Nigeria: Govt's Dilemma - Can Lockdown Ease Amidst Rising Deaths and Spread of COVID-19?

(file photo).
27 April 2020

As the second stanza of the lockdown President Muhammadu Buhari imposed on the Federal Capital Territory (FCT), Lagos and Ogun States comes to a close tonight, the president faces a dilemma on the way forward in the nation's fight to defeat the COVID-19 pandemic that has afflicted 1,273 persons, killed 40 and left only 239 off its hook so far across 32 states.

The nation recorded 91 new confirmed cases and five deaths yesterday. Four states, Ebonyi, Bayelsa, Kebbi and Taraba got their index cases. The 91 new cases were reported from 16 states, Lagos 43, Sokoto 8, Taraba 6, Gombe 5, Ondo 3, FCT 3, Edo 3, Oyo 3, Rivers 3, Bauchi 3, Osun 2, Akwa Ibom 1, Bayelsa 1, Ebonyi 1, and Kebbi 1.

Today the president would have to decide whether to ease the lockdown as requested by the Nigeria Governors' Forum (NGF) even as the cases are rising and risk an exponential outbreak of the virus; or extend the restriction and imperil an already fragile economy, with possible civil disobedience from a restive citizenry that has been complaining of hunger arising from its inability to earn a living in the last four weeks.

Although the president received an update on the lockdown from the Minister of Health, Dr. Osagie Ehanire, and the Director-General of the Nigeria Centre for Disease Control (NCDC), Dr. Chikwe Ihekweazu, yesterday at his residence in Abuja, it is obvious that the options before him are not easy and whichever one he takes would have dire consequences for both the polity and the citizenry.

When the president announced the lockdown in a nationwide broadcast on March 29 and signed the COVID-19 Regulations 1, effective from March 30 for 14 days, he said it was necessary to rein in the virus at the three epicenters through testing, tracing and treatment, explaining that the measure would ease the achievement of the three-prong objective. Extending the restrictions on April 14 by another two weeks, he argued that it was necessary to consolidate the gains of the previous weeks.

But the outcome has not been cheering. The cases have continued to rise, spreading to more states and creating new epicenters, the latest of which is Kano State. Hamstrung by the global scarcity of testing kits, reagents, and personal protection equipment (PPE), the nation's testing capacity has remained low around 1,000 testing per day coming far behind many other African countries, including Ghana and South Africa.

Although it has been argued that Nigeria's molecular testing is more accurate by over 95% while its peers' rapid testing has 44% accuracy, it's a much slower method with the attendant effect of undermining the objective of scaling up testing, tracing and treatment.

In the meantime, the citizenry, many of which are in the informal sector of the economy, are complaining that left without a livelihood, coupled with the failure of the government's palliatives, the choice before it is death by COVID-19 or hunger.

For the formal sector too, the lockdown has had serious adverse consequences on its businesses and has warned that continued shutdown would hurt the economy badly and it might be difficult to revamp it if it is not reopened immediately.

But with the rising cases of infection against the background of a sluggish rise in the capacity for testing, tracing, and treatment, it is obvious that this is hardly a good choice for the president as it could lead to an escalation of the COVID-19, a situation that might restrain the people from coming out for fear of contracting the virus.

"This would be counterproductive because the aim of opening the economy by getting back to work might be defeated," said an economist that spoke to THISDAY last night, explaining: "In any case, it is only a healthy people that would be able to work and push the economy. If they fall sick or are afraid to come to work because of health concerns, how would the economy run?"

The other option of extending the lockdown has its downside as it has the potential for worsening the economy with the possibility of sliding into a recession as well as the danger of civil disobedience by the citizenry that is already restive. But the argument for this is that with effective implementation of the restriction, a rapid up-scaling of testing, tracing, and treatment, the virus could be brought under control in a matter of weeks and then the economy could be reopened.

The advantage of this, said another analyst, would be that the nation would have a healthy workforce uninhibited by health concerns that would be productive enough to kick start the economy.

"The economic gains of this would be more," he said.

There were no indications of what recommendations the Presidential Task Force on COVID-19 gave to the president yesterday through the Minister of Health beyond Ehanire's terse comment that the decision was Buhari's to make.

It was also unclear last night if the president would be communicating his decision through a nationwide broadcast or a proclamation.

FG in Desperate Search for RNA Extraction Kits

Meanwhile, the federal government yesterday stepped up efforts to expand testing for COVID-19 as it sought to acquire more reagents that would facilitate the determination of people's status.

Ihekweazu, in a tweet, sought for assistance to acquire the reagents.

He said NCDC needed ribonucleic acid (RNA) kits for the COVID-19 test.

RNA is a critical component to identify and test for the presence of a virus.

The kits are used for extractions.

In a tweet yesterday, Ihekweazu gave specification of the products needed and the manufacturers.

