Nigeria: Has Nigeria Better Managed Coronavirus Than Many Developed Countries?

Nigerian flag.
analysis

By March 27, a month since its first recorded COVID-19 case, Nigeria had confirmed 70 cases of the virus, a speed of spread that pales into insignificance when compared with that of the United States' for the same period.

The U.S. went from 60 cases to 104,126 within that period, and now tops the table as the country with the world's highest number of COVID-19 cases with 367,650 as of April 7, according to Worldometres. Nigeria now has 238 cases, but 35 of the patients have recovered and been discharged, with five deaths in less than six weeks.

Of America's total cases, at least 10,943 fatalities have been recorded since late January, translating to 2.9 per cent fatality rate, compared to Nigeria's 2.1 per cent.

But apart from the US, the numbers from Nigeria suggest that Africa's largest economy has had a better response against the spread of COVID-19 - despite decrepit public healthcare infrastructure - than many countries, including the great powers of the global North.

Depending on statistics from Worldometres, PREMIUM TIMES compared the speed of spread and recovery and fatality rates in the US, the United Kingdom, Italy, Saudi Arabia, Brazil, and Nigeria. By these indicators, our analysis shows Nigeria may have better-managed COVID-19 than many countries including in Europe and America.

On February 27, when Nigeria recorded its first case in an Italian traveller, the UK had only 16 cases. One month later, the Kingdom had documented 14,543 cases, while Nigeria was still below 100. Now, as of April 7, the UK has 51,608 cases, including 5,373 deaths and 135 recoveries.

Thus, the UK has had a 10.4 per cent fatality rate and 0.3 per cent recovery rate, compared to Nigeria's 2.1 per cent and 14.7 per cent, respectively. In the US, the recovery rate is 5.3 per cent, still far lower than Nigeria's.

With 16,523 deaths in 132,547 cases, Italy's fatality rate, 12.5 per cent, is worse than Nigeria's 2.1 per cent and indeed than any other country's.

Nigeria and Brazil recorded their respective first cases on the same day, February 27. Currently, while Nigeria has 238 recorded cases, the American nation has 12,240, including 566 deaths and 127 recoveries, translating to 4.5 per cent fatality and 1.04 per cent recovery rates.

Saudi Arabia had its first record case on March 2, days after Nigeria's; yet, the Islamic kingdom has now reached 2,795 cases, including 41 deaths and 615 recoveries. However, in terms of rates of fatality and recovery, 1.5 per cent and 22 per cent, respectively, Saudi Arabia comes ahead of Nigeria.

"We are still learning"

Meanwhile, despite faring better than many countries in terms of speed of spread, fatality and recovery rates, Chikwe Ihekweazu, the Director-General of Nigeria Centre for Disease Control, told PREMIUM TIMES, "It is too early to conclude that our response is better than that of most countries.

"We are still learning and continue to do so on a daily basis. Ultimately, our aim is to protect the health of Nigerians and we remain committed to this mandate.

In any case, limited testing capacity may cover Nigeria's true reality. Nigeria has tested only about four thousand people, according to the NCDC, the frontline agency against the virus, compared with nearly two million and over 250,000 in the US and the UK, respectively.

But Mr Ihekweazu suggested limited testing capacity may not be covering Nigeria's true reality. He told PREMIUM TIMES that authourities are testing and tracing "promptly" contacts of confirmed cases, most of whom are returnees and their direct contacts.

"Till date, we have tested nearly 4,000 people for COVID-19," he said. "Surveillance in terms of contact tracing and monitoring is one of the most important yet resource-intensive and rigorous aspects of our response to COVID-19."

"For every confirmed case, intense contact tracing is carried out to promptly detect and treat contacts who may be infected. As at the 3rd of April, 7,868 passengers of interest have been identified and monitored. Over 70% have completed their follow-up period without showing symptoms of COVID-19."

Controlling community-level spread in Nigeria

Nigeria's comparatively better statistics are clearly not results of sound healthcare infrastructure and services. The country's elites barely patronise public hospitals, poorly equipped and staffed as impacts of corruption and years of neglect.

An investigation, based on direct observation by PREMIUM TIMES, showed the public hospitals in the capital Abuja are poorly prepared to help stem the spread of the virus.

Apparently aware of the country's inadequacies, the authorities have ratcheted up efforts to control COVID-19 from becoming a community disease, a case that could prove disastrous.

Apart from lacking facilities to respond to a widespread transmission, measures such as social distancing may not work substantially in Nigeria, where many families live in clumsily compacted manners and would need to go out daily for means to merely survive.

"Currently, the majority of the confirmed cases that have been recorded in Nigeria are returning travellers or contacts of travellers," said Mr Ihekweazu, suggesting that COVID-19 is not a community disease crisis in Nigeria yet.

"In the last one week, we have reviewed our case definition to ensure we can detect cases that are not in returning travellers or contacts of confirmed cases. This will enable us to make informed decisions to mitigate the impact of the disease," Mr Ihekweazu further told PREMIUM TIMES.

"Hopelessly out of depth"

The efforts of port health officials have also played into Nigeria's performance so far. At the time Nigeria had increased screening at the international airports, passengers arriving UK's London Heathrow could walk out without thermal temperature check or hand sanitiser.

"Just arrived at Heathrow T5 after 4 days in Milan - was fulling expecting a thermal temperature check. Nothing. Straight enough," tweeted Nick Dixon, an ITV correspondent on February 27. In a reply, one Twitter user, @Orwelland30, said, "Yes. I was checked on my way into Bologna 10 days ago but nothing on return. UK government appears hopelessly out of their depth on health issues."

"No surprise we landed at Heathrow from Singapore and nothing, not even hand sanitiser," replied another Twitter user, @1411gibson.

Nigeria has now gone from closing airports and issuing nationwide social distancing and personal hygiene advisory to a lockdown of the capital Abuja, Lagos, Nigeria's epicentre of COVID-19, and Ogun State.

"There is a strong chance that if these interventions are properly implemented and adhered to, we can flatten the curve and control this outbreak," said Mr Ihekweazu.

"By limiting movements, we are reducing the possibility of spread of the virus causing COVID-19, which is highly transmissible. This requires a whole-of-society approach to ensure we do not gravitate towards the worst-case scenario."

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