•Disease real, but many Nigerians still do not believe
•Lifting of the restrictions premature
•Poor public awareness, enlightenment campaign in many areas
By Sola Ogundipe
THE worst fears of Nigerians about the coronavirus disease (COVID-19) have not yet come to pass essentially because the country has so far been spared an exponential increase in COVID-19 case numbers.
However, Nigeria may be treading on thin ice with the recent relaxation of the lockdown restrictions by the Federal government and inadequate awareness campaign as many Nigerians especially the uneducated who still believe the disease was either a ruse or too far from them.
On the 26th of April 2020, President Mohammadu Buhari announced measures expected to gradually
ease the effects of the COVID-19 pandemic on the country. Part of the measures included extension of the 4-week lockdown on Lagos and Ogun states and the Federal Capital Territory, FCT, by one week, as well as lifting of the lockdown restrictions and the introduction of a nationwide curfew from 8pm to 6am daily as from Monday 4th of May.
“I have approved a phased and gradual easing of lockdown measures,” the President announced in an evening nationwide broadcast in which plans for the start of a return towards normalcy in Lagos, the FCT and Ogun state were outlined. There was an immediate two-week lockdown in Kano following a spate of mysterious deaths.
According to Buhari, the stay-at-home order imposed on March 30 came at a “very heavy economic cost,” as ordinary Nigerians, millions relying on daily wages to survive, have been left without enough money to eat. “No country can afford the full impact of a sustained lockdown while awaiting the development of vaccines,” he said. Beginning on May 4, a dusk-to-dawn curfew would remain and anyone out during the day will be required to don a face mask.”
The announcement elicited mixed reactions from the general public and many likened the planned lifting of restrictions to a formula for explosion of coronavirus cases. Many noted that the idea of suspending the lockdown restrictions while the outbreak is yet to peak in the country is premature and a worrying sign that the government made a wrong move.
Although President Buhari based his argument on the need to slowly reopen the economy so that the poorest Nigerians could eke a daily living, but health watchers faulted this position, saying while concern about the impact on the poor was justified, enough measures and steps have not been taken against the virus.
As of Thursday April 30, 2020, Nigeria had recorded 58 deaths from the dreaded disease, but many Nigerians remain largely unconvinced that a pressing emergency is at hand. They point to the level of public awareness that remains relatively poor particularly within the grassroots and even among the enlightened. There are hordes of people within the populace who still believe that all the attention and alarm over the pandemic are exaggerated and a smokescreen to perpetrate fraud.
In January 2020, when COVID-19 emerged as a global health threat, Nigeria was among countries that enacted public health measures to slow the spread of the virus. But each new day continues to bring more anxiety for Nigerians over the COVID-19 pandemic. The anxiety increases with every daily count of new confirmed cases announced by the Nigeria Centre for Disease Control, NCDC.
On the 30th of March 2020, when the lockdown in Lagos and Ogun states and the FCT kicked off, there were 20 confirmed new cases and a total of 131 cases of COVID-19 and two deaths in 12 states of the Federation. Lagos recorded the highest number with 81 cases, FCT 25, and Ogun 3.
Precisely one month into the lockdown on the 30th of April 2020, 204 new cases were recorded (highest daily record since the index case was diagnosed in the country). By then, the total number of confirmed cases in the country had increased to 1,932 with 58 deaths in 34 states and the FCT. Lagos recorded the highest number with 976 cases, FCT 178 and Ogun 56.
So what was achieved with the lockdown? Was it a success? In February, prior to the lockdown, the Lagos state Ministry of Health had predicted a worst case scenario of 39,000 cases in the state, but noted the number of cases could be limited to 13,000 and “the curve could be flattened” if measures such as physical distancing, effective public health measures to test, trace and treat were strictly adhered to.
While the number of cases have multiplied especially as community transmission has taken hold within the country, the number of new cases has been on the gradual increase, nevertheless there are fears that should this trend continue, an explosion of COVID-19 cases is imminent in the country.
With the lifting of the lockdown restrictions, there are fears that infection and death rate may surge in the nearest future. Infection prevention and control experts warn that the outlook appears bleak and that the last thing Nigeria should consider is to prematurely lift the lockdown restrictions.
Be careful how you lift restrictions – WHO
The flagrant disregard of the rules of containment efforts in the country remains worrisome. In the absence of any approved cure for the disease, basic but proactive prevention methods such as social distancing, hand hygiene, wearing of face masks, etc., have been widely recommended to help stop spread of the disease in the country and globally. Generally, Nigerians have not been too obedient of these rules. Even before the lockdown, there was a stay-at-home directive that was serially disobeyed.
In a reaction, the World Health Organisation, WHO, Regional Director for Africa Dr Matshidiso Moeti, noted that while national and regional lockdowns have helped to slow down the spread of COVID-19, it remained a considerable public health threat. “Lockdowns are being eased in some parts of Africa, but we cannot just revert to how things were before the outbreak. If governments abruptly end these measures, we risk losing the gains countries have made so far against COVID-19.”
Moeti argued that targeted lockdowns, based on data and accompanied by public health measures, contribute to flattening the COVID-19 curve, and could help balance the huge social costs of these measures for African countries.