"We're desperately looking for more RNA extraction kits as we expand #COVID19 testing. Product: Total viral RNA extraction kits (preferably spin column and with a lysis buffer). Manufacturers: Qiagen, ThermoFischer, SeeGene, Inqaba, LifeRiver, etc," he tweeted.

Headquartered in Hilden, Germany, Qiagen is listed on both the New York Stock Exchange and the Frankfurt Stock Exchange.

While ThermoFisher is based in the United States, Seegene is headquartered in Seoul, South Korea.

Inqaba is headquartered in South Africa, just as LifeRiver is in China.

THISDAY gathered that the specialised test kit does not show cross-reactivity with common respiratory tract pathogens and blood stream pathogens and also has both positive and negative internal controls to prevent the reporting of incorrect results.

The kit is said to offer unprecedented sensitivity and specificity in the detection of infectious disease.

Other common kits are said to be very expensive, large and require a modern laboratory and trained technicians to operate.

These have restricted their use in developing countries.

The Chinese Academy of Sciences had earlier this month said its biomedical institute in Suzhou, Jiangsu province, had created a nucleic acid test kit that could produce results in just 45 minutes.

The kit can be stored and transported at room temperature and it only requires 20 microlitres of nasal swab or mucus samples to produce a result, according to the institute.

A single test machine can analyse 60 samples an hour, while patients can be tested with an accuracy rate of over 99 per cent.

Buhari Meets Health Minister, May Address Nation Today

Ehanire and Ihekweazu yesterday briefed the president on the ongoing efforts to stop the spread of the virus in the country.

The meeting, which held behind closed doors at the president's residence in the State House, was announced by the president's Special Assistant on New Media, Bashir Ahmad, on his twitter handle @Bashir Ahmad.

"FLASH: President @MBuhari receives a briefing on Nigeria's #COVID19 situation, from Minister of Health Dr. Osagie Ehanire and Director-General of the NCDC, Dr. Chikwe Ihekweazu this evening at the Presidential Villa, Abuja," Ahmad tweeted.

Ehanire, who later appeared on Channels Television last night, failed to disclose whether the lockdown in Lagos, Ogun and the FCT would be relaxed or extended.

Instead, he said the president would make a proclamation on the situation at the nick of time.

"The president will make that announcement in his own time. We have given him the facts. He will consider the facts and make his own announcement using his wisdom," he said.

Ehanire also responded to a question on whether it would be right to relax the lockdown now or not, saying in handling a dreadful matter like this, both economic and medical interests have to be balanced to ensure that neither of the two situations is put in jeopardy.

According to him, such consideration does not apply to Nigeria alone but to other countries, adding, however, that since the Presidential Task Force has briefed the president on the current situation, the president will weigh the options and make a decision.

"Well, what happens is that in every country, we balance the medical and health related benefits from the economic-related benefits because you have an economy you don't want to kill and you also have a health sector you don't want to destroy.

"So, it is a very delicate balance, which you need to do and all countries do that. It is not only in our country, even in the United States you have that debate all the time - do we open the economy now or do we not open the economy now?

"The decision has to be tailored according to the needs of our country. Every country weighs its own benefits and decides what is best for her. In our case, we have presented the facts to His Excellency, Mr. President. We thought of the pros and cons and then gave him the options and then leave him to use his wisdom to make the choice," he said.

The president had on April 13, extended the lockdown he initially announced for 14 days for another two weeks to hasten the containment of COVID-19.

NMA Issues Advisory on Tackling Pandemic

The NMA has urged the federal and state governments to consider a coordinated implementation of policy measures such as lockdown, palliatives, public awareness on hygiene practices, use of face mask and social distancing.

In an advisory issued yesterday, the association said the implementation of lockdown should be accompanied by large-scale public enlightenment down to the grassroots.

It said such a measure should also be accompanied by the distribution of palliatives to the most affected segments of the population.

NMA also advised that the governments should enhance the enforcement of all measures to maintain physical distancing of at least two metres in public spaces and avoidance of public gatherings larger than 20 persons.

"The enforcement of the wearing of face masks must be in addition to other mitigation measures like increasing access to clean water and hand washing to provide significant infection and mortality risk reduction," it said.

NMA called for massive up-scaling of testing or mass screening using RDT and further confirmation with the PCR method, concentrating mainly in areas with high disease burden.

The association explained that it would soon unveil N500 million support programme tagged: "Save Our Private Health Practitioners Initiative" to raise financial and material support for private healthcare practitioners in the containment and management of COVID-19 outbreak.

UNILAG Medical Centre Shut after Exposure

The University of Lagos has announced a temporary closure of the UNILAG Medical Centre after being exposed to a COVID-19 patient.

A statement yesterday by the university said the temporary closure, which began on Saturday, would last for 14 days.

