a resident of Minnesota, United States of America. On February 28, 2020, the case travelled from America to Marshall, Margibi County. The case later travelled from Marshall Margibi County to Zuotuo/ Tappita District, Nimba County to perform dowry payment (Traditional marry rite). He travelled along with six (6) persons including his wife to be on March 31, 2020 to his home town, Zuotuo for the said ceremony.
On Saturday 4th April 2020, the County Surveillance Officer received a phone call from the National Public Health Institute of Liberia (NPHIL) informing him of a man that traveled from the United States of America to Nimba County, but was pronounced dead on arrival at the Jackson F. Doe Memorial Regional Hospital in Tappita, Nimba County.
The District Surveillance Officer’s noted that the deceased complained of fever, chill, and stomach pain while en-route to Nimba County on 31 of March 2020, but treated himself with Tylenol. His condition reportedly improved after the self-treatment and he continued with the journey to Zuotuo Nimba.
On April 2, 2020 his condition persisted where as he presented with the signs and symptoms of elevated temperature, as well as persistence chill.
Accordingly, the report notes, the patient decided to use the commode and while there he was observed to have overstayed which attracted the attention of his wife to be to check on him, but only to discover that he was unresponsive.
Upon this observation he was immediately rushed to Tappita, Jackson F. Doe Memorial Regional Hospital where he was pronounced dead on arrival by the Medical Doctor on call with suspicion of COVID-19 disease.
The County surveillance Team along with WHO immediately moved in to verify the information and to conduct investigation with the following objectives:- ✓ Confirm the existence of the case at Jackson F. Doe Memorial Regional Hospital ✓ Collect specimen from the deceased ✓ Document and report to the next level the findings.
The incident management team reported that deceased as transported on a motor bike to Hospital supported by one person. “COVID-19 was suspected based on travel history and might have suppressed symptoms due to consistent use of Tylenol.”
Case Marred by Hauling & Pulling
A FrontPageAfrica correspondent in Nimba says health authorities, mainly the Jackson Fiah Doe Memorial Hospital, have concluded that the traveler from the US died from COVID-19.
According to Dr. Philip Sahr, head of Nimba County Health Team, specimen of the 42-year-old was taken and the testing result showed that he was positive of the corona virus disease thereby registering Nimba’s first case.
However, our correspondent says, the family are disputing the results from the county health team, terming it as false.
One family member said at first the medical authority at the JFD said their deceased relative was negative, but after some hours came back again to announce that the deceased was positive; something, the family contends, does not add up.
Family members are instead suggesting that the deceased was a victim of poisoning.
The contend that the deceased was doing well throughout the time of the marriage preparation and from the day he entered Tappita, but fell ill suddenly to their surprise.
Medical diagnosis of coronavirus is said to comprise sneezing and coughing for days before attacking the lungs to turn severe, but the family argues that the deceased did not exhibit such symptoms. Instead, the claim, he came down with cold that made him to chill and sweat profusely, and while using the bathroom he fell off in the process thus leading them to take him to the hospital and he died along the way.
Several health workers assigned at the Jackson Fiah Doe Memorial Hospital including the Assistant Administrator, Ebenezer Strother, who was the first person to interact with the deceased, are under quarantined.
Also, family members and the motorcyclist, who transported the decease to the hospital are now quarantined as the hospital is completely empty due to fear that the rest of the patients may get the virus, according to our correspondent.
Despite the situation, people in Nimba, especially the busy city of Ganta, continued normal activities until pronouncement by President George Weah for a state of emergency when residents started purchasing basic commodities including rice in huge quantities on Thursday to store for the two weeks the state of emergency is to last for.
Others were purchasing and leaving Ganta for the villages for fear that during the course of the state of emergency, the situation may become much more difficult.
In other parts of the county, residents are living in denial that the virus is not in the county or the country at large, but cases said to be confirmed are just a strategy to draw the international community’s attention to Liberia to provide money.
Most parts of the county have been empty since the lockdown commenced last Saturday and despite the skepticisms and doubts, some are not taking chances and doing their best to fall in line with the health protocol of social distancing.
Nevertheless, not all are playing by the rules.
Traditional practices continue to go on, like the Sande School in Lao Clan in District No. 8 and Garr Clan in district No. 2 in Nimba County. More than five thousand women and girls are attending the bush school in the county and county authorities are yet to stop such practices but rather continue to collect money from women zoes in-order to allow them to carry on such practices.
Meanwhile, Dr. Philip Sahr of Nimba County Health Team says since the outbreak of the virus and the county reported its first case, they are yet to have a holding center.
He disclosed that Saclepea and Kpain Town in Electoral Districts 7 and 8 have been identified for use by the government as holding centers, but no funding has been provided to prepare the areas.
Several young people who spoke with our Nimba County correspondent accuse the County Superintendent Nelson Korquoi and the County health team for seek funding from the international community to get rich.
Nimba County Correspondent Franklin Doloquee Contributed to this report