Lagos-born Nurse Qazeem Oladele Bello is a Surgical and Endoscopy specialist and the first perioperative nurse that delivered the first COVID-19 patient through cesarean section at the Lagos University Teaching Hospital.
Bello joined Federal Health Service Commission in 2015. He is currently a Scrub nurse for M&N with COVID-19 Team.
He worked with several hospitals including Lagoon Hospital before he moved to LUTH, Idi-Araba as perioperative nurse at the Nursing Department.
The Osun State indigene attended School of Nursing, Ilorin, School of Post-Basic Nursing (Perioperative) LUTH and Obafemi Awolowo University, Ile-Ife where he bagged Registered Nurse (RN), Registered Perioperative Nurse (RPON) and Bachelor of Nursing Science (BNsc) respectively.
In this interview with Wilson Adekumola, he shares his experience. Excerpts:
How has it been taking care of COVID-19 patients?
COVID-19 as we all know is a novel pandemic virus that is everywhere. Scientists have not found any certified drug for it now. That is why it is challenging to actually handle or manage COVID-19 patients. Then psychologically, you have to summon courage because it is an unseen devil you are going to fight. Another difficult part of it is the stigmatization of our people and the deceptive attitude from co-workers. Being a new disease it has not been easy managing victims.
If there is no cure why are the drugs working on some patients?
Presently, the World Health Organization, WHO, and the world entirely have not confirmed any specific drug on the cure of COVID-19. I think everybody knows that. The action that is being used presently is spelt out in many of the centres that are taking care of COVID-19 patients. Not that there is a certified drug for the cure of coronavirus. Scientists and every stakeholder in the health sector are still in search of a cure. Even with hydroxychloroquine, there is no evidence of its effectiveness against COVID-19.
There are cases of people with the virus that don’t show symptoms, how do you explain that?
Well, that is asymptomatic patients. The virus itself is a disease that goes for upper respiratory tract organs like lung, bronchia and all the associates. People without an underlying health condition may not show symptoms initially. If I may explain, the asymptomatic patient depends on its immunity and virulent level of the virus itself. Presently if somebody is being asymptomatic and does not have an underlying issue or any underlying health condition there is a tendency for the person to not present any symptom at the first point, but it is always advisable once you are tested positive a quick approach can actually save lives and the tendency for saving a life is a quick approach which is always advisable.
There are people who are down with the virus, what is the rate of the mortality?
Talking about the mortality rate between high income and developing countries, there are lots factors that we need to consider basically on that but most of these factors are yet to be proven but presently to consider the demographic factor, it has been proven that elders are more vulnerable to this virus and we have a high density of elderly people mostly in developing countries so that can be a factor. The susceptibility also is a factor.
Vaccination rate can be another factor. The environmental factor is another thing, that is, the temperature level, the population density, the sanitary condition.
You know COVID-19 has been described as a hit-seeking missile. So with these things, the indicator is bold and globally comprehensive but the dichotomy cause can be explained better but still under research. So that is what I can say about the dichotomy rate comparison between advanced and developing countries. But the rate of mortality in Nigeria now is being controlled compared to what is obtainable in advanced countries probably because of the culture or environment.
The factors between these two countries have not been identified for now because the majority are comparing the nature of weather on both sides but it has not been scientifically proven. But compared to that of West Africa for now, the mortality rate is being controlled. We have timely update through the media so we can actually compare the mortality rate of Nigeria with other countries.
Can we say it is COVID-19 that is killing the patients or underlying sickness they have?
If somebody is being diagnosed positive for COVID-19 and there is associate underlying sickness attached, the tendency of having a challenge with the recuperation is about 70% compared to somebody that has no underlying health issue. The rate at which the virus will attack somebody that has health challenges before cannot be compared with somebody that has no health challenge but it is good if early presentation to the centre is always advisable so that measures can actually be put in place to curtail any further complications.
How reliable do you think the kit for testing is?
The reliability of the kit for diagnosing COVID-19 is confirmed because if any kit that is coming or being presented or used such would be tested. It would have to undergo a laboratory test before it is being used. So, they would all have undergone a laboratory confirmation before being recommended or preferred to be used for the test. I believe the effectiveness should have been confirmed and recommended from the laboratory. So, I can say the kits are reliable.
There are instances of people getting worse in the hospital, how true is this?
That cannot be true because if a patient is taken to a standard or tertiary hospital like (LUTH) we have different specialists that are always on ground to attend to any issue at any time. For instance, a respiratory team is on standby; the cardiologist is present, the ICU is also there regularly and all that. So, we have all these specialists in the tertiary hospital to handle any situation.
For people to have such presentation these specialists can actually come in and help. So to say the deteriorating rate of somebody in the hospital is high is a blatant lie. It is not true because all these specialists know what to do and how to go about any condition at any time. So, now compare somebody that is at home without the attention of these specialists with somebody that is receiving adequate care from the specialists. The chance of survival is definitely high in hospital.
What is that unique thing about the virus that is different from malaria?
