By World Healthcare Journal-
The return of movement to the streets, businesses reopening and a swathe of people in mandatory face masks - Lagos, Nigeria’s commercial hub, is slowly easing out of lockdown measures put in place to contain Covid-19. The city itself is the epicentre of the coronavirus in the West African country.
There have been various phases of the national reaction to the Coronavirus. At first, earlier this year, the rampant spread of the virus across the globe was seen as a remote and otherworldly problem. It was a sentiment that echoed across Africa where some even suggested that the black community was somehow immune to the virus.
Things quickly changed when the first case was announced by Nigerian authorities on February 28. Two months later the number of confirmed cases recorded stands at over 3,000 with a death toll of 98 across 34 of the 36 states including the capital, Abuja.
Calculating infection numbers and challenges in estimating the spread of the virus
The emergence of Covid-19 exposed the perennial challenges of public health care in Nigeria, leaving the government to acknowledge issues with budget allocation and misappropriation, existing issues with health management and policies as well as the lack of facilities and equipment like ventilators.
The Lagos State Governor, Babajide Sanwo-Olu, quickly identified the gap and proactively set up a series of isolation centres across the state to tackle the impending menace. The State Government also quickly ramped up testing capacity by setting up sample collection centres across its 20 Local Government areas.
The Nigeria Centre for Disease Control (NCDC) provides a Coronavirus daily update of confirmed cases, discharged cases, and deaths in Nigeria. Over 21,000 samples have been tested in its laboratories so far.
Dr Chikwe Ihekweazu, the Director General of the NCDC, acknowledges that the infrastructure to tackle the disease was way behind but the organisation was working on accelerating testing and operating with what they had.
“The first thing we had to do was to rapidly scale up, rapidly develop testing capacity in Nigeria. And starting from zero, that was a challenge we all faced on the continent,” disclosed Dr Ihekweazu, at a joint media briefing with the World Health Organisation and World Economic Forum.
“We have an elaborate laboratory strategy at the moment, converting infrastructure that was built for TB and HIV for Covid-19 testing. The only challenge now is enabling the supply chain to bringing the reagents and primers that we need, which is challenged by the global challenge of the supply chain all together,” he said.
Estimating the spread of the virus is difficult because of the low levels of testing. The samples taken so far make up less than one percent of Nigeria's almost 200 million population.
Kano and Abuja are also leading states with confirmed cases. Kano, the second largest city in Nigeria has been placed under investigation and lockdown following a spike in the mysterious deaths of over 500 people. The deaths have not been officially classified as Covid-19 related deaths, but the symptoms leading to the illness appear consistent with the disease. It has caused enough consternation for the densely populated city to become a major concern for the NCDC.
Hospitals holding up
In a bid to contain and treat those affected, health care personnel have been exposed to the virus. On April 13, BBC News reported that 113 health workers on the frontline had tested positive for Covid-19. A laboratory in Kano had to be closed for a couple of days for decontamination after two attendants tested positive; this further slowed down testing in the state and surrounding states it serves.
The NCDC recently shared that it had just around 3,500 bed spaces for Covid-19 patients. This has prompted Nigeria’s health minister, Dr Osagie Ehanire, to request that property and hotel owners loan their spaces to the government for a short period.
Containing the virus
In March, Lagos was one of the first cities to take action with government officials issuing warnings, and restrictions limiting the number of people allowed in social gatherings were introduced. The state enforcement team was on hand to ensure the new guidelines were being adhered to.
Following this, President Muhammadu Buhari announced lockdowns in Lagos, Ogun and Abuja to contain local transmission of the virus.
Despite this, the virus has been steadily spreading across the country revealing that this is a fight that goes beyond the NCDC and a task force put together by the Nigerian Presidency, which reiterated that all citizens have a role to play.
Dr Aliyu, National Coordinator of the Presidential task force, said for there to be success in responding to the pandemic, there needed to be a diverse mix of stakeholders.
At a recent media briefing he said the task force including the NCDC and WHO representatives were “linking up quite closely with the private sector, development partners and civil society as well as community and religious leaders. ”
The past couple of weeks has seen the private sector also step up in the response to Covid-19 with monetary donations, logistics and even the creation of isolation centres.
Lagos lockdown and restrictions in states
Four weeks ago, Lagos - a city that never sleeps - became a ghost town overnight; schools, mosques, churches and offices, typically heaving with activity, were shut. A new semblance of life took over the city where those who could afford mobile data connected with friends, family and colleagues via the internet and social media. Church services and schools also moved online.
“Our first cases were in Lagos and Ogun so they had the opportunity of learning quicker and therefore they have developed a bit more. So now, what we are trying to do is transfer some of the knowledge that we have gained in one state to another state to ramp up those capacities,” Dr. Ihekweazu said.
The Federal Government’s initial lockdown applied only to 3 states directly but several states have taken Lagos’ initiative and introduced restrictions of their own, including curfews. The governors of all 36 Nigerian states came together and agreed to ban inter-state travel for two weeks through to May 7th.
“Even though we know Covid-19 is of major health concern, the impact goes beyond just the health sector,” Dr. Aliyu said.
With the lockdown, however, came security and economic concerns. Lagos state has a largely informal sector that has millions of people who literally work for their daily bread. Both states and federal governments put in place relief measures to assist the vulnerable with Lagos State, for example, setting up a “Food Kitchen” programme to feed 100,000 people daily.
The Federal Government went an extra step by offering cash transfer schemes and distribution of dry food in underprivileged areas.
“We’ve worked with the Federal Ministry of Humanitarian Affairs; we’ve released 70,000 megatons of grains from the national reserve; we also provided about a 100 trucks of rice to be distributed across the country, relief materials including in the IDP camps as well as conditional cash transfers,” Dr. Aliyu revealed.
Lifestyle and social distancing
It has been an unusual time for Africa’s most populous country. For a nation that is highly enterprising, culturally social and dynamic, physical distancing and a restriction on mobility has taken quite a bit of getting used to. In spite of this, the number of official cases has remained relatively low due to decisive measures taken by the Government. The longer-term effects on the economy remain to be seen but, thus far, the war on Covid-19 appears to be winning.
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