90 days of pandemonium: A nation at war with COVID-19

IMOLEAYO OYEDEYI assess the fight against the deadly COVID-19 pandemic and how the country has fared in the battle to save humanity

WHEN the Nigerian Presidential Task Force (PTF) on Coronavirus codenamed COVID-19 was constituted on Tuesday, March 17, the mandate was clear. With a timeline of six months, the body was assigned to “strengthen the national response strategy, particularly in the areas of testing, containment and management of COVID-19 and brace up collaboration with all tiers of government, private sector, faith-based organizations, civil Societies, donors and partners among others”.

It was also commissioned to “build awareness among the populace; direct the deployment of any relevant national assets when necessary; lay a foundation for scientific and medical research to address all emerging infectious diseases; and advise the government on the declaration of national emergency as part of the containment measures when necessary”.

As of the time the committee was appointed, the country had only three confirmed cases of the virus, all in Lagos and the third being a 30-year-old Nigerian female citizen who returned from the United Kingdom on March 13. But three months down the line, the country has recorded no fewer than 18,480 confirmed cases with 6,307 recoveries and 475 casualties as of Thursday, June 18. With a total of 106,006 samples tested according to the Nigeria Centre for Disease Control (NCDC), the country is still battling with 11,698 active cases across 34 states and the Federal Capital Territory.

While presenting a midterm review to ascertain how far the body has gone in achieving its term of reference, the chairman of the committee and Secretary to the Government of the Federation (SGF), Mr. Boss Mustapha said, “There has, no doubt, been some modest achievements, challenges and lessons learned over the past three months. COVID-19 is certainly the greatest invisible public health emergency that has threatened humanity in modern history.”

“As of the last recorded numbers on Wednesday, 17th June, 2020, global figures of confirmed cases were 8,408, 203 resulting in 451,463 deaths in 213 countries. Unfortunately, as of the same period, Nigeria accounts for 17,735 and 469 fatalities. Ladies and gentlemen, these are not just numbers. They are our brothers, sisters, mothers, fathers, friends and colleagues. These fatalities are forceful reminders of the task before us all.”

The PTF chair said with functional working areas such as PTF National Pandemic Response Center (NPRC) Coordination, Epidemiology & Surveillance, Risk Communication & Community Engagement, Laboratory, Security, Logistics & Mass Care, Points of Entry, Resource Mobilization, Infection, Prevention & Control, Research, Case Management, Finance Monitoring and Compliance, among others, the committee has initiated and enforced some measures. Among these, he said, are the initial lockdown of Lagos and Ogun states as well as the FCT; ban on flights to prevent importation, ban on inter-state travels and domestic flights; closure of schools and religious centres; imposition of nationwide curfew; easing of the lockdown in phases to allow for gradual reopening of the economy; prescription of measures to be observed to prevent spread (mandatory use of non-medical face mask/covering in public spaces), among others.

Also, he said the body has effectively enforced mandatory provision of hand-washing facilities/sanitisers; extensive temperature checks in all public spaces; physical distancing of two metres between people in workplaces and other public spaces and prohibition of gathering of more than twenty (20) persons outside of a workplace among others.

In addition to non-pharmaceutical measures, Mustapha said the PTF has also built certain capacities among which he said are “expansion of the testing laboratories from two (2) to 38 as of Thursday; training of over 13,000 health workers in Infection, Prevention and Control (IPC); development of policy and protocols for testing returning Nigerians; enactment of policies and protocols for integration of primary healthcare into national response; broadening of policy for community engagement and risk communication; collaboration with development partners to boost our resources and enrich our capacity for technical response; and raising of the isolation centre bed space from three thousand to over five thousand nationwide”.

Meanwhile, with over 18,000 confirmed cases out of almost 200 million Nigerians within the space of three months, some have argued that the PTF strategic efforts and measures have worked considerably, but with barely over 100,000 samples tested out of the escalating Nigerian population and the spate at which the virus prevails in the country daily; it appears many miles are still left to be crossed with over 190 million Nigerians still to be tested. If all variables remain constant and the lasting scientific cure for the virus remains unobtainable, the implication is that the country may record no fewer than 36 million confirmed cases by the time the entire population is tested.

A bigger country for instance, the United States with a population of 328.2 million people, has tested 26,500,497 samples, recording 2.23 million confirmed cases, 699,000 recoveries and 120,000 fatalities in less than six months of the coronavirus prevalence, according to its Centre for Disease Control and Prevention (CDCP). South Africa, which leads Africa’s coronavirus testing challenge and has a smaller population of 57.78 million people compared to Nigeria’s 195.9 million, according to worldometers, has tested a total of 850, 871 samples and recorded 83, 890 confirmed cases according to the global COVID-19 testing statistics on Wikipedia. Out of the confirmed cases, the country has recorded 44, 920 recoveries and 1,737 casualties.

