The novel Coronavirus disease (COVID-19) has to be the most discussed topic anywhere in the world today. It is about that one thing that even living under a rock may not have spared you from. Much has been said about this highly contagious virus that has effectively shut down the world.
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Following the first cases of Coronavirus disease (COVID-19) in China, the spread has been nothing short of remarkable. We have been abruptly reminded that the world is a small village after all, given the speed of this spread. It has left governments shaken and healthcare systems struck.
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Virtually every country, but for a very few exceptions, has recorded at least one case, with strong economies like Italy reporting spikes in new cases of Coronavirus disease (COVID-19) and deaths within a space of weeks.
The horse has truly bolted, but for Africa, and Nigeria particularly, one must wonder if we made judicious use of the heads-up other countries gave us in this pandemic.
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‘’The village cripple is never caught in the crossfire of a pre-announced war’’ – African adage.
Nigeria got a heads-up on this pandemic and had ample time to ensure it was adequately prepared for what was essentially inevitable. It is instructive to note that following the onset of the pandemic in November 2019, Nigeria did not record its first case till February.
Now, we must accept our infrastructural limitations in this response. We know very well that we do not have the technology or political will to build a one thousand-bed hospital facility in ten days as the Chinese did in Huoshenshan to stem the tide.
We know very well that we do not have the critical care capacity and capabilities of the health systems of countries like Germany or the Nordic nations where fatalities are minimal.
Alas, we are that village cripple that somehow managed to get caught in the crossfire of a war that was pre-announced almost four months before.
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We should have set out at dawn, given our overt limitations.
We have missed an opportunity to proactively ride a storm which may now overwhelm us. A number of low-hanging fruits come to mind that may have been game-changers for Nigeria and we must ponder on these and ensure we do not miss the teaching moments a crisis like this inadvertently offers.
First, we know the virus is not indigenous to Nigeria. Indeed, the index case was a foreign individual who visited Nigeria on business and was also responsible for the second reported case, who was a contact of this index patient.
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The authorities relied too heavily on the screenings at ports of entry. They are not fail-proof as has now been shown. The body temperature screening simplistically assumes that contagious individuals would be symptomatic. This is false! Whilst it is a commendable step, Nigeria ought to have been more discerning.
The problem with such highly contagious pathogens is that all that is required is just that index case and things can go south really fast. It was noteworthy that countries that reported a handful of cases suddenly had thousands of new cases in periods as short as ten days. The only way it was going to get to Nigeria was going to be by importation and so it made control at that point straightforward.
Understanding the infection process of Coronavirus disease (COVID-19), we missed a golden opportunity to undertake supervised isolation of all arriving passengers. It would have been cost-intensive but it was doable.
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Nigeria could have issued travel advisories to all intending visitors and returnees. All international arriving passengers would be mandatorily isolated for a two-week period. You have not denied them entry, you have only just insisted on direct supervision of the isolation process.
As many more countries instituted travel restrictions, the numbers of arriving international passengers dwindled and as such would have made the process of supervised isolation easier as time went on.
The Lagos State government eventually had to track every passenger on that flight that brought in Nigeria’s index case. They advised them to self-isolate, which was worrying in itself as a strategy.
The authorities appeared to overrate people and their sense of responsibility. It was not a very well-thought-through decision as we know human beings are not likely to fully comply when asked to do things on their own volition.
The authorities could have advised other nationals to either submit to the supervised isolation or be denied entry and subsequently deported to their home countries on the next available flight.
Since that flight landed, there have been several other flights that have been responsible for bringing additional cases into the country. Tracking the passengers on those flights has become more difficult given the limited capacity of Nigeria’s contact tracing personnel, ignorance on the part of travelers and a general distrust in government.
The Lagos State government has had to implore such passengers to present themselves for further assessment via social media. This is a while after such people have been in public circulation assuming they refused to self-isolate.
Social distancing has been touted as one of the best means of prevention as with hand washing, personal hygiene, good cough/sneeze etiquette and avoiding ill people.
Social distancing essentially entails keeping a distance of one to two metres from anyone coughing or sneezing and generally avoiding gatherings.
Unfortunately, not many people really understand the concept of social distancing and it behoves on the government to embark on mass education on what the concept entails and its benefits.
