Death of Buhari's Chief of Staff evidence that coronavirus is real

The death of Abba Kyari, the late Chief of Staff to President Muhammadu Buhari, from complications of COVID-19 infection could be just the eye-opener Nigerians require to drive home the seriousness and authenticity of the message that, indeed, the highly infectious COVID-19 pandemic is real and does not respect boundaries.

Kyari, who tested positive to the novel coronavirus in March following a trip to Germany, is the first high profile public official to die of the disease in Nigeria. Health watchers expect that his death could be the eye-opener needed to convince millions of cynical Nigerians that, indeed, the disease is real.

As of Friday, April 17, a total of 493 confirmed COVID-19 cases, 159 discharges and 17 deaths had been recorded in 20 states including the Federal Capital Territory, FCT.

As the numbers of COVID-19 cases and deaths in Nigeria continue to rise, treatment centres are compelled to provide emergency care for those most severely ill. There is currently a lockdown on Lagos State, the FCT and Ogun State, while other states have imposed varying degrees of lockdowns and social distancing approaches to help break the chain of transmission of the pandemic and help “flatten the curve”, but a number of Nigerians have discountenanced the measures with argument that they are unconvinced the pandemic exists.

Public health experts describe the novel coronavirus as a respiratory virus. This simply means it can enter and invade the respiratory system after which it stays in the upper and lower respiratory tracts. The virus gets into the respiratory tract through respiratory droplets that are breathed in or on the fingers or some other virus-contaminated objects touch the nose, lips or eyes.

The virus itself causes damage to the respiratory system by invading the body through the mouth, nose and airways. In the first week of infection, according to a public health specialist at the Lagos University Teaching Hospital, LASUTH, symptoms are relatively mild, with sore throat, cough and fever.

“Some people may carry the virus without symptoms, but the first typical symptoms are common with respiratory illnesses — fever, a dry cough and shortness of breath. there could be headache, sore throat, fatigue and diarrhoea.

The Nigeria Centre for Disease Control, NCDC, advises that patients with milder symptoms should consult their physician to make sure their symptoms don’t progress to something more serious, even if they do not require major medical intervention. ‘The coronavirus typically attacks the lungs, but in about 20 per cent of patients, infections can get more serious. As the virus enters lung cells, it starts to multiply, destroying the cells, and this triggers the immune system to try to contain and control the virus and stop it from multiplying.

“However, this immune system response can also destroy lung tissue and cause inflammation, and then result in pneumonia – a condition in which the lungs become inflamed, fill with fluid, making it harder to breathe and harder to get oxygen to the blood. It creates a dilemma as lack of oxygen leads to more inflammation and more problems in the body. Without which the liver and kidneys die.”

The World Health Organisation, WHO, particularly notes that COVID-19 is relatively mild in about 80 per cent of cases and while people who are young and healthy can die from the disease, majority of those with serious disease and who will ultimately die are the elderly or those with underlying conditions.

In severe cases, about 6 per cent of COVID-19 patients, end up in intensive care with multi-organ failure, respiratory failure and septic shock. They may also require supplemental oxygen and when things get really bad, may require mechanical ventilation to breathe.

Findings show that chronic illnesses may be a crucial mark of biological aging and declining immunity.

Underlying reasons for older people’s greater susceptibility to the virus have manifested as serious cases in middle-aged people and the elderly because the immune system gets weaker with age. People with other underlying medical conditions, such as heart disease, diabetes or chronic lung disease, are also vulnerable.

These conditions can make it harder for full recovery to be achieved. For long-term smokers, it could be worse because their airways and lungs are more vulnerable.

Dr George Kuchel, a geriatrician and gerontologist at the University of Connecticut notes: “It is not chronological age alone that determines how one does in the face of a life-threatening infection such as COVID-19. Having multiple chronic diseases and frailty is in many ways as or more important than chronological age.

Most Nigerians want to know how likely is it that someone infected with COVID-19 will die? It’s a simple question, but one that is hard to answer because accurate estimates of the true risk of death from the disease are difficult to calculate.

The risk of death or infection fatality rate is a ratio of the total number of cases and the total number of deaths; however, the total number of cases in Nigeria is unknown, partly because not everyone with COVID-19 in has been tested.

What is available is the total number of tested cases and this will not give the true picture of the infection fatality rate.

An estimate of elderly people’s elevated risk of serious illness and death from the COVID-19 shows that patients in their 80s and above, are at higher risk compared to those in their 50s and 40s.

According to a study published in The Lancet Infectious Diseases, fewer patients in their 60s die, compared to those in their 70s. But there are exceptions.

An 80-year-old who is otherwise healthy and not frail might be more resilient in fighting off infection than a 60-year-old with many chronic conditions. Reason may be a younger immune system.