Letter to Medical Social Workers in the Era of Coronavirus Pandemic

Dear Colleagues,

The world has been plunged into an unprecedented crisis by the spread of the Coronavirus, we are experiencing new challenges that require new behavioural and cognitive processes to address it.

As observed by the many negative reactions to countries “shutting down”, the human race does not readily adapt to change. Especially change that is sudden and forced as many believe it strips them of their fundamental right to freedom. Unfortunately, in this situation, the greater good of the community surpasses the right of the individual. Global health systems are under a huge strain combating this novel virus so atypical approaches have to be used to battle it.

As Medical Social Workers, we are trained to value and respect the rights of the individual, but our ethical standards provide guidelines and regulations for flexibility and decision making that benefits the larger community as a whole and aids us during these public emergencies.

What are Medical Social Workers doing to help globally?

The pandemic started in China and the Chinese Association of Social Workers played an active role in fighting the virus in China. What lessons can we learn from them and incorporate in a culturally sensitive manner into our interventions here in Nigeria? The International Federation of Social Workers released guidelines for our role during this global emergency that can be adapted for our setting on their website.

The situation in Nigeria has presently not developed to the levels we are seeing in China, South Korea, Italy, Iran or the U.S.A and hopefully, we will not reach those stages, but the reality is that we need to be proactive and prepared for such a situation.

What can Medical Social Workers in Nigeria do?

We, as a nation find ourselves at a critical point where we have to actively contain and prevent further infection. The Federal Government has closed the borders to reduce the risk of new infections being brought unknowingly into the country (as evidenced by several of the first few positive cases we have in Nigeria). The Federal Government and several states have banned public gatherings including gatherings of religious organisations to reduce the spread and have asked all civil servants except essential services to stay at home. As Medical Social Workers, working in health facilities, we fall into this category and are expected to be at work doing our part to fight the pandemic in Nigeria. We must be seen following all government directives concerning the containment and prevention of the Coronavirus as recommended by experts. It is the professional and responsible thing to do.

Within our different facilities, our roles will be varied and evolving as the needs arise but primarily, we need to: –

  1. Advocate and Mediate: Be involved and play a prominent part in developing strategies and protocols of engagement amongst staff and with patients and their relatives. This is essential because as patient advocates and mediators, we understand the peculiar needs and expectations of patients within the system but are also aware of the resources and capacity of our medical facility. We need to ensure that patient’s rights and expectations are paramount, protected and addressed as the health system adapts to deal with the Covid-19 crisis.


  1. Disseminate information: One of our primary roles is that of educating patients, this cannot be overemphasized during this global crisis as we are all aware of the amount of fake information being peddled especially over social media. We need to educate ourselves about Covid-19, social distancing and prevention from reliable sources such as the World Health Organisation (WHO) and Nigeria Centre for Disease Control (NCDC).

The internet is awash with advice on how to prevent or cure Covid-19 and some people are being mercenary by selling unproven, untested and probably life-threatening cures. We need to be pushing out accurate, real-time information as published and verified by reliable sources. As professionals, we should not be seen repeating, posting or forwarding false information. Please beyond providing accurate information with references in public, we must refrain from providing unverified information that can be repeated by people who will claim “a healthcare provider/expert told me”

The onus of responsibility is on YOU as a professional to verify information from official websites before sharing.

  1. Contact Tracing & Home Visits: As the numbers of people diagnosed with Covid-19 increase across the country so also will there be a need for increased levels of contact tracing to help contain the infection. Home visits will be required to ensure that people who have been identified as being in contact with someone with Covid-19 are self-isolating as mandated. As a core skill of social work, contact tracing and home visitation in this era will require changes in the way in which we carry it out, things like social distancing, observing standard infection & prevention control methods and in necessary situations wearing Personal Protective Equipment (PPE).


  1. Psychosocial Support: These are unprecedented times, high levels of anxiety, fear, paranoia and despair arising from multiple reasons i.e. fear of infection, financial insecurity, job security and loneliness may occur due to the extended periods of self-isolation and lockdown of the country. Psychosomatic symptoms such as unexplained fatigue, irritability, abdominal bloating, chest pain, increased blood pressure, palpitations, changes in libido &appetite etc. will be common during these periods and should be expected. Though these are normal human reactions during crisis periods, the individuals experiencing them should not be belittled or made to feel they are overreacting, rather they should be educated and supported. Patients who have preexisting health concerns are extremely vulnerable at this period and would require extra support.

Working in conjunction with other healthcare workers we should provide counselling and therapeutic services. These will help but may be constrained by the need for social distancing. The services may then need to become virtual via telephone or private one-on-one social media apps such as WhatsApp, Telegram, FaceTime, Skype etc. Please note that the rule of confidentiality still holds and is expected irrespective of means of providing social work interventions. (You are advised to consult and follow your facility’s guidelines in respect of such communications).


  1. Referrals: Referrals will also be essential during these periods, referrals to community resources that will provide counselling services, food banks, visitation for the vulnerable etc. should be identified and proper linkages should be established to foster referrals. AMSWON can spearhead this by creating a national database of referral organizations that Medical Social Workers can tap into to aid adequate referrals to verified service providers.

Final Thoughts

The world and Nigeria are in an unparalleled health crisis, one we have not witnessed before in our lifetimes and it requires novel attitudes and thinking to deal with it. The Coronavirus doesn’t discriminate by religion, political party, socioeconomic standing or tribe. It can affect everyone directly or indirectly and we have to deploy concerted, unified efforts as a country to get ahead of this virus.

Personal responsibility should be the watchword of fighting this pandemic, personal responsibility to adhere to social distancing and personal hygiene, personal responsibility to self-isolate and above all personal responsibility to do all we can as Nigerians to end the pandemic in our country.

Thank you,

Warm regards and stay safe everyone.


Ms Titi Tade

Deputy Director, Medical Social Service, Lagos University Teaching Hospital, Idi Araba &

Guest Lecturer, Department of Social Work, University of Lagos, Akoka.


Coronavirus Resources

  1. World Health Organisation: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  2. Nigeria Centre for Disease Control (NCDC): https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  3. Nigeria Centre for Disease Control (NCDC) dedicated Covid-19 micro website: http://covid19.ncdc.gov.ng/
  4. Federal Ministry of Health: http://www.health.gov.ng/
  5. National Association of Social Work (U.S.A): https://www.socialworkers.org/Practice/Infectious-Diseases/Coronavirus
  6. Centre for Disease Control: https://www.cdc.gov/
  7. National Health Service: https://www.nhs.uk/conditions/coronavirus-covid-19/
  8. Live Science Guide for children: https://www.livescience.com/coronavirus-kids-guide.html
  9. San Francisco Department of Public Health: https://www.sfcdcp.org/infectious-diseases-a-to-z/coronavirus-2019-novel-coronavirus/
  10. Centre for Disease Control fact sheet: https://www.cdc.gov/coronavirus/2019-ncov/downloads/2019-ncov-factsheet.pdf
  11. https://www.nctsn.org/sites/default/files/resources/fact-sheet/outbreak_factsheet_1.pdf
  12. Self Isolation guide:
    1. https://www.health.gov.au/resources/publications/coronavirus-covid-19-isolation-guidance
    2. https://www.publichealthontario.ca/-/media/documents/ncov/factsheet-covid-19-guide-isolation-caregivers.pdf?la=en
  13. Twitter Handles:
    1. NCDC: @NCDCgov
    2. Federal Ministry of Health: @Fmohnigeria
    3. WHO: @WHO
    4. CDC: @CDCgov

Tedros Adhanom Ghebreyesus (DG, WHO): @DrTe