The country’s limited testing capacity and inconsistent contact tracing has been a major concern.
It’s been 250 days since Nigeria reported its first coronavirus case; an Italian traveler. And the numbers of cases are still growing even though infection and death rates have turned out to be much lower than initially feared.
In stark contrast to several predictions suggesting that the pandemic will wreak havoc in Nigeria and much of the African continent, Africa’s most populous country has not been badly hit about 35 weeks into the outbreak, unlike many European and American countries.
Few months into the outbreak in Nigeria, the World Health Organisation (WHO) warned that nearly a quarter of a billion Africans would have contracted coronavirus by the end of this year, with between 150,000 and 190,000 of them dying.
But as of November 3, the total infection in the continent stood at 1,784,083, less than one per cent of Africa’s one billion population. About 42,000 people have died, not even up to a quarter of the WHO prediction.
Nigeria, despite having reported its first case of COVID-19 about eight months ago and having a population of over 200 million, still has about 15 times fewer cases than Texas, a state in the United States where nearly one million infections have been recorded so far. Texas has a population of 28 million people.
Daily coronavirus cases in Nigeria have been below 300 since mid-August. Last week, a total of 623 new cases were reported, lower than the country’s highest single-day tally of 745 recorded on June 19.
Likewise, deaths have been hovering around 10 and 20 per week over the past month, even as hospitalisations have continuously declined since peaking at over 20,000 in mid-July. On the other hand, recoveries have improved significantly.
On Tuesday, 72 new cases were reported, one of the country’s lowest in eight months, taking the total tally to 63,036. Nearly 60, 000 infected persons have been discharged from hospitals after treatment while a little over 3,000 active cases remain in the country.
But the country’s limited testing capacity and inconsistent contact tracing has been a major concern. There has also been a troubling uptick in mystery cases which health experts believe raise more questions.
Majority of Nigerians who contracted COVID-19 so far did not have relevant travel history or exposure to another individual with the virus, meaning that the origin of their infection is unknown, according to data from the Nigeria Centre for Disease Control (NCDC).
Response started at snail pace
Nigeria appears to have moved at a snail-pace in its initial response, a situation health experts have continued to blame for the spread of the disease in the nation.
The WHO upgraded the status of the COVID-19 outbreak from an epidemic to a pandemic on March 11, with a strong call for countries to detect, test, treat, isolate, trace, and mobilise their citizens to ensure that those with just a handful of cases could prevent the wider spread of the deadly virus.
The novel coronavirus was introduced to Nigeria on February 27, by an Italian engineer traveling from Milan via Istanbul to Lagos on Turkish Airlines.
It took another 11 days for the second case to be confirmed in the country, a contact of the Italian national, on March 9.
The WHO and health professionals advised African countries to shut their skies and borders to prevent importation of the virus from European and Asian nations where the disease has started to spread.
Nigeria appeared not to heed that advice until the country’s caseload rose to at least 30. International flights were still operating despite rising cases overseas, making Nigeria particularly vulnerable.
On March 18, the government announced it was restricting entry into the country for travelers from China, Italy, Iran, South Korea, Spain, Japan, France, Germany, the US, Norway, UK, Switzerland, and the Netherlands. All five cases reported that day came from the blacklisted countries.
Three days later (on March 21) when the Nigerian government announced it would close its two main international airports in the cities of Lagos and Abuja for one month, 10 additional cases were announced.
All 10 new cases recorded on that day were Nigerian nationals, nine of whom had travel history to the UK, Spain, Netherlands, Canada, and France.
Oyewale Tomori, a virologist and the immediate past president of the Nigerian Academy of Science, said the increasing number of cases in Nigeria is “expected and a natural follow up to our late start in instituting appropriate preventive measures”, according to a Daily Trust report.
“The real question is why let the virus into the country in the first place? This is important because, for all intents and purposes, COVID-19 arrived Nigeria not as a matter of inevitability, but almost by the government’s own invitation. The federal government had at least three clear windows of opportunity to shut the virus out of Nigeria altogether. Unfortunately, the government did not take any of them,” he said.
After a prolonged silence, President Muhammadu Buhari on March 29 announced the shutdown of Lagos, Abuja, and Ogun State.
Sweeping lockdown measures followed in other states with the banning of interstate travels, shutting of schools, offices, sporting, and social activities with services considered to be non-essential closed.
The Presidential Task Force
The president had on March 9 constituted the Presidential Task Force (PTF) on COVID-19 chaired by the Secretary to the Government of the Federation (SGF), Boss Mustapha, with membership from various sectors.
Since then, the PTF has coordinated a multi-stakeholder response to the pandemic, while providing technical and material support to states to manage the outbreak.
The PTF also serves as an advisory body to the president on specific decisions such as imposing and lifting lockdowns and provided daily feedback to Nigerians on the work being done to contain the pandemic through daily media briefings with journalists.
Sani Aliyu was appointed as the national coordinator of the PTF.
Due to the impact of the lockdown on the Nigerian economy, especially the oil and gas industry, trade and manufacturing, the federal government revised the 2020 budget down by more than N71 billion.
