By Sola Ogundipe, Health Editor
The COVID-19 pandemic is gaining ground in Nigeria. For the first time ever, millions of Nigerians are
having an encounter of the first kind with a pandemic.
Saturday Vanguard findings reveal that the single digit number of cases recorded in the country may not be a true reflection of the situation. Available projections and modellings indicate that there could possibly be hundreds if not thousands of cases undetected in the country.
Projections by the WHO is that there are hundreds of cases in Nigeria currently based on prediction models and analyses that take into consideration the population, trends of other infectious diseases among other parameters.
People are beginning to refrain from gatherings, weddings, birthday parties, and other ceremonies are being shunned. All non-essential forms of travel are being shelved. Many Nigerians are fully aware that there is no medication to treat coronavirus, and are taking no chances as a result.
They are heeding warnings by doctors that cough syrup, cold medicine, antibiotics and other forms of medication do not help ease symptoms. The knowledge that rest and hydration are key to recovery of those affected is becoming more acceptable. In the same way the culture of regular washing of the hands with soap and water, the use of alcohol-based hand sanitisers, and keeping safe distance from people who are sick and adoption of social distancing are more commonplace than ever.
Lockdown in progress
Health watchers opine that Nigeria has shown remarkable level of preparedness since the onset of the Coronavirus pandemic even with just 12 cases confirmed to date.
The Nigeria Centre for Disease Control, NCDC, is relying strongly on experience of the 2014 Ebola outbreak to continuously respond to health threats. There are 23 Public Health Emergency Operations Centres, PHEOCs nationwide, They serve as an epidemic intelligent hub for effective communication and efficient resource management during outbreaks.
Lockdown measures are in place in many cities in Nigeria against the rampaging COVID-19 pandemic that has sickened over 256, 800 and killed 10,580 in 183 countries as of 20th March, with almost 90,000 had recovered and been discharged from hospital.
A nationwide lockdown is all but imminent as millions across the country are preparing for the worst as plans mount to stay home and wait out the COVID-19 pandemic. It would not be a new measure. China started it in January when it placed dozens of cities and provinces into full quarantine for weeks before it broke the chain of the infection. Currently almost the whole of Europe is in lockdown. Italy set the pace by placing its entire 60 million population into quarantine and several other European Union countries have followed suit.
Other countries currently on lockdown are the US, Iran, South Korea, and the UK.
Africa shuts its doors
As of March 20, 2020, the outbreak of the COVID-19 pandemic had spread to six continents, and approximately 10,580 people had died after contracting the respiratory virus. More than 3,200 of these deaths occurred in China. Nigeria has joined other African countries shutting their airports and land borders to keep out people from countries with a high number of coronavirus cases. Most African countries have suspended all international flights and closed the country’s land borders in an attempt to contain the outbreak. Several have banned gathering in markets, churches and other places and even introduced a nighttime curfew, sealed off all sea ports, and land crossings.
Even some countries such yet to record a single case, have suspended all international flights.
There is widespread support for governments to impose travel bans, even against the advice of the WHO, which has urged countries to not apply blind travel restrictions in a way that would impact trade and travel.
Nigeria in battle mode
The full reality of the COVID-19 pandemic is gradually hitting Africa’s most populous nation. After recording the index case in late January and tracking one of the contacts that tested positive, the nation’s mode of relaxation was quickly shattered with the confirmation of five new cases on Wednesday. Nigerians were yet to recover from that shock when four fresh cases were announced barely 24 hours later.
With contact tracing of more than 1,300 persons from Lagos alone, the nation, now faced with the threat of a highly contagious viral outbreak, governments at federal and state levels in Nigeria quickly instituted various modes of pre- lockdown measures.
After much pressures, the federal government eventually took the of banning travel by public servants to 13 countries highly affected by COVID-19 pandemic disease.
Less than 24 hours later, the government came up with more measures, restricting entry into the country for travelers from countries with more than 1,000 cases. They include China, Italy, Iran, South Korea, Spain, Japan, France, Germany, the United States, Norway, UK, Netherlands, Switzerland, Austria and Sweden.
Government also suspended issuance of visa on arrival to travelers from the countries. All travelers returning from these countries prior to the restriction will be in supervised self-isolation, monitored by the NCDC and Port Health Services. The restriction that took effect starting from 20th of March is to be in place until further notice.
Currently, schools have been shut down, religious congregations banned till further notice, and all forms of activities that attract large gatherings of people all effectively outlawed.
Pandemic preparedness is an unusual race because it is a combination of a sprint and a marathon. It not only requires the quick reflexes of a sprinter but also the tenacity of a marathoner. Some of the states were quick off the mark, others were late starters.
Lagos state was the fast off the mark. In rapidity, the Lagos state government announced a string of measures to checkmate the coronavirus menace. Lagos was first to shut down all schools and ban public gatherings of more than 50 people, with tougher measures to follow in the event of more cases.
But successfully locking down a megapolis like Lagos is easier said than done. With 11 confirmed cases so far confirmed, Lagos is the indubitable hub of COVID-19 attention and activity in Nigeria, and with a population in excess of 21 million, this is hardly surprising. Because of its huge population, projections show that the state is likely to record hundreds if not thousands of COVID-19 cases while the pandemic lasts.
