Second wave of COVID-19 in Nigeria: Lessons from the first wave.

The COVID-19 pandemic struck the world unawares. The virus is now spreading as never before, despite the initial progress recorded by several countries towards kerbing the pandemic. As the pandemic continues to spread across Africa, there is a need for countries in the continent to re-evaluate, re-strategise, and re-invigorate their COVID-19 responses and efforts based on lessons from the first wave, and Nigeria is no exception. Before the second wave was officially announced by the health authorities on 17 December 2020, there were 78,434 confirmed cases and 1221 deaths reported with a case fatality rate (CFR) of 1.6%. To ensure that Nigeria achieves total pandemic control and reacts better given the possibility of a second wave, we propose workable recommendations to strengthen our preparedness and readiness efforts. Here, we argue that lessons learnt from the first wave of the COVID-19 pandemic can help Nigeria better react to the second wave.

COVID-19 and Antimicrobial Resistance: A Review.

As the world continues to respond to the coronavirus pandemic (COVID-19), there is a larger hidden threat of antimicrobial resistance (AMR) lurking behind. AMR remains worrisome in that the pathogens causing resistant infections to thrive in hospitals and medical facilities, putting all patients at risk, irrespective of the severity of their medical conditions, further compounding the management of COVID-19. This study aims to provide overview of early findings on COVID-19 and AMR as well as to provide recommendations and lesson learned toward improving antimicrobial stewardship. We conducted a rapid narrative review of published articles by searching PubMed and Google Scholar on COVID-19 and Antimicrobial Resistance with predetermined keywords. Secondary bacterial infections play crucial roles in mortality and morbidity associated with COVID-19. Research has shown that a minority of COVID-19 patients need antibiotics to treat secondary bacterial infections. Current evidence reiterates the need not to give antibiotic therapy or prophylaxis to patients with mild COVID-19 or to patients with suspected or confirmed moderate COVID-19 illness unless it is indicated. The pandemic has also brought to the fore the deficiencies in health systems around the world. This comes with a lot of lessons, one of which is that despite the advances in medicine; we remain incredibly vulnerable to infections with limited or no standard therapies. This is worth thinking in the context of AMR, as the resistant pathogens are evolving and leading us to the era of untreatable infections. There is a necessity for continuous research into understanding and controlling infectious agents, as well as the development of newer functional antimicrobials and the need to strengthen the antimicrobial stewardship programs.

The use of antibiotics in COVID-19 management: a rapid review of national treatment guidelines in 10 African countries.

Antimicrobial resistance is a hidden threat lurking behind the COVID-19 pandemic which has claimed thousands of lives prior to the emergence of the global outbreak. With a pandemic on the scale of COVID-19, antimicrobial resistance has the potential to become a double-edged sword with the overuse of antibiotics having the potential of taking us back to the pre-antibiotic era. Antimicrobial resistance is majorly attributed to widespread and unnecessary use of antibiotics, among other causes, which has facilitated the emergence and spread of resistant pathogens. Our study aimed to conduct a rapid review of national treatment guidelines for COVID-19 in 10 African countries (Ghana, Kenya, Uganda, Nigeria, South Africa, Zimbabwe, Botswana, Liberia, Ethiopia, and Rwanda) and examined its implication for antimicrobial resistance response on the continent. Our findings revealed that various antibiotics, such as azithromycin, doxycycline, clarithromycin, ceftriaxone, erythromycin, amoxicillin, amoxicillin-clavulanic acid, ampicillin, gentamicin, benzylpenicillin, piperacillin/tazobactam, ciprofloxacin, ceftazidime, cefepime, vancomycin, meropenem, and cefuroxime among others, were recommended for use in the management of COVID-19. This is worrisome in that COVID-19 is a viral disease and only a few COVID-19 patients would have bacterial co-infection. Our study highlighted the need to emphasize prudent and judicious use of antibiotics in the management of COVID-19 in Africa.

Community distribution of oxygen: a unique COVID-19 intervention.

The rapid spread of COVID-19 around the world has exposed some long-standing deficiencies in health systems, particularly in environments with low financial and medical resources. Most patients ill with COVID-19 require oxygen and supportive therapy for survival as there remains no conclusively established curative therapy. Following a number of critical research work and drawing from a millennia-long evolution of medical practice, respiratory support has been identified as a paramount intervention to ensure lives are saved when supportive care is required, and oxygen is an essential commodity to achieve this. This letter focuses on the numerous means for oxygen delivery to health facilities and in turn the end users and expands on the importance of innovation to improve oxygen supply. We describe a community distribution system with a telemedicine structure that can be leveraged for oxygen delivery.

COVID-19 Misinformation and Infodemic in Rural Africa.

The world has witnessed rapid advancement and changes since the COVID-19 pandemic emerged in Wuhan, China. The significant changes experienced during these times remain unprecedented. The African continent has initiated significant responses to curb the spread of the pandemic. However, there is an increasing concern that rural Africa is facing serious challenges in their responses to the COVID-19 pandemic. This is due to the uncertainty if the populations are detached from or in synch with information on COVID-19. The findings reported here suggest that rural Africa is burdened with misinformation and infodemic regarding COVID-19 due to widespread misconceptions and anecdotal reports. It is, therefore, necessary to engage with community leaders to provide awareness campaigns in rural communities to ensure access to reliable information issued by local and international health authorities. It is pertinent to set up avenues that improve health literacy in communities in rural Africa as it is a major determinant of information assimilation.

Impact of COVID-19 on access to healthcare in low- and middle-income countries: Current evidence and future recommendations.

The COVID-19 pandemic continues to be a major public health threat globally and low- and middle-income countries (LMICs) are not an exception. The impact of the COVID-19 pandemic is far-reaching on many areas including but not limited to global health security, economic and healthcare delivery with a potential impact on access to healthcare in LMICs. We evaluate the impact of the COVID-19 pandemic on access to healthcare in LMICs, as well as plausible strategies that can be put in place to ensure that the delivery of healthcare is not halted. In order to mitigate the devastating effect of the COVID-19 pandemic on the already weak health systems in LMICs, it is much necessary to reinforce and scale up interventions and proactive measures that will ensure that access to healthcare is not disrupted even in course of the pandemic.