With this staggering statistics, the immediate past president of the Nigerian Medical Association (NMA), Dr. Adedayo Faduyile and the president, National Association of Nigeria Nurses and Midwives (NANNM), Comrade Adeniji Abdulrafiu told Sunday Tribune that the Federal Government still has more to do in the area of testing as bigger hurdle lies ahead in the fight against the virulent disease. But the Director-General of NCDC, Dr. Chikwe Ihekweazu said South Africa’s statistics shouldn’t be used as yardsticks to rate Nigeria’s testing achievement.

Speaking at a recent joint media briefing between the World Health Organisation (African Region) and the World Economic Forum, Ihekweazu said, “We have to work with what we have. We definitely didn’t start at the baseline South Africa started from. I am aware of the facility they have built up over the past 30 years – the National Health Laboratory Service. It is something we will aspire to build here in Nigeria. But the truth is that you can’t just start building a structure that would take 30 years in the middle of a crisis.”

Corroborating Ihekweazu on the challenges that daily confronts the PTF in the curtailment of the dreaded coronavirus, the PTF chair said, “In the course of our monitoring and surveillance of compliance across the nation, we have observed an escalation in the level of non-compliance with simple measure to keep social distancing, wearing of masks in public places, sanitation and hygiene. This is more prevalent in markets, motor parks and some places of worship.”

“Like the rest of the world, our National Response continues to face challenges, especially as there is no known cure for the virus presently. These include inadequate infrastructure, manpower shortage, global shortage of essential items (test kits, PPE), strain on the economy which has compelled the need to balance between lives and livelihoods.

Mustapha said, “By far, our greatest challenges have also been human resistance to change, stigmatization, mental health, scepticism, culture, religious belief, rising incidents of domestic violence and a host of others. COVID-19 has changed our ways of life and we may never go back to what we used to know.

“As we push the frontiers of research at domestic and international levels with reliance on data and science, we eagerly look towards crossing the threshold of experiments into a world of cure. We continue to encourage our researchers and scientists to rise up to the occasion by submitting to the validation processes. The PTF’s position is that every treatment regime must be supported by incontrovertible scientific evidence”.

Going forward, Mustapha stressed that, “all relaxed measures are still subject to review and advisories issued are for personal and public safety purposes,” adding that. “The breach of the ban on inter-state travels is also a point of concern. Over the last couple of days, you must have observed that the daily figures of confirmed cases have been on the rise. This is an indication that we are conducting more tests across the country and that we are fully in the community spread phase.”

Speaking to Sunday Tribune on the efforts made by the PTF so far, the convener of #MakeOurHospitalWork campaign and Chief Executive of talkhealth9ja.com, Dr. Laz Eze said, “Generally, I will rate the Presidential Task Force above average. I think they’ve done fairly well in performing their roles. The states are directly responsible for testing.  While some are doing well, many are not.”

“In awareness creation, NCDC has done well on this as well, especially on social media. But many local government areas haven’t done well at all on this. Some states are playing more politics and doing show with the control of the pandemic. But in the area of collaboration, I believe the PTF has been doing fine with states that are cooperative. Only Cross River and Kogi have been obviously not cooperating. The private sector coalition CACOVID also appears to be getting along well,” he added.

In the next three months and beyond, he urged the PTF to put in place “more effective communication, especially at the community level using trusted channels and the language the people connect with, more testing, more testing and more testing with effective contact tracing, economic stimulus to businesses and strengthening of the health systems”.

In his own submission, the current Registrar of the West African Post Graduate College of Medical Laboratory Science, Dr. Godswill Okara said, “The PTF has done very well despite the myriads of odds it faces as a result of decades of pervasive mismanagement of our healthcare sector,” adding that, “The vigorous activities of the PTF have led to the establishment of more testing laboratories from five to over twenty centres across the country which has reduced the bottleneck of transporting clinical samples from very far distances to the testing laboratories.”

“The NCDC leadership has justified our confidence in their ability to serve the best interest of Nigeria.”

“As you are aware, early diagnosis and treatment are very key to full recovery, good prognosis and effective cure of patients with the disease. The vigorous awareness campaigns by the PTF through the daily engagement of the mass media have also been very successful in my view. It has brought about remarkable behavioral changes in public participation in surveillance and control activities in the fight against the pandemic. It has paid off in reducing the case fatalities and community spread of the virus in Nigeria.

He stressed that, “The efficient mobilization and deployment of relevant national assets in the fight by the PTF is indeed commendable. The private sector (CACOVID) corporate collaboration and involvement in raising funds and other resource inputs in the COVID-19 fight has revealed the inherent in-country capacity to rebuild the health sector in Nigeria to the desired status,” adding that, “The PTF has demonstrated that with honest and transparent leadership, the best in our people can be unleashed to build an enviable country in general and an effective health sector in particular.”

Going forward, Dr. Okara noted that since medical laboratory has been treated as an afterthought in the health sector, the Federal Government should set up molecular testing laboratories and run them effectively at every Local Government Area in the country in order to have prompt diagnosis, treatment and control of Nigerians that will contact the disease in days to come.

 

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