But Lagos appears to be prepared. Two of the five testing centers in the country are located in the state – one at the virology laboratory of the Lagos University Teaching Hospital, LUTH, and the other at the Nigeria Institute of Medical Research, NIMR, in Yaba. Also, the refurbished isolation centre located at the Mainland Hospital in the city is widely acknowledged as the most functional in the country.
Since the announcement of the index case in late January, Lagosians have been in a state of pandemic paranoa. Now at fever pitch, the residents are going about with trepidation and forebode of the unknown.
Mixed transmission is bad news – WHO
As the coronavirus pandemic seeps into the darkest corners of the world, the party appears to be over for sub-Saharan Africa and the rest of the continent which before the 19th of March, had recorded relatively low cases. This ”stroke of luck”appears to be ending as the coronavirus is picking up speed across the region.
Currently, there are more than 600 cases of COVID-19 confirmed in 34 countries in Africa as of 19th March, compared with 147 cases the previous week. Twelve countries in the region are experiencing local transmission.
Dr Matshidiso Moeti, the World Health Organization Regional Director for Africa, noted that: “The rapid evolution of COVID-19 in Africa is deeply worrisome and a clear signal for action. But we can still change the course of this pandemic. Governments must draw on all of their resources and capabilities and strengthen their response. Africa can learn from the experiences of other countries which have seen a sharp decline in COVID-19 cases through rapidly scaling up testing, isolating cases and meticulously tracking contacts.”
Nigeria is already experiencing mixture of imported and local transmissions which the WHO has routinely warned against. As explained by the Lagos State Commissioner for Health, Prof Akin Abayomi, one of the new cases that tested positive was a contact of the third case in Nigeria.
“We have combination of imported cases and local transmission,” he announced. .
”The best way to slow the rate is to halt movement of the virus from person to person.”
The WHO Africa Regional Director, Moeti, cautions thatit is crucial that African governments prevent local transmission from evolving into a worst case scenario of widespread sustained community transmission.” Such a scenario will present a major challenge to countries with weak health systems,” she warned.
“COVID-19 is one of the biggest health challenges Africa has faced in a generation. We can only stop this virus through solidarity. And the world is coming together. Donors are stepping up to the plate and providing funding while private sector in many countries are offering their support as well.”.
Long haul battle
Fighting COVID-19 is a long-haul battle, like running a marathon, as the contagion will remain with mankind for a long time, at least until there is an effective vaccine, said Thailand’s renowned virologist Dr. Yong Poovorawan.
Yong, who is helping contain the spread of the virus in Thailand, said that the virus has already caused a pandemic and development of an effective vaccine will take quite a long time. It is up to each country to devise the means to control the virus, reduce the loss of life and limit economic damage.
To fight a long-haul battle against coronavirus, he said that planners must devise a plan which has the right balance, taking into consideration the resources available and the knowledge that 80 percent of infections are not serious, “and some do not exhibit any symptoms at all” with the elderly and the sick being the most vulnerable.
Risk of infection
Coronavirus infection causes a respiratory illness called COVID-19, that has now been reported on every continent except Antarctica. The risk of infection is serious in Nigeria where there are confirmed cases. In a pandemic, most people can continue to go about their daily life as normal, but recent travelers to an affected area or being in close contact with someone with the virus, should seek medical advice and try to stay away from public places.
Because it can take up to 14 days for symptoms of the illness to start being noticed, Nigerians are on the look out for the tell tale symptoms. The most commonly reported symptoms are a fever and a dry cough, leading to shortness of breath. The early symptoms are similar to other common viruses, such as the common cold and flu. It is not yet known whether or not temperature impacts the spread of the coronavirus.
Social distancing, best defence
Social distancing – successfully practiced by some cities during the influenza pandemic of 1918 – is our current best defense against the cascading effects of COVID-19, says Michelle A. Williams, Dean of the Harvard T.H. Chan School of Public Health,in the USA. Because COVID-19 can result in severe disease, including hospitalisation, admission to an intensive care unit, and death, everyone is urged to take evasive measures, such as social distancing, to help slow the spread and protect those that are vulnerable to severe illness.
10 most affected countries
Since 31 December 2019 and as of 20 March 2020, 242 488 cases of COVID-19 have been reported, including 9,885 deaths. The deaths from the 12 top countries are as follows: Italy (3 407), China (3 254), Iran (1 284), Spain (767), France (372), United States (150), United Kingdom (144), South Korea (100), Netherlands (76), Germany (43), Japan (33), Switzerland (33)
This shows that the virus has killed more people in Italy than in China where it originated.
All countries are united behind a common goal – stamping out COVID-19 as soon as possible. Each has designed its own approach and unique challenges to keeping the population safe. Countries beginning to experience exponential growth in case numbers are learning from mistakes made elsewhere, and adopting ideas that are proving successful at slowing the rate of infection. The main measures of control include: quarantining, encouraging social distancing, encouraging working from home, closing schools and other institutions, placing hard limits on the size of crowds at events