"The university has made this necessary decision in order to decontaminate the centre following exposure to an outpatient who was seen at the centre on Monday, April 20, 2020, and immediately referred for COVID-19 testing. The medical centre was notified of the results on Friday, April 24, 2020, and immediately sought the guidance of the COVID-19 response team and institutional infectious disease experts," it said.

Lagos Arrests 39 Strippers, 580 Violators of Lockdown

The Lagos State Police Command has arrested 620 violators of the lockdown imposed by the federal government to flatten the curve of the COVID-19 pandemic.

Among the arrested violators were 39 strippers and club-goers, a cleric who held group prayers, 95 interstate travelers and other random motorists and fitness enthusiasts.

Acting on credible intelligence, operatives from Idimu Police Station had arrested 39 suspects in a hotel at Idimu, for clubbing and strip teasing, in violation of the lockdown order and social distancing regulations.

The 95 interstate travelers were passengers in seven commercial vehicles who were arrested based on a tip-off to operatives from Denton Police Station.

Confirming the arrests, the state police spokesman, Mr. Bala Elkana, a Deputy Superintendent of Police (DSP), said the buses were impounded while the drivers and passengers were charged to a mobile court.

Lagos Govt to Distribute 3m Masks

The Lagos State government has also said it is producing three million face masks for distribution to the vulnerable in the state.

Governor Babajide Sanwo-Olu in a tweet on his official handle yesterday, said the planned distribution of the face masks was part of the state's preparations for compulsory wearing of face masks.

While restating that face mask protects people from droplets from coughing and sneezing, Sanwo-Olu noted that it should be used in conjunction with social distancing as well as other safety guides to curb the spread of COVID-19.

Kaduna Extends Lockdown by 30 Days

The Kaduna State government has also extended the lockdown occasioned by the outbreak of the pandemic in the state by 30 days.

The government had imposed quarantine orders on the state for one month beginning from March 26.

A statement yesterday by the media aide to Governor Nasir El-Rufai, Mr. Muyiwa Adekeye, said the governor's extension decision followed the recommendation of the State Standing Committee on COVID-19, chaired by the Deputy Governor, Dr. Hadiza Balarabe.

It said the increasing record of cases in neighbouring cities, especially Abuja, called for stiffer measures to curb the spread of the pandemic.

The government stated that the lockdown extension was effective from yesterday, adding that the two-day window during which the restriction of movement was relaxed on Tuesdays and Wednesdays has been reduced to only one day - Wednesdays.

Suspected Killer of Fasoranti's Daughter Tests Positive

One of the four suspected killers of Mrs. Funke Olakunrin, a daughter of the Leader of Afenifere, Chief Reuben Fasoranti, has been identified as one of the two new confirmed cases of COVID-19 in Ondo State.

The suspect, along with three others, were ordered to be remanded at Owo Correctional Centre by the Magistrate, Ms. Victoria Bob-Manuel, after their samples must have been taken for COVID-19 screening to prevent them from infecting other inmates in case they are positive

The confirmation of the status of the suspect was later disclosed by the Governor, Mr. Oluwarotimi Akeredolu (SAN), in his Twitter handle.

Agbakoba Canvasses Herbal Cure, Kicks against Lockdown

A former President of the Nigerian Bar Association (NBA), Mr. Olisa Agbakoba (SAN), has canvassed a review of the nation's strategy on the fight against the pandemic to include all retired professors of virology and infectious diseases in the country to complement the efforts of the NCDC.

Agbakoba, in a telephone interview with THISDAY, also emphasised the need to include traditional herbal medicine in the fight against the pandemic.

He urged the federal government to end the lockdown, which has caused more hardship than expected, saying it is not a viable option.

The legal luminary also advised the federal government against going to Western nations or the international monetary institutions for financial assistance, saying instead, Nigeria should look inward to solve its problem.

While commending the government on how far it is combating COVID-19, he said the NCDC was being over-stretched and needed to add capacity to assist its Ihekweazu by bringing out all retired professors of virology and infectious diseases to boost its capacity to effectively combat the pandemic.

BUA Commits N3.3bn to Fight COVID-19

Meanwhile, BUA Foundation, a philanthropic arm of the BUA Group, has signified its intention to commit N3.3 billion grants to Kano and Lagos States through the Presidential Task Force on COVID-19 to help in the ongoing fight against the pandemic in the two states and the country in general.

The Founder of BUA Foundation, Mr. Abdul Samad Rabiu, in a letter addressed to the presidential task force informing it of the proposed grants, said the grant would be made through a working group made up of the presidential task force, the NCDC and other stakeholders.

He stated that the fund would be used to equip two permanent facilities in Kano and Lagos States in collaboration with the teaching hospitals in those states.

According to Rabiu, two grants of N2 billion would go to the Kano-based intervention and N1 billion for Lagos State while cash of N300 million would be given to the presidential task force to assist it with logistical and operational activities.

He explained that the grant was in addition to BUA's earlier contributions to the private sector-led CACOVID coalition and donations to other states.

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