Meanwhile, the government received donations of commodities worth billions, including benefitting from Jack Ma’s donation of 1.1 million testing kits, 6 million masks and 60,000 protective suits to Africa.
One major response is the government-funded N500 billion COVID-19 crisis intervention fund, and enhanced support to states for critical healthcare expenses.
The Federal Ministry of Humanitarian Affairs, Disaster Management, and Social Development was tasked with implementing palliative measures across the country.
Some of the measures included the disbursement of four-month grants of N20,000 to the poorest households in various states, donation of food items to state governments for onward distribution to citizens, and continuation of the school feeding program by giving more than three million households food items through the primary schools their children are enrolled.
Gaps, Loopholes and Challenges
While Nigeria’s national COVID-19 strategy is being centrally developed, it relies heavily on individual state governments to localise and enforce national guidelines.
The states are solely in charge of the coronavirus management and response while the country’s infectious disease outfit, NCDC, supports and receives daily infection information from them.
The daily infection update is then published by the NCDC on its microsite, which ultimately serves as the yardstick by which Nigeria’s COVID-19 outbreak is being measured, just as it is in all countries battling the contagion.
However, the reliability of these figures is in doubt due to several loopholes and challenges, including state officials not turning in enough test samples.
Health experts believe the virus must have infected more people than reported, due to limited testing and poor contact tracing mechanism, a situation they say can also mask the severity of localised outbreaks in slums and crowded cities with large clusters of people.
Prior to the COVID-19 outbreak, there was already an acute lack of accurate data across Nigeria. Experts believe this has limited a data-driven response. Linked to this is the perceived politicisation of the pandemic by some state authorities.
Getting a true picture of the pandemic has been made difficult, especially by a few state authorities who have repeatedly flouted NCDC directives.
Two clear cut instances were in Nigeria’s North-Central Kogi and the South-South Cross Rivers states, the last states in Nigeria to report COVID-19 infections. The COVID-19 situation in both states has been enmeshed in controversies, accusations, and counter-accusations between governments and health authorities.
The governors of both states had in different instances, described the deadly disease as a hoax even before they reported their index cases.
The Nigerian Medical Association (NMA) had threatened the health commissionersof both states with a lawsuit for allegedly obstructing COVID-19 testing and control measures.
When the index case was reported in Kogi on May 27, state officials said they will not accept any test result “conducted outside the state”, a position described as “unfortunate and condemnable” by the NMA.
Kogi has gone almost 130 days without recording a single COVID-19 infection or a death attributable to the virus, with only five cases and two deaths reported in the state yet. The low figures are attributed to a lack of testing.
Kogi, a state of almost 3.5 million people, has tested less than 300 samples as of last week, according to the NCDC boss, Chikwe Ihekweazu.
“Sometimes, it is a sense of rivalry or personal pride that leads governors to downplay the caseload of COVID-19 in their state,” Oyewale Tomori, a Nigerian virology expert, told Devex, a social enterprise and media platform.
Reopening
But despite the gaps and challenges, including fears that the country’s fragile health system will be overwhelmed, Nigeria was left with no option but to reopen and live with the pandemic to limit the economic damage it was causing.
In fact, concerns have shifted from the daily rise of infections to the economic downturn, plummeting oil and commodity prices, and an imploding tourism sector occasioned by the restrictions.
The ban on local and international flights has been lifted. Intercity travel travels have resumed.
Students have fully returned to schools in many states. Restaurants and hotels can now open while parks, gyms, and cinemas are allowed to open at half capacity.
Daily curfews initially imposed from 8 p.m. to 6 a.m. were shifted to start from 12 a.m.
Meanwhile, the reopening is fueling long-held misconceptions that Nigerians are immune to the coronavirus.
Earlier in April, a survey from NOI Polls, a country-specific polling service, showed that nearly three in every 10 Nigerian believe they have some form of immunity to the coronavirus.
The fact that authorities appear to be lax about enforcing control measures has also shown that social-distancing and hygiene measures will be hard to enforce as people get back to normality.
Since the reopening, two governorship elections have been held in Edo and Ondo with a massive turnout. Safety protocols were widely breached during the exercise.
More recently, in complete defiance to safety advisories against mass gatherings, thousands of youths trooped out across the country for the #EndSARS protest, as they demanded the disbandment of the Special Anti-Robbery Squad (SARS) of the Nigeria Police.
The protests, which lasted for at least three weeks, saw the breaching of several COVID-19 protocols, including the use of face masks and maintenance of social distancing, as there were mammoth crowds of protesters packed in tight spaces without face masks.
There is no evidence yet that the wave of the #EndSARS protests will spark fresh COVID-19 outbreaks, according to health officials.
However, the NCDC had warned that there is likely to be an even more devastating second wave of coronavirus.
The health agency said it is only when more persons are tested that the spread of this deadly disease can be addressed and tamed.
Currently, Nigeria has over 625,000 confirmed cases out of its about 200 million population. The country has only tested over 630,000 people.
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