COVID-19 and Malaria have been incorrectly linked. To mention a few unique things about them; different mode of transmission, the different organs of the target, different incubational period, malaria symptoms appear usually 10 to 15 days while COVID-19 symptoms develop within 5 days. Malaria fever is cyclical with a predictable time of reoccurrence while COVID-19 doesn’t appear to occur in cycles. When it comes to virus no one can actually say much about it. Presently, the WHO, NCDC and all the concerned agents are really working hard to detect the virulent rate and how to handle the virus. Anything virus we cannot say this is how it is being handled that is why HIV has no cure for now but we can manage and prevent it.
There is an argument about the coronavirus; some say it is airborne while some say it can only be contracted from the droplets. Can you shed light on this?
It is a new (novel) virus and facts are ongoing. The research is on day in day out. There are lots of information about it. If a finding comes in and there is a tendency for another one to come out in a few minutes because research is on. But presently it is an airborne virus. W.H.O has pronounced that it can even stay in the air for eight hours. That is the present update for now on the virus. It is good to observe all the precautionary measures put in place by WHO.
Sir, being the first nurse that delivered a first COVID-19 patient of her baby, how was the experience, were you not afraid of contracting the virus?
It was not an easy experience being the first perioperative nurse to deliver COVID-19 patient because when I got a call from my Deputy Director Nursing Services (DDNS) speciality that I should come and help them to deliver the patient through the cesarean section I was worried. I had to think about it for an hour before I could tell my wife. What the man told me that put me in the mood of no retreat no surrender was that he was hoping on me after everyone he called had rejected him.
It was part of encouragement for me because I have to just think and rethink but on my own side, I like doing things that are extraordinary, I like being exceptional in most of my activities. So, I saw it as an opportunity to do things that people have never done before and being referred to, at least you reckon with me that this is the first man that could take the risk. It is just like a risk because it was not an easy thing. Life itself you know is a risk. If you take it and you win people will call you a hero and when you take it you lose you become a martyr.
But once I made up my mind to do it, I discussed it with my wife. I told her that I’m the only one my DDNS speciality is depending on as a nurse to scrub for the COVID-19 patient that has to be delivered via CS. She looked at me and nodded. Fortunately for me, my wife is also a nurse. She knows what it takes to give care to people. She responded that at least there must be somebody somewhere that must help these people. She said I should go ahead but I must have it in mind that doing it is doing it for all, that there will be a day somebody like them will need help elsewhere. That word is more of an encouragement to me. Hence, I had to take a lead immediately without hesitation. I called my DDNS that I had made up my mind. Meanwhile, other departments have selected their people that would move for the surgery. It only remained nursing department. So, I knew somebody had to be there to do it.
How is the child now?
The baby is fine. Both mother and child are fine.
Is COVID-19 hereditary like HIV/AIDS?
There are no indications that it is hereditary.
Some are wondering how the frontline workers still contract the virus since they know all the safety protocols. What is your take on this?
In fact, managing a COVID-19 patient is challenging because one needs to be tactical. No compromise. There are lots of things that could be responsible for that but basically, rate of exposure to the virus is high, unfavourable environmental condition is a factor militating against it, inadequate Personal Protective Equipment (PPE) to use and work overload. You can see that if all these factors I have mentioned are not looked into there is a tendency for health workers to contract the virus.
We observed that some people don’t believe the report released daily by NCDC saying the figures are being manipulated. How will you react to this?
You know, people outside don’t actually see what is happening inside. When you are looking at something from afar your judgment cannot be compared with somebody that is very close not just closer but witnessing the occurrences day in, day out. When you witness the scenes as it unfolds your perception will be different from people outside. I wish they could just walk down to have a view but I don’t pray or wish any of them to be a victim of COVID-19 before they believe it is a reality. But then, if somebody has gone through and know what it is all about he or she won’t stoop so low and say that they are manipulating or falsifying figures politically or otherwise. The rate at which NCDC is giving the report every day is based on the report they got from each hospital that COVID-19 patients are being managed.
There are so many activities out there, yet worship centres are closed, do you think this makes sense?
Shutting down of worship centres is to prevent the spread of the virus because from experience so far and from the findings made so far, there are two age groups that are vulnerable to the virus, that is, the elderly people and the children, these categories of age cannot handle the precautionary measures laid down at this level.
So, it will be very difficult if they are relieved without proper measures that are on the ground or provided for them. So there will be a challenge to contain the further spread of the virus. I think that is why the government is working steadily to ascertain proper guidelines before they can lift the ban on both schools and worship centres. You know, the churches are dominated by elderly people. It is a matter of time we will get rid of this virus. The government is working tirelessly to know what the virus is all about and how to curtail it. I hope people will understand and work with the government to eliminate this infectious virus.
Is it possible for a survivor of COVID-19 to be infected again?
Yes. There is a possibility to contract the virus again if all the precautions put in place are not heeded. It is just like when you are being treated for a particular disease and you did not take the measure laid down. The coronavirus is real. We just have to believe that and join the government in the fight against the virus.
From your experience what best advice will you give to victims of the virus and people generally?
The advice will be normal advice in the media already. Some other organizations have also joined to announce it day by day, you journalists always put words together to let people know what it is all about. My own advice first of all is to observe all measures that have been laid down by WHO and the government and at the same time, we must keep social distancing, wear a mask as mandated, avoid unnecessary gathering and maintain personal hygiene by washing our hands regularly. The use of sanitizer is a paramount thing that I will advise we should all encourage. By the time we maintain all these measures, there is a tendency for us to be safe or prevented from contracting the virus.