For Nigeria, which has just recorded its first novel coronavirus death, the tragic footprints of the global pandemic have become inescapable. Not surprisingly, tension escalated around the country on Monday after the Nigeria Centre for Disease Control announced the death of a 67-year-old national, whom it said contracted the highly contagious virus during his medical sojourn in the United Kingdom. His death and the rapid increase in the number of infections at the weekend are a wake-up call to the Nigerian authorities at all levels that the country has a long battle in its hands in its bid to contain the human and economic toll of the fast-spreading contagion. The Major General Muhammadu Buhari (retd.) regime should immediately declare an emergency in order to roll out extraordinary measures to fight the pandemic.
Nigerians should not be fooled. The coronavirus pandemic is deadly serious, and it is everyone’s problem. But, until now, the official response has been tepid and disappointing. Although all the indicators that the pandemic might grow worse were vividly present, particularly after the index case of the Italian traveller hit the country on February 27, the authorities still acted lethargically. Nevertheless, from the index case, who was discharged on March 22, the cases of infection have shot up alarmingly, reaching 36 on Monday, according to the NCDC.
Last week was frightening. After a seeming lull, the number reached 12 on March 19, mostly in Lagos. Health officials said these were mainly people who flew into the country from Europe and the United States. The cases inched up to 21 on March 21, from where it spread to Ekiti State, the Federal Capital Territory, Abuja and Ona Ara Local Government Area in Oyo State. Disturbingly, a case was confirmed in Edo State on Monday, bringing the total to 36. The scope of infections may be far higher than what is reported because of slow and inefficient contact tracing process.
Being the state with most cases, because it has been more rigorous in conducting tests, Lagos took the lead in curtailing the spread of Covid-19, the medical name of the pandemic that exploded in Wuhan, China, in December 2019. It shut down schools, a significant development that was swiftly copied by other states and the Federal Government. Lagos restricted social gathering to 20 people to promote the appropriate social distancing recommended by the World Health Organisation. Additionally, the state directed civil servants below grade level 13 to work from home.
The problem with these measures is that they are coming in piecemeal, and it seems there is no nationwide coordination. For instance, it took the Federal Government until March 23 to shut the airports to international travellers. Bearing in mind that Italy, the United States and Britain had high cases of COVID-19 for weeks, the action took too long in coming.
This is one time that the notorious inefficiency, complacency and sheer irresponsibility of officialdom should not be allowed to inflict avoidable carnage. Already, all these are at play: the slow response in restricting flights from afflicted countries and setting up testing and treatment centres allowed the index case to land and enter the local stage of infection.
Most unpardonable is the usual failure to enforce laws, orders and regulations. In Lagos and Ogun states, as well as the FCT where the authorities had separately ordered the closure of schools and forbidden gatherings of more than 50 persons, many faith-based organisations flouted the order. News outlets reported that many churches held their usual Sunday morning services, despite the police disruption of several other such gatherings. This is a flagrant failure of governance. The claim of “80 per cent compliance” by the Ogun State task force head is unacceptable.
Nigeria has every reason to be deeply worried with its broken health care system. Nothing really works here, aided by official corruption, which erodes the little funds available for health services. In the 2020 budget of N10.59 trillion, the health budget accounts for just 4.14 per cent or N427.3billion.
Medical personnel, especially doctors, are in short supply. Their strikes for improved conditions of service are routine. Frequently, they flee to Europe, America, Saudi Arabia and other countries where the remuneration is attractive, medical equipment available and the working environment conducive to service delivery. Nigeria, according to the Nigerian Medical Association, has a ratio of one doctor to between 10,000 and 22,000 patients, as against WHO’s recommended ratio of 1:600. This is compounded by the weak capacity to produce pharmaceuticals at a time countries, including the UK, have placed restrictions on medical materials. Israel has directed its spy agencies to embark on an undercover purchase of testing kits from abroad.
There are adequate lessons to draw from other countries. Singapore, Taiwan and Hong Kong have had to fall back on their experiences to tackle the COVID-19 pandemic, while Nigeria very quickly forgot about the experience of Ebola Virus. Even contrary to WHO’s advice, by February 1, Taiwan, Singapore and Hong Kong had already started implementing travel restrictions on passengers coming from mainland China. Sadly, up till last week, the Nigerian government was still dilly-dallying on that particular step. The Asian trio took the action despite the fact that China remains their biggest trading partner.
Despite being the third country to report cases of COVID-19 outside of China and, at a point, having the highest number of cases outside of China, Singapore, through a combination of strict contact tracing and testing, was able to track down almost all the cases of the disease and deal with them, working round the clock. In Hong Kong, social distancing was strictly enforced and schools closed even up to the forthcoming Easter period. Measures such as hand sanitising that had been in use during the SARS period were reintroduced. In Germany, the government has limited the number of people allowed to gather outside to just two. Failure to comply would result in a response from the state.
What is to be done immediately? The government should set up an efficient emergency response team with a large infusion of experts. Typically, Buhari has been unimaginative and aloof as COVID-19 spreads; the committee to assess its impact on the economy is not enough. By now, there should have been daily briefings by the team at the federal, state and local levels; the President should be visible.
As coronavirus spreads, tragedy looms with the country having the highest tuberculosis burden in Africa and ranked sixth in the world. TB, cardiovascular, asthma, diabetes, kidney patients and those with other underlying chronic health conditions are most vulnerable to coronavirus. The elderly and people with severe chronic illnesses of any age, prolonged respiratory illnesses, autoimmune diseases and malignant diseases are seriously at risk of infection. This risk population should be made to observe self-isolation.
This is not the time for the President to delegate to his narrow circle as usual; it is a time for him to take charge as the heads of government across the world have done. Everyone should be alarmed: Nigeria has a large population with large urban centres such as Lagos and Kano, a poor public health system and inefficient governance. The required coordination from Buhari has been signally absent.
Restrictions and quarantine should be tightened and strictly enforced by all tiers of government. The authorities should make examples of those who organise gatherings above the stipulated numbers by arresting and prosecuting them. Sadly, some people are irresponsibly delinking COVID-19 from science. Religious leaders who have great influence on public opinion should be discouraged from making claims that are not scientific. Relevant health authorities should monitor and issue clarifications on misinformation regarding the disease. No one is above the law; individuals, organisations and religious groups that endanger public health should be duly prosecuted.
Not much is known about COVID-19 as experts are still gathering information about the virus. All hands should be at the plough; apart from mobilising all health professionals like Lagos and many countries who have recalled retired care givers, student doctors and other volunteers, other states and the government should follow and mobilise all segments of the society to confront this plague.