In a bid to proffer solution to the corona virus pandemic ravaging the whole world, G.Okewih designed a two-pronged approach comprising of ‘A medical Personal Protective Equipment (PPE) enhancement jacket’ and ‘A Continuous Mass Sterilization Program (CMSP)’.

The PPE enhancement jacket focuses on providing extra measure of protection to health workers and frontline covid-19 respondents, while the CMSP puts humanity on the offensive against covid-19. While physical distancing and the use of general protective equipment like face masks is a good measure, they are quite passive. A combination of CMSP, physical distancing and protective equipment is a more active approach to combating the menace called SARS-CoV-2.

A successful deployment of this approach would require a high degree of cooperation between adopters, and adequate sensitization and enlightenment of health workers, frontline respondents and the general public.

The nature of the corona virus pandemic has to some extent dampened globalization and has forced all nations of the world to look inwards and provide solutions for themselves in the short to midterm. Nigeria is no exception, and we shall surely prevail.

INTRODUCTION

The corona virus code named ‘Covid-19’ has shaken the very core of human civilization, it literally declared war on humanity as a social being; targeting our freedom, lifestyles, economies, health and even our lives. It ushered in a different kind of warfare, very different from WW I and WW ll, a kind that our fierce tanks, missiles, fighter jets, nuclear weapons and soldiers are powerless against; a kind of warfare that unites all mankind against a common enemy.

This new kind of warfare isn’t fought by soldiers, but by medical practitioners, frontline respondents, medical scientists, paramedics and health sector workers. However, as more of these frontline respondents get infected with the virus, their numbers reduce and their confidence diminishes. Though conventional medical PPE (Personal Protective Equipment) protects health workers to some extent, they don’t entirely prevent health workers from mistakenly infecting themselves with the virus by either their own gloved hands or from the PPE itself.

In a bid to defeat a common enemy, the G.Okewih two-pronged approach aims to better protect our frontline workers from contracting the virus from patients, and to collectively put humanity on the offensive against the virus prior to the emergence of a vaccine.

THE APPROACH

The two-pronged approach includes:

1. A PPE Enhancement Jacket.
2. Continuous Mass Sterilization Program (CMSP).

• PPE Enhancement Jacket

The PPE enhancement Jacket is a multipurpose waistcoat suited for reducing the rate of exposure of health workers and other frontline respondents, when attending to persons infected with covid-19 and other contagious diseases. A pictorial sketch representation is given below.

From picture 1 [front facing] above,

• Pockets A1 and A2 are hard plastic cases, sewn into the fabric at the front of the Jacket, both with openings, that can simultaneously accommodate the left and right hands of a health worker or frontline respondent, for instant automatic or manual hand sanitization, before reaching out to touch personal items, other items or scratch.
• Storage pouches 1 and 2 are convenient and easily accessible front pockets for storing essential and personal items for the health worker or frontline respondents. These pouches are waterproof and prevent the passage of vapour.
• Outlet spray head C1 is a small retractable hose, capable of spraying disinfectant at moderately high rates. This hose can be pulled out from the bottom of the Jacket, and used to spray the entire PPE (including the Jacket) of the health worker or frontline respondent, as well as surrounding areas at regular intervals. It could also be used to spray patients exhibiting symptoms of a contagious disease prior to handling by the health practitioner. Persons wearing the Jacket should have their hands sanitized prior to handling C1.
• D1 is a badge bearing a unique code for each Jacket. This code would prove useful for the second phase of the approach – The Continuous Mass Sterilization Program.
• E1 and E2 are badges bearing logos of primary companies or organizations associated with the Jacket and program. While one would bear manufacturers logo, the other would bear the logo of partnering company or organization. 

From Picture 2 [rear facing] above,

• C2 is a recoil mechanism embedded inside the Jacket that ensures C1 is retracted after being pulled out for use.
• B1 and B2 are portable disinfectant storage tanks capable of holding between 1 – 2 litres each of disinfectant, depending on Jacket size. The tanks are located on the back of the Jacket, but sewn into its fabric, and are durable enough to withstand compression forces. While B1 would contain disinfectant for A1 and A2, B2 would contain disinfectant for C1.
• D2 just like D1 would hold the same unique code but on the rear side of the Jacket.
• F1, F2 and F3 are badges at the rear of the Jacket bearing the name, logo and/or details of the supervising Government body and location of operations of that specific Jacket. These come in useful in the second aspect of this approach.
• G1, G2, G3 and G4 are badges of the logos of secondary companies or organizations associated with the Jacket and program; these could include sponsors to the program.

Relative to health workers and frontline respondents, the PPE Enhancement Jacket is most effective when used with conventional medical PPE.

Conventional Medical PPE          

                 Source: Lighthouse Medical Supplies Ltd

• Continuous Mass Sterilization Program (CMSP)

Continuous mass sterilization is a program that seeks to utilize the services of at least 10% of the people in a geographical area or community at any given time as ‘Covid-19 Exterminators’, using the PPE enhancement jacket for the continuous sterilization of every area of that community that they ordinarily get to, while going about their daily lives. This could carry on for a 2 or 3 year period.

The program could have voluntary and compulsory exterminators, who are either ‘self sponsored’ or ‘program sponsored’. Individuals, companies, organizations and governments could provide jackets and disinfectant refills for registered ‘program sponsored’ exterminators at filling stations, on public transportation systems as well as in stores for easy accessibility. The goal would be to make disinfectant refills easily accessible to exterminators after jackets have been provided.