Indeed, this was another low-hanging fruit for the authorities. How do you practice social distancing in a typically overcrowded commercial bus with very poor ventilation stuck in Lagos traffic gridlock?
Pictures emerged from Rwanda last week that showed specially designed contraptions that used plastic water cans and tubes to create mobile handwashing sinks.
Interestingly, having participated in Eko Free Health Missions, I know such contraptions were deployed in the mobile operating theatres used during those health campaigns. The Rwandans deployed several of these to bus stations and motor parks.
These mobile sinks made hand-washing feasible, even without the prerequisite pipe-borne water infrastructure that would have ordinarily taken weeks to put in place. The authorities missed another opportunity there. It was a great chance for the government to back up its frequent hand washing message with practicable action.
Given the economic realities of Nigeria, Coronavirus disease (COVID-19) reaching our shores was inevitable. That is a fact. It was always going to get here and so we should have braced for impact earlier by designating and upgrading the isolation facilities.
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The stories from Enugu where a suspected case, who eventually tested negative for Covid-19, was quarantined and eventually passed on are simply not tenable. This is a shared failure between the states and federal ministries of health. It has become very clear now that not much was done to ensure the facilities were set up and appropriately equipped to receive suspected and confirmed cases.
Matt Hancock currently serves as the UK Secretary for Health. He is a politician and not a trained medic. He previously worked in his family business and the Bank of England and has an educational background in Economics. While giving an update on the state of preparedness of Britain, he specifically mentioned the number of functional ventilators in-country (five thousand), how many more were required and how the government planned to close that gap in the availability of critical care equipment bringing the number to twelve thousand ventilators. He was clear in articulating what needed to be done and how things would get done. He inspired confidence.
Nigeria’s health minister, Mr Matt Hancock’s colleague, is a trained medical specialist and somehow, Nigeria was caught flat-footed in this pandemic even with significant fore-warning.
At the time I started writing this op-ed, Nigeria only had eleven cases with two already testing negative for Coronavirus disease (COVID-19). Since then, the number of reported cases has doubled with an additional ten cases reported in twenty-four hours.
Unfortunately, it appears Nigeria has entered the exponential infection phase meaning many incubating cases will become symptomatic en-masse. What this means is that we have moved from simple multiplications to cases occurring as proportions of existing cases. For certain, it will get worse before it gets better and we must accept that reality for starters.
Yes, the horse has bolted but one hopes lessons have been learned.
Going forward, we must all take responsibility for our safety by taking all the necessary precautions.
How To Stay Safe From Coronavirus disease (COVID-19)
- Be calm and do not panic. Panic and fear are known to cause more havoc than the virulent organisms in a pandemic.
- Wash your hands like you have obsessive-compulsive disorder. Use soap and water and do so for at least twenty seconds at every opportunity you get.
- Get handy alcohol-based sanitizers between periods when hand washing cannot be done.
- Avoid big gatherings as it is known that Coronavirus disease (COVID-19) can remain active on surfaces for days.
- Avoid handshaking as much as you can. You cannot tell where that hand you are shaking has been. Fist bump or wave if you must.
- Practice good cough/sneeze etiquette by doing so into your elbow or into a tissue which you must dispose off immediately.
- Avoid public places if you are coughing or sneezing. Use an absorbent face mask that properly covers your nose and mouth.
- Be mindful of your surroundings. Watch out for people coughing or sneezing and maintain a one to two-metre distance from such people.
- Be mindful of keeping your unwashed hands off your eyes, nose and mouth. Try very hard, and trust me this is harder than many people believed, not to touch your face. Just try!
- If you feel unwell or have any respiratory symptoms, remain indoors till such resolve.
- Build up your immunity by instituting a good healthy diet and exercise. Arm your defense system appropriately so that they are able to wade off as many infections as possible.
- Be the light. Rather than spread unverified information capable of causing mass panic, educate yourself and be quick to educate others around you on the myths and mistruths that are common at times such as this.
It is easy to understand that many business owners, especially in emerging economies like Nigeria with virtually no safety nets will be anxious about the loss of revenue from business disruption.
However, health remains the greatest wealth. That much has proven beyond any iota of doubt by Coronavirus disease (COVID-19). We need to be alive and well to create any value or earn any income.
Please take every precaution and be safe out there.
Photo Credit: CNN.com
