 Welcome back. It's still the breakfast on Plus TV Africa. On this particular segment, we will be focusing on health specifically right now. We're looking at the COVID-19 new variants, the Omicron, and there are several issues right now making the rounds. Well, the World Health Organization is targeting it as a virus of curnsome, and the Omicron variant, according to the NCDC, is not yet in Nigeria, but Canada said there are some travelers from Nigeria, actually found that particular variant. We have joined us this morning to look at all of these issues, and what we need to do to protect ourselves more in Nigeria. Dr. Neso Chi-okei-kei-wokei, she is a health expert. Many thanks for joining us on the breakfast on Plus TV Africa Doctor. Thanks for having me this morning. Yeah, yeah, our pleasure. So let's just start either just to do a bit of an education for Nigerians who may not be so aware about this particular virus, the Omicron, you know, the WHO has talked as a virus of concern. What should we be worried about? What are we expected to know as Nigerians? So when we're talking about any of virus variants of concern, what basically has happened is that there's been a change to the genetic code of the virus, essentially a mutation of sorts. The more mutations that occur in the viral genome, it allows the virus the potential to basically cause more harm to the human body. The reason it is deemed a variant of concern is because it has the potential to be more transmissible, more virulent, and potentially it could evade the efficacy of the vaccinations that we have in place. So with the Omicron variant that we are seeing emerging at this point, there's still a lot that we don't know about it, and there's still more studies to be done to determine how virulent this new variant can actually be. It could potentially pose a serious global threat, but we don't know the extent of that at this point in time. So I think that's why we kind of see all the buzz about this variant, because if it does do the potential amount of damage due to the amount of mutations it has, it can really cause problems worldwide in the global community in this fight against the pandemic. Okay, let's also talk about, because we're still trying to understand what the Omicron is all about, what's the difference between the Omicron variant and other COVID-19 infection? So it is still a COVID-19 infection, but as stated before, it's called a variant because over time, throughout the course of this pandemic, the actual virus has undergone these changes, these mutations. As long as the virus is spreading in the community and thriving, it gives it the opportunity to change some of its genetic code, meaning that there could be a change in some of the coding of the virus that can cause various changes, and it can make the virus potentially more transmissible. So when we're talking about Omicron variant in particular, why there's so much concern, because so far the preliminary data has showed us there is up to almost 50 mutations on this new variant. One of the areas of the actual virus is what we call the spike protein. Spike protein is usually what the vaccines target to try to help one build up immunity against COVID-19. So what the preliminary data is showing us, there is an abundance of these changes, these mutations, to this spike protein that could potentially cause problems, many problems. So Dr. Okeke Bukwe, if we got you correctly, so over time, we should expect to see another set of Omicron variant of this particular COVID-19. So that's the main behavior of viruses. Virus behavior lets us know that over time, if we do not contain any kind of virus, it has the potential to mutate and change as it replicates. If we were able to get to a point whereby we had herd immunity, it would really give the virus an opportunity to really thrive and change and mutate. As long as we do not contain the COVID-19 pandemic and the spread of the virus, as long as the virus continues to thrive, it always gives it an opportunity to mutate. It gives it an opportunity to change. Anytime the virus mutates and changes, there is always a possibility to have another form of variant. So with Omicron that's going on right now, it might not be the last variant of concern that we're going to see because we have to contain this pandemic. So there's always a chance and a possibility for mutations to continuously occur and really affect the human body when one is exposed to such a variant. Okay, so let's also, you know, pour that. Do you know if the Omicron variant is transmissible, you know, just like you have with other COVID infection? Yeah, so it's very likely that it is transmissible, but it's the extent of the transmissibility that is still needed to be determined at this point. Anytime there's a variant of concern, it's concerning because it's usually more transmissible than other forms of the virus. It's typically more virulent, meaning that it has a higher load of virus that can really affect the body deleteriously. And it's easier to evade certain public health measures that we have in place like vaccinations. So yes, there is going to be a level of high transmissibility, but we don't know how high that level of transmissibility is going to be at this time with Omicron. Right now we're in the land of the unknown. There are so many studies and research that still needs to be done, and only time will tell how this variant is really going to affect the population. But just before you're coming now, you know, some researchers are already saying that, yes, we know that the virus was dictated in South Africa, Botswana on the 11th of November, but you already have, you know, expats on top of their game. And some persons are saying that they are concerned with the modeling, showing that the spread could be five times, you know, the increase. I mean, the rate could be five times of that of the 2020 COVID. That's the delta variant. What are your thoughts on that? Do you think it's something we can go by? I mean, that's definitely a possibility, but at this point and at this stage we cannot say definitively how damaging this strain is going to be. There's still too much research that's