Need for more tests
While it is difficult to fathom just how this applies to Nigeria, the country may learn from the experience of African countries that have already relaxed their confinement measures. Ghana the first to lift the partial lockdown in Accra and Kumasi, is averaging around 30 COVID-19 tests per 10,000 people per day – the highest in West Africa while South Africa is considering easing its confinement measures and has scaled up testing efforts. Average testing for COVID-19 in the WHO African region is nine tests per 10,000 people. Nigeria is currently averaging around 3-4 tests per 10,000 people.
As essential businesses are to be opened and mass gatherings likely to get more common, Nigeria need to carry out more testing. As of Friday, the country had conducted a total of 15,769 tests in a country of more than 200 million according to the NCDC. In comparison, Ghana had conducted 114,000 while south Africa had done 208,000
Poor public awareness and enlightenment
Many Nigerians still do not clearly understand the purpose of the lockdown, partly because the government hurriedly enforced the measure and there was no sustained attempt to utilise the period to carry out the required public enlightenment. Power supply is not regular for many Nigerians to view the little on televisions. It is worse in rural areas where millions of people don’t have access to electronic and print media news. Nigerian is far from ready for the worst-case scenario. Increasing awareness on proactive measures to prevent the spread of the virus at the grassroots is what the National Orientation Agency and Ministry of Information would have to intensify. It is not enough for now.
It is not surprising that many people have not been particularly obedient of the rules. Even before the lockdown, there was a stay-at-home directive for certain categories and groups of persons. That was serially disobeyed. Flagrant disregard of social distancing rules has been order of the day. Ignorance is a factor, necessitating aggressive awareness campaign especially in suburbs and rural communities.
Disregard for social distancing
In many states, hordes of Nigerians still troop out enmasse, disregarding the social distancing order. Health watchers argue that the Nigerian response to the pandemic has been average at best. In the views of a public health expert at the Lagos University Teaching Hospital, LUTH: “Nigeria is responding quite right, but curiously the government has not declared COVID-19 a national emergency. We have not done too well in public enlightenment and awareness creation. The level of awareness and education among many groups is not only abysmally inadequate, behaviour and attitude is terribly wrong. People still gather in large groups. It is appalling and embarrassing that after almost three months since the index case was recorded, several Nigerians are yet to come to terms with the fact that COVID-19 is real, and that it is an incurable and deadly disease currently ravaging Nigeria and the entire world.
There is need for more public enlightenment and sensitisation on the seriousness of the COVID-19 pandemic. This is unarguable. What the federal government should do, as a matter of urgency, is to intensify efforts so that more Nigerians would be aware. It is not only a compelling need, it is critical.
To stop the Covid-19 pandemic and reopen the economy, Nigeria needs to do is to advance detection, testing, treatment, vaccines, and contact tracing efforts. But there are knotty challenges.
Diagnosis is rising because more testing is being done, more isolation centres opening up. But only those that present with symptoms of COVID-19 are tested. As Nigeria eases into a less restrictive lockdown, with offices reopening in effort to kick start the economy , there are impressions that the relaxation is premature.
Saturday Vanguard gathered that Nigeria should have gone hard early to stamp out the worst of virus. With shortages of intensive care beds, isolation centres, test kits and reagents and even face masks, Nigeria needs prompt action and should be slow to roll back prevention measures. The number of confirmed cases is still on upward trend, so logic determines that the lockdown should remain.
“Nigeria is ramping up testing at a modest rate. Currently there is capacity for about 5,000 tests per day, according to the NCDC, but far fewer tests are actually carried out.
Most states are crippled by a lack of equipment. So far only people showing symptoms are being tested. The NCDC has made a call for test kits which are in short supply, in order to expand testing. On Thursday, the NCDC, also said it is currently “struggling” for bed spaces for the treatment of COVID-19 patients in Lagos State. Dr. Chikwe Ihekweazu, Director-General of the Agency told listeners at the briefing of the presidential task force on COVID-19 that Lagos is one place they were struggling with inadequate bed space and were being made to change strategy so that the inadequate bed space would not affect the COVID-19 fight.
While admitting that 90 percent of its bed space had been used up, the Lagos state government said arrangements were in place with big hotels in the state to utilise their facilities as isolation centres even as more expansion work was ongoing at existing centres in the state. The state currently has more than 500-bed capacity in total and is aiming at 1,000-bed capacity.
“So with the increase in the number of beds we have in our isolation facilities, and we are hoping that in another month or so, we will have about six or seven isolation facilities each with a capacity of just over a 100 beds,” said the Health Commissioner, Prof Akin Abayomi. “That will give us a total bed capacity of close to a thousand. And even if we are seeing several hundreds a day we will be able to absorb them in our various isolation facilities across the state.”
The Nigerian Presidential Task Force on Coronavirus has urged state governments to ensure that they have isolation facilities in their localities. Each facility is expected to have at least 300 beds, and be linked to existing infectious disease centres or medical centres.
The race against the COVID-19 pandemic is neither a swift race nor is it a race for the swift. It is a long race and every runner needs the stamina to win. The World Health Organization warned that the coronavirus would likely hang around for the foreseeable future as cases level off or decline in some countries, while peaking in others and resurging in areas where the pandemic appears under control.
“Make no mistake; we have a long way to go. This virus will be with us for a long time, and the virus remains extremely dangerous,” said the WHO Director-General Dr. Tedros Adhanom Ghebreyesus.