Use of telemedicine consultation for healthcare access to Nigeria Armed Forces

COVID-19 is an illness that is caused by a novel coronavirus, known as SARS CoV 2. Coronaviruses are large families of viruses that cause a variety of sicknesses ranging from the common cold to more severe illnesses. COVID-19 causes a range of symptoms including sore throat, muscle aches, headaches, coughs, and difficulty in breathing and in more severe cases, pneumonia. For most otherwise healthy people symptoms often mirror that of the common cold, but for others, and in particular seniors and those with weakened immune systems and preexisting medical conditions like liver and kidney problems, high blood pressure, diabetes, etc., symptoms can be severe and require intensive and long hospital care. The best form of protection (and not cure) is practicing good hygiene, especially frequent hand washing (with soap under running water for at least 20 seconds), staying home, and practicing physical distancing (sometimes referred to as social distancing).

In different locale where COVID-19 had made its hotspot like China, Italy. Spain, France, Iran, Germany, Japan, the United Kingdom, and USA, testing has been a major item in their diagnostic toolbox (a precursor to properly fighting the illness in the absence of a tested and proven cure). Africa and particularly Nigeria, is ill-prepared for the testing and more importantly the treatment regime (protocol) principal in which is the ventilator (in cases of acute presentation of the disease). Western countries with well-oiled medical system fail miserably on both the testing and the treatment of COVID-19, just ask America with nearly 400,000 people tested positive and over 10,000 death as at April 6,2020.

The lockdown as enacted by the Federal Government of Nigeria will have to be implemented mainly by the Army and the Police with a population of 250,000 and nearly 400,000 enlisted men and women respectively. This assignment makes them frontline personnel in the fight against COVID-19 as it puts them in close proximity with both symptomatic and asymptomatic carriers without symptoms in the society. Hence, the possibility of contracting the illness is high and the propensity to be super silent spreaders of the illness is even aggravated. For instance, a single South Korean who travelled to China came back infested and visited a mega church in Seoul on return. The visit resulted in over 700 people dead. The possibility of that scenario being replicated through the participation of the Army and the Police in enforcing stay at home order is very real.

Furthermore, lack of access to adequate healthcare facilities, especially for members of the Police Division, posted to the rural and remote areas of Nigeria may be a serious challenge to work productivity. Telemedicine can be of immense assistance in providing the needed access to this group of people with minimal cost.

In summary, telemedicine enables healthcare professionals in the Army and Police to assess, diagnose, plan, implement and evaluate patients centered care and treatment through the use of telecommunication technology. Telemedicine allows patients in remote locations to access medical expertise quickly and efficiently without the need to travel, thus reducing the chances of further spread of infection.

Telemedicine can be instrumental in containing and treating diseases during emergencies like the current crisis of Coronavirus that most parts of the world (if not all) are experiencing. While Telemedicine cannot take the place of scientific testing achieved by patients going onsite to meet a medical professional, it can help healthcare providers make special arrangements to safely attend to a patient who is suspected to be infected. Telemedicine also offers a way for patients to receive urgent care without having to go to the healthcare provider’s office and risk coming into contact with sick patients.

Advice and Suggestions:
1) Design a practical strategy crafted by experts in the Army and Police that includes lesson learned from other hotspots
2) Create an operational plan that is practical, achievable and flexible
3) Bring awareness that is useful and practical for the targeted audience early in the process. – America is an example that if COVID-19 leads; you pay with body bags, while China shows that if you lead it, you come out strong.
4) Biological warfare may become the format of future wars and combat. By using the current pandemic as a medical case study from a wide spectrum of countries and their responses, failures and successes, this will enable a better preparation for future biological warfare. Lessons can also be drawn from Ebola, SARS and Zika all recent examples.
5) Training of Army and Police Healthcare Professionals in the method and use of Telemedicine technology is a smart way to frog jumps these two critical institutions to be in a position to lead biological warfare and its ramifications, which are completely different from the familiar conventional warfare.
6) Equipping the Army and Police Physicians and Healthcare workers with appropriate telecommunication equipment will facilitate the effectiveness of diagnosis and transmission of vital information, which is central to winning this pandemic scourge.
7) Conducting telemedicine workshops frequently for Healthcare workers and Administrators, and other stakeholders involved in healthcare provision for the Army and Police.
8) The Medical core, Military, and Police hospitals are prime candidates for Telemedicine adoption in the near future.
9) The Armed Forces should develop process strategies to ensure that the Telemedicine program works effectively. For example, in the case of Nigeria Police Force, a team should be set up consisting of the seven major departments, including the Public Relations Officer (PRO). Deputy Commissioner of Police (DCP) should be nominated headed by an Assistant Inspector General (AIG), to look into areas of operation that involves regular contact with the public.

A healthy Army and Police workforce is vital in ensuring their productivity. Majority of the Force members work directly with members of the community in ensuring that peace and order are maintained throughout the county. Some of the members of the community that the Police forces deal with directly may have been infected with COVID-19 without knowing it, because they have not been tested (or the Police Force members may have contracted COVID-19 without knowing it). It is therefore important that a proactive approach is made by those at the helm of the affairs of the Armed forces and Nigeria Police Force to provide adequate funding and training to their Healthcare workers in the use Telemedicine for easier accessibility and initial diagnosis, to ensure an efficient, effective, and affordable healthcare service.

Nigeria, in view of its inadequate medical structure can be smart in its strategy by approaching this invisible enemy COVID-19 by making Telemedicine a central piece of its war plan. This is an enemy that does not need to decimate our nation as Italy and other nations are currently experiencing. I believe Nigeria can do better.

*Dr. Femi Obikunle Certified Telehealth Clinical Presenter (CTCP) -USA, Doctor of Business Administration – Healthcare Management (Telemedicine), and USA. He is the Founder and Chief Executive Officer of Elvote Consulting Services (A venture Capitalist company (based in the USA), that specializes in Telemedicine, Telehealth Consulting, Medical Research, and Information Technology).