left at this point up in the air that we don't have that data and that information to really make that call. The concern is the amount of mutations. When you have this level of mutation for any virus, that's always concerning. It puts us on edge thinking that this really can be an issue in regards to infection rates, reinfection rate for those that are vaccinated. The more of these changes and mutations that occur on this variant, it gives it an opportunity to really cause issues, more infection, more transmissibility, and just more virulence of the virus. All right. Let's try and localize it and bring it to Nigeria. Let's talk about some of the public health concerns regarding our challenges as a country. What are the major concerns for us right now? We still have issues of our most Nigerians not being vaccinated and nowadays another variant that is really very transmissible. What should we be looking at? What should we be putting in place at this particular time? So the major concern at this point is the very low rate of vaccination in Nigeria. Vaccination rates are very low, less than 5 percent of Nigerians are fully vaccinated at this point. So the goal really is to try to get as much of the population vaccinated. Vaccinations are really the only way out of this pandemic. So if we have this low vaccination rate and we have a potentially highly transmissible, more virulence variant that is potentially going to be out there, it can really cause some serious problems on the African continent, in Nigeria in general. If this becomes a variant that really begins to reach Nigeria and spread throughout the population. The major concern right now is really vaccine equity. If we do have enough of the vaccines available in Nigeria, how do we get it to most of the population? We generally have an issue with Nigeria when we talk about the healthcare sector in regards to access. Access to good healthcare. If we did want every Nigerian potentially vaccinated against COVID-19, do they know where to go to get this vaccination? If it is available to them, do they have proper education to understand why and the importance of why vaccines are actually necessary during this pandemic? I recently arrived in Lagos and a lot of people that I have been speaking to and contact with that are not vaccinated, a lot of them have not had that patient education to let them know why vaccines are actually fundamentally important at this point in stage of the pandemic. I think many people need to really understand the benefits that vaccination affords one in regards to lowering the rate of death if potentially exposed to the virus, lowering the rate of hospitalization and severe illness. There's a lot of misinformation that tends to be spread about this vaccine that makes some people quite hesitant about moving forward with vaccinations. I had a conversation with somebody recently upon my landing in Lagos and they were telling me COVID-19, it's only a problem in the Western world. It's only a problem in America where you live and everyone needs to realize that this is a global issue. This is a serious illness that has the potential to cause severe illness and severe death if you don't have that potential protection. The only protection that we really have at this point really are the vaccinations. But just how, sorry if I have to vote in, but just what do we know as we get some of this vaccination, what with this new Omicron, talking about protection, just how effective are these, you know, vaccines, you know, to these Omicron variants? Okay, so but just you also chipping to that particular question because I mean it's the same line of thoughts. Now we also have arguments saying that the G20 has failed to vaccinate Africa and this is where we are of course not just part of Africa. Now you have said that this virus keeps mutating and the fact that we're talking about mutation that becomes stronger, you know, they have different characteristics, they become something else. So what's the potency of saying that the vaccines that we have right now can mitigate against them? So the vaccines that we have and the research that has been done, it's really to help protect against the various strains of COVID-19 that we've seen throughout the course of the pandemic. Are the vaccines that we have available right now going to help protect against the Omicron variants? Only time will tell. There's still too many unknowns and we don't know the level of protection that the vaccines that we currently have available globally would help us in protecting against the Omicron variants. But with that said, we want to protect ourselves what we do have available. We want to try to protect ourselves against COVID-19, other COVID-19 variants in general and hopefully get to a point where by we understand more about Omicron and if there needs to be some adjustments in any of the vaccines that we have available, then researchers would do the needful to determine if they can create a formulation of the vaccine that would cover for Omicron if it is found to be that it is such a variant that is evading vaccinations that we currently have. All right, the Utah is just around the corner, you know, with most nations including the United Nations and some, you know, European and South Asian or Southeast Asian countries, you know, imposing travel bans. Should Nigeria be looking along that direction and just one more can we do to protect ourselves, you know, vis-à-vis people coming in and leaving Nigeria? So, I mean, a lot of these travel bans that are going on right now, they're a bit premature and they tend to be somewhat ineffective. At this point, it gives a false sense of protection and an illusion that this is kind of helping us avoid this spread by having any kind of travel ban in place. We have to look at the fundamentals of where we've been in the pandemic over the past year and nine months plus. Basic things that we need to be concerned about, especially with the holiday season upon us, people are going to be gathered in crowds and a lot of gatherings. We need to make sure that most people stick to the basics in regards to proper hand hygiene, mask wearing, the basics that help