The compulsory exterminator services would be on a rotational basis over a period of time, amongst people within every geographical area, as a civic duty. The utilization of corps members of the National Youth Service scheme in Nigeria and its equivalent program in other countries could be considered. Also to be considered is the inclusion of paid exterminator services in certain areas.

A chart of the entire public transportation system and network in a geographical location, as well as areas prone to large gatherings should be mapped out, for easy assignment of exterminators to routes and areas.

Some of the possible high risk germs transmission areas could include but not limited to:

1. Public transport systems: these must have exterminators on them at all times.

1. City and local buses along the exterminators’ regular commute axis (front seats could be reserved for exterminators in local buses).
2. Metro trains. A few minutes would have to be spared for the sanitization of every area of the train at each stop. Also, continuous sanitization of the Metro station by commuting and/or paid exterminators all day long.
3. Motor parks/Bus stations/Bus stops
4. Ferries and boats used for mass transportation
5. Airplanes on local and international routes.

1. Markets, Malls and Stores
2. Street corners, Parks and public gardens
3. Offices and office complexes – every office and business should have a specific number of exterminators available at all times depending on the size of the office and number of staff.
4. Eateries, Restaurants, Lounges, Pubs and Bars
5. Hospitals, Clinics and Pharmacies
6. Banking halls and ATMs  
7. Local and International Airports, as well as air cargo ports.
8. Seaports, 
9. Primary, Secondary and Tertiary schools – to include classrooms, lecture and assembly halls, sit out areas, gardens, hostels and general areas. 
10. Police stations, prisons, military and paramilitary bases.
11. Salons, studios and workshops
12. Cinema halls and gymnasiums. 
13. Occasions, Events and ceremonies venue. 

Relative to ‘physical distancing’, continuous mass sterilization is much more of an active approach to tackling contagious pandemics; when combined with physical distancing and protective equipments like face masks, continuous mass sterilization becomes quite formidable to flatten the ‘rate of infection’ curve.

Requirements from Adopters

Prior to getting the G.Okewih two-pronged approach fully functional in Nigeria, the PTF, NCDC and FMoH would be required to:

1. Thoroughly vet the workability of both aspects of the approach.
2. Intimate Federal and State governments on the approach.
3. Sensitize and enlighten medical workers and the public on both aspects of the approach.
4. Place purchase orders for PPE enhancement jackets – after necessary verifications.
5. Outline a detailed framework for the deployment of the CMSP.
6. Ensure adequate training of medical workers and frontline respondents on the functionality of the PPE enhancement jackets.

Notes, Comments and Conclusion

• To some extent, the effectiveness of the G.Okewih approach in any given country would be determined by: Centre for Disease Control (CDC), Health practitioners, Government and General public.
• A prototype PPE enhancement jacket would be made as sample.
• The PPE enhancement jacket can be used multiple times for the CMSP and can be cleaned when dirty.
• The disinfectant used in B1 and B2 should be effective against SARS-CoV-2, and could be alcohol based, chlorine based or some other base chemical. Though, due to the dangers of chlorine poisoning and the ‘Haram effect’ of using alcohol based disinfectant in the midst of Muslims, as well as the dangers associated with fires, an environmentally friendly disinfectant that is neither alcohol nor chlorine based, but still very effective against SARS-CoV-2 would be preferable.  
• In Nigeria, for a more rapid deployment of this approach and to reduce hiccups caused by bureaucracy, portions of this approach could be deployed by the Private Sector Coalition Against COVID-19 (CACOVID).
• The PPE enhancement jacket could conveniently be worn with other clothing without much discomfort to the exterminator.
• Everyday people that are neither healthcare workers nor exterminators could purchase and wear the PPE enhancement jacket for increased protection against covid-19.

• Closed national and inter-state boarders could hinder the sourcing of materials for mass producing the PPE enhancement jackets and certain aspects of the CMSP.

• Under pressure to reopen the economy, the CMSP in conjunction with physical distancing and the use of face masks can prove quite effective against community spread of covid-19. The ‘G.Okewih Economic Restoration Model’ could also be considered for a rapid economic jumpstart.

• To incentivize healthcare practitioners and frontline respondents in this battle against covid-19, life insurance packages could be opened for them. More importantly, there might be need to redeploy health workers to other places that are in short supply or deemed to have higher risks of contracting the virus. In such situations, cash bonus packages could be made available to them (1 – 2 Million Naira) and paid directly into their accounts such that it reflects on their account balance, but held frozen and inaccessible for the period of time they’re expected to be in those regions (3months, 6months, 1 year etc), until the expiration of their tours. These bonuses are different from their monthly salaries.

• Owing to disruptions caused by the Covid-19 pandemic, nations of the world are currently too preoccupied with proffering solutions to their own problems to spare much thought for other countries. Each country is now saddled with the responsibility of providing its own solutions for itself, without the luxury of over dependence on the international community or WHO. Should treatments and vaccines be developed, the host country would be sure to cater for itself first.

In conclusion, to avoid a situation whereby our already inadequate healthcare system gets totally overwhelmed by the corona virus pandemic in Nigeria and Africa, it is paramount that frontline respondents get ahead of the situation as against current approach of ‘attempting to catch up’. This can be achieved by reinforcing frontline respondents, safe guarding healthcare practitioners and deploying active preventive measures. 

Nigeria and Nigerians are capable of providing solutions for themselves and exporting some of those solutions.