Amidst concerns that the COVID-19 virus has infected more people in the country than have been reported, health watchers argue that gaps in the nation's testing protocol and inadequacies in contact tracing among others, are undermining containment efforts.
New cases have been on an upward trend since early December 2020 and last week, the total number of confirmed cases in the country passed the 100,000 mark even as the number of samples tested totalled in excess of one million.
Over the weekend, the global death toll from the pandemic surpassed two million as Nigeria joined nations around the world in the race to procure vaccines and stepped up efforts to detect new variants of the virus.
Nigeria has been off track in testing for new confirmed cases. In April 2020, a target to attain two million tests by the end of July was not achieved. To date just over one million COVID-19 tests have been conducted in the country.
In its update for 16th January, 2021, the Nigeria Centre for Disease Control and Prevention, NCDC, noted that Nigeria had carried out tests on a total of 1,154,138 samples averaging 5,439 tests per million population which is rated among the lowest in the world.
In comparison, Ghana had carried out tests on over 701,000 samples, averaging 22,300 tests per million population, while South Africa, had tested over 7.5 million samples to give a total of 126,500 tests per million population while Morocco, had tested 5.1 million samples to give 139,134 tests per million population.
Nigeria laying foundation on faulty first wave - Tomori
Expressing worry over the recent surge in cases, renowned virologist and former president, Nigeria Academy of Science, Professor Oyewale Tomori called for urgent action.
According to Tomori, over the last couple of months, many states have not been testing because of lack of reagents and other challenges.
"We are having a surge in cases. We have a 2nd wave of infections but we do not know how big it is going to be because we are laying foundation on a faulty first wave. There is a challenge with that because we are not testing enough," he noted.
Calling for stricter policies to control the epidemic, Tomori warned that the Covid-19 epidemic was far from over.
"We need stricter policies, the message for the people now is that Covid-19 is not gone, it is still here. The problem is here and it is severe. People need to get the message right and take precautions. Cover your nose and avoid gatherings. Obey the basic instructions. The disease is around and spreading and people are dying," he warned.
Nigeria still in acute phase - Dr Chikwe Ihekweazu
"The COVID-19 pande-mic is not over. The low number of cases in Nigeria compared to other parts of the world does not mean we are safe, " said the Director General of the NCDC, Dr Chikwe Ihekweazu.
"We are still at the acute phase of the pandemic in Nigeria just as in most other countries across the world. The reality is that no country in the world is safe, until every country is safe. The virus that causes the disease is still circulating among people and is easily transmitted. With this risk and poor adherence to public health and safety measures, we will continue to record cases. We also do not know a lot about the long-term effects of this disease yet. Please take responsibility to protect yourself, family and friends."
Ihekweazu who admitted that Nigeria was yet to attain its testing target said the situation had improved in recent times as more laboratories and testing centres had been established across the Federation.
"We are working very hard to reach our target numbers for COVID-19 testing in Nigeria. This is why we have supported every state in Nigeria to have at least one laboratory with capacity to test for COVID-19. We have also supported states to establish sample collection centres to ensure people have access to testing as needed. Importantly, we have been implementing a household sero-survey starting with four states in Nigeria, to test people for COVID-19 antibodies.
"This will enable us to estimate the number of people that may have been infected but did not develop symptoms and provide clearer understanding of the rate of transmission. Notwithstanding, we continue to work with states and our partners to increase demand for and access to testing."
Surveillance and testing structures have collapsed - Dr Casmir Ifeanyi
Also speaking a medical laboratory scientist/public health analyst, Dr Casmir Ifeanyi, lamented that the sampling and testing structures put in place at the beginning of the pandemic had collapsed.
Ifeanyi, in his response, said Nigeria should urgently commence a sustainable and active surveillance and sampling protocol, to make up for the gaps in testing.
"We are not testing enough. Early last year we had only five testing laboratories, today we have over 100, unfortunately the capacity that we get in a day is not adequate compared to our population. Just NCDC gives us the number of positive cases on daily basis, they should also put side by side, the number of tests. It will help us to give more public health significance to testing that is on going.
"The truth is that enough samples are not being collected daily. The logistics of sampling is very challenging now. At the early time when we had the pandemic, people were being paid to do the sampling and contact tracing, but all those structures have collapsed. They are no longer supported and so the outcome has become very questionable and weak."
Further, Ifeanyi said the problem was not as a result of shortage of human resources.
"The managers of the government testing facilities are frugal with the recruitment of persons to support the testing process. That is the challenge. With the second wave now, it has become very pertinent that we need to review the way we recruit personnel in the Covid response.
"Particularly, we need to commence a sustainable and active surveillance and sampling protocol, that is the only way we would be able to give a true picture of the second wave and the overall pandemic in Nigeria," he asserted.
NAFDAC should do the needful about COVID-19 vaccines
Ifeanyi said the issue about the vaccines and the alarm raised by NAFDAC is worrisome and raises a whole lot of questions.
"NAFDAC is the watch man of medical devices and drugs that come into Nigeria, if the watch man is the first to give an uncertain tone, for me, it is worrisome. The Covid-19 vaccines have not become commonplace across the globe so we least expected NAFDAC to start crying foul, Government is expected to be the one driving the procurement process and making the vaccines available in Nigeria.
According to Ifeanyi, the alarm raised by NAFDAC cast doubt on the procurement process by government. "I expect the government to be solely in charge in this response. You can see that it is largely in Nigeria you will see such alarm been raised about fake vaccines, you have not heard it in any other part of the world. It shows how Nigerians leverage on all manner of challenges for profit at the detriment of fellow human beings.
"The NAFDAC D-G should sit up and do the needful. They should ensure that when government finally procures the vaccine, they will be in the picture and ensure that Nigerians do not fall victim of fakes.
Further, he argued that Nigeria is often considered a dumping ground where people don't want to comply with in-country regulations.
"For example, the Medical Laboratory Council of Nigeria as of today has not validated any Covid-19 rapid testing kits for use in Nigeria, but I can tell you that private hospitals in Abuja and Lagos and other institutions have commenced the use of Covid rapid test kits. That is what they want to extend to the vaccines.
"As a nation that has very poor health system and infrastructure, we need to be careful as we approach the vaccine. We must be careful with the deployment of vaccine," he warned.
Vanguard News Nigeria