protect against the spread of viruses, but more so getting back to it, the vaccination situation. We just need to essentially get more people in the community vaccinated against COVID-19 to help curb the spread. All right, so my question now is, just as we're asking for measures, how can we, what are the basic things we need to do to ensure that we reduce the spread of this virus across board? Some countries are already talking booster shots and for us, we know that that's Nigerians were still grappling with having people getting the vaccination, getting the first dose and not talking about the second dose. Do you think that Africa should be considering booster shots at this point in time? I think that's definitely a consideration. I can tell you from my personal experience, I've had my booster shot and why is that so key and why is that important? Because after one has been fully vaccinated, some of the data has shown over time, some of that protection that you have from being fully vaccinated, it kind of wanes over time. So you want that booster shot to give you that extra level of protection after the effect of your initial vaccination kind of wanes off with time. So essentially, I think boosters are definitely a consideration in Nigeria. But we have to talk about getting the population even initially vaccinated, make sure that people get their first dose of the vaccine for we even fast forward and jump the gun to talk about boosters. But definitely that is going to be a consideration when we start getting more and more of the Nigerian population vaccinated. There's going to come a point whereby there wouldn't be a need likely for booster shots. All right, Dr. Okke Igbukwe, are you concerned about the hinterland specifically getting access to vaccination here in Nigeria? Because over time, there is still this vaccine hesitancy across both here and the main cities. Would you be concerned of insecurity and most health workers not wanting to go down to the hinterlands? What should we be focusing on? How can we get there to ensure that everyone, no matter where they are, gets at least one or two shots of these vaccines? So I think it really comes down to kind of the infrastructure of health care in Nigeria. We really need to make sure that we have regulatory and government bodies that are actually focusing on having us have this access for more vaccinations in the country. We need to make sure that we actually have certain, let's put it this way, certain level of education for the entire population to let them know why a lot of these vaccines are important. We need to just have a plan of action in place to make sure that we have these vaccines available. We have to consider if it is a matter of even trying to produce and manufacture some of these vaccines on the African continent in Nigeria to ensure that we have the availability for all Nigerians to have a vaccination available for them. Campaigns need to be available to really educate as well because it's one thing to get to a point whereby we do have adequate amounts of vaccine for every Nigerian, but will everyone really be open to getting the vaccination? Will everyone really understand the importance of vaccination? So campaigns focusing on educating about vaccinations about the risks of COVID-19, that's extremely important at this time, but really I think we need to get to a point whereby the issues that have always been long-standing in Nigeria about access to good health care and access to resources, things need to pretty much change and I think it starts with really a change in the infrastructure of the health care system here in Nigeria. Okay so let's talk more about what to expect with the variant, that's the omicron variant. Are there symptoms just like you have with other ailments? What are the symptoms? Do we know of any symptoms? So when we're talking about COVID-19 in general, we do understand when we do know that it is a respiratory illness. In regards to the symptoms of the omicron variant, there are so few cases that we have the case studies on to determine if the symptomology, if it's going to be any difference from various variants like Delta and various strains that we've seen globally at this point. But in regards to just general symptoms to be aware of, you want to be aware of any changes in respiratory status. If you're having issues with cough, difficulty breathing, shortness of breath, issues with fever, essentially this is still the COVID-19 virus but it's just a variant. So there could be essential changes to the symptom profile that we see but again it's still too early in the information we have about omicron to know if there are specific symptoms that are super specific to this strain. Okay so there also can sense, I mean I know that you know for the much that we have had this conversation, you have really been on the fact that we need to be vaccinated, more people need to be vaccinated but we also have cases where peasants have been vaccinated and he doesn't really stop the fact that they still get to contract the virus and in most cases we've actually recorded deaths of some peasants. So how would you explain all of this vaccine, vaccination, is it really the solution to you know stopping this virus or ending it? So yeah, vaccinations are still the solution. I think what you're alluding to and what you describe are what we call breakthrough infections meaning when one is fully vaccinated they've still had issues with COVID-19 exposure and some level of illness. What we know about vaccinations, no vaccine is going to be 100% effective. Okay and we do know with time when you are fully vaccinated some of that immunity and the protection that you get is going to wane over time. So I think it goes back to what we were talking about the need for boosters to really give you that kind of robust effect to build up that immunity that you've gained from the initial set of vaccinations that were received. There's always a potential for reinfection but what we do know in regards to vaccinations if you have somebody who has been vaccinated against COVID-19 versus somebody who has been unvaccinated against COVID-19 and both individuals are exposed