Nigeria: Covid-19 in Nigeria, One Year On

27 February 2021

On 30 January, 2020, the World Health Organisation declared COVID-19 to be a public health emergency of international concern. The pandemic which broke out earlier in December 2020 in Wuhan China had spread across the world.

Nigeria's index case was confirmed in Lagos on the 27th of February 2020. The Italian, who returned from Milan, Italy on the 25th of February 2020, was confirmed by the Virology Laboratory of the Lagos University Teaching Hospital, LUTH, and was successfully managed at the Infectious Disease Hospital, IDH, in Yaba, Lagos.

A massive contact tracing rapidly commenced to identify all the contacts of the index case. From that single case in Lagos state, the country has recorded over 154,400 cases and almost 1,900 deaths in the 36 states and the Federal Capital Territory, one year after.

The good news, however, is that almost 132,000 of those sickined by the virus have recovered and been discharged from hospital.

More good news because vaccines that are protective against the disease have been developed and are available. Nigeria is planning to roll out its own COVID-19 vaccination campaign in a matter of days.

Nevertheless, life has not been the same for millions of Nigerians. Lagos state has remained the epicentre and from the first case recorded a year ago, Lagos currently has almost 55,500 confirmed cases and over 400 deaths.

Essentially it hasn't been smooth sailing.

On 1st April, President Mohammad Buhari imposed a lockdown in Lagos, the FCT, and Ogun states. The lockdown, which was the first of its kind, was later extended. There were also curfews nationwide.

Nigeria initially lacked adequate capacity to prevent, detect, and respond to a public health emergency of the magnitude of COVID-19, both in prevention and response.

At the onset of the pandemic, diagnosing the viral disease was the No.1 challenge that Nigeria faced. The pandemic exposed a critical weakness in the diagnostic capacity of the country.

There was dire shortage in adequate capacity to prevent, detect, and respond to a public health emergency of the magnitude of COVID-19.

This was most evident from the relatively low testing rates for COVID-19 in the country. There were acute shortages of just about everything - human resources, testing kits, laboratories, intensive care units, face masks, hand sanitisers, etc.

Worse still, the case definition for testing prioritised only symptomatic cases and their contacts.

At the outset, there were only three molecular laboratories in the country with the capacity to test samples and diagnose COVID-19. Two of the labs were located in Lagos, at the LUTH and IDH, and the third in Ede, Osun state.

Today, however, there are well over 100 accredited public and private laboratories and the country has tested about 1.49 million samples so far.

Back then, there were shortages of just about everything - human resources, testing kits, laboratories, intensive care units, face masks, hand sanitisers, etc. Over the last 12 months, however, response measures have been strengthened to contain the outbreak.

After government set up a multi-sectoral Coronavirus Preparedness Group that transformed into the Presidential Task Force on Covid-19, that included the Federal Ministry of Health, Nigeria Centre for Disease Control, NCDC, and other agencies, Nigerians quickly learned to recognise the common symptoms of the disease.

In addition, everyone is now used to adhering to social distancing avoiding crowds and maintaining at least two metres apart. Same goes for the maintenance of respiratory hygiene through wearing of face masks, as well as hand hygiene through regular and thorough washing of hands with soap and water, and use alcohol-based hand sanitiser. However adherent remains a challenge.

One of the major obstacles to the national COVID-19 response has been the persistent conspiracy theories and the attendant social media infodermic.

So much unverified claims on social media and misinformation have fuelled fear and doubt.

Before the outbreak, Nigeria had just just around 600 ventilators and ICU beds, currently, there are several thousands. The federal government adopted numerous health, social, and economic measures to cushion the impact of COVID-19, however, the economic packages were controversial and unpopular because they were not commensurate with the magnitude of the problem.

Even the so-called palliatives or food assistance programme of the Federal Ministry of Humanitarian Affairs Disaster Management and Social Development for vulnerable households in the locked down states, failed catastrophically.

Affer the lock down was extended, there was palpable hunger in many regions of the country.

The distribution system of the palliative was seriously marred by sharp practices

The procurement of medical equipment, personal protective equipment, PPE, and medicines was procured through private, bilateral, and multilateral arrangements

with global financing institutions, international partners and the private sector which established the Coalition Against COVID-19 (CACOVID) to help the government to control COVID-19 in Nigeria.

At the federal and state levels generally, response implementation remains largely based on weak health systems, sluggish emergency response, weak accountability systems, and fragmented data and information monitoring systems. The weaknesses have led to implementation gaps, but Nigerians are coping.

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