to this virus, chances are the individual who was unvaccinated they have a high likelihood of having more severe illness, more issues with potential hospitalization and a higher chance of death from the virus as compared to that individual who was vaccinated. So the benefits of vaccination are truly beneficial to all those that actually move forward with their vaccine. If you are unvaccinated at this point basically the virus is really looking for you as a host to really do its damage so it is to your benefit to get the amount of protection or to get the potential protection against having severe illness from COVID-19. Okay I like the way you captured it when you said that the virus is actually looking for you you know but let's talk about the vaccinations still and you mentioned that the likelihood that it cooled them way in overtime can we talk about like a window period how soon do you get to get a bolster shot when you've done your first vaccination the second and you know there is a window that it might you know you might stand a chance of getting infected just how soon can you get a bolster shot. Okay so if we're talking about some of the mRNA these vaccinations so for example Moderna that was the vaccination that I received after being fully vaccinated some of the data showed that after a six month period post vaccination being fully vaccinated getting the full set of the two doses after that six month window studies show that there is that waning of the protection at waning of immunity so after that six month mark those that did receive their vaccinations they are eligible to move forward with a booster so you don't have that full protection that robust amount of protection as you had initially over a period of time so after several months it will be likely that one would need to have the booster to help with protection so usually around the six month window with the mRNA based vaccinations to really give you the opportunity to get the booster to give you that help and that kind of boost with the immune protection. All right now with the new Omicron variant are there specific concerns even that we know of for the elderly for the infants? So in regards to any kind of variants that we're talking about when you have a high level of mutation and you have a high level of transmissibility and potentially high level of virulence from any of these variants we are always concerned obviously about the elderly population we are always concerned about the immunocompromised why is that because as everyone gets older and those who have chronic medical conditions those that are immunocompromised with issues like certain kinds of cancers with chronic conditions like diabetes, high blood pressure just all types of chronic medical problems it increases your risk of how the virus can actually target the body your level of immunity is already lower than the average normal healthy individual so if you are elderly or immunocompromised we are going to be more concerned about exposure to the Omicron variant we are going to be concerned about exposure to any of the variants really in the immunocompromised and elderly population. All right so let's quickly show your thought do you think that there's a possibility of course the health authorities in Nigeria are saying that we do not have the Omicron virus yet or the variant right now in the country but we also have reports from Canada saying that some Nigerians who traveled you know across have been dictated with the virus is there a possibility that we do have the variant in Nigeria? I mean it is it is always a possibility and again time will tell if we're seeing the cases that are popping up in the global community in various countries already it's only a matter of time until we actually get a confirmed case of the variant in Nigeria. So the issue is that we might have not done the exact sampling it might be just as staring at us in the face and that we don't know yet. It's a possibility it's a very high possibility in a matter of time and this is just my speculation in regards to the way these viruses these mutations these variants actually work and operate when you kind of see this these cases and these surges in various areas globally worldwide in a country as heavily populated as Nigeria it's very likely there's a potential unidentified case already but we need the data we need the confirmation it's too soon to say that it's already here without actually having the confirmed case but in in some time I would suspect that we would have um a confirmed case um forthcoming. All right Dr. Ibuke Ibuke just before we let you go maybe just sort of sort of a recap for Nigerians who may still be worried how would you allay their fears? So in regards to the variant I would say this is not a time to really panic but it's a time to really educate yourself about the benefits of vaccination. It's a time to really have that understanding and that discussion with a healthcare provider that you actually trust to discuss why it is important to move forward with your vaccination. I think it's a time to really remove some of the misinformation that is out there from from our minds I think it's an opportunity to really understand how the vaccines that are available if they are available to you how important and how necessary it is to move forward with the uh with the vaccination to help give you the protection amidst um this pandemic. The pandemic is not over yet. I think with Omicron it's an eye opener to let us know that to let us know that this um pandemic is still um amongst us all and we need to do what we can as best as possible to protect ourselves against this. So I think it's really a call to action at this point to see what can be done for us to really protect um our health throughout the course of this pandemic. All right thank you very much. We have been speaking with Dr. Neso Chio KK Iwakui a health expert and she has done a whole lot of uh you know education for us Nigerians. We do appreciate your time. Thank you for having me on this morning. It is our pleasure. Well take a quick break and when we return we'll be focusing on nation building on the show this morning. Do join us again.