Our COVID-19 scorecard and the way forward by Ehi Braimah

We have now crossed the 10,000 milestone of COVID-19 cases in Nigeria since our first index case was recorded on February 27, 2020. On Sunday May 31, 2020,307 new cases were recorded in a single day in 14 states,taking our tally to 10,162 cases; 3007 discharged and 287 deaths over a period of three months (March – May). With a significant spike of 553 cases the day before, the exponential growth of infected cases translates into 3% death rate. Lagos state, in spite of the best efforts of Governor Babajide Sanwo-Olu and his team, remains the epicentre of coronavirus. 

How have we fared so far? What have we done well and where did we miss the mark? A performance management review will allow us to evaluate the quality of intervention and outcomes over the 90-day period. To be fair, the Presidential Task Force on COVID-19 headed by Boss Mustapha, secretary to the government of the federation (SGF), has been working round the clock with the Ministry of Health;Nigeria Centre for Disease Control (NCDC), the Central Bank of Nigeria (CBN), essential service providers and other stakeholders to tackle the deadly virus on various fronts.

There’s still no cure and every effort is being made by leading scientists around the world to find a vaccinefor COVID-19 but we are not there yet. As it is,there are still no easy answers to the public health challenges posed by coronavirus – prevention, from what we now know, is still the best cure for the disease. It is in everyone’s interest to wear a face mask in public places; maintain social distancing; disinfect commonly touched surfaces and washing our hands frequently with soap and water. The use of hand sanitizers also forms part of the safety protocol. When you are sick, you have a responsibility to yourself and your family to seek medical attention and if what you have are coronavirus symptoms, you are required to call any of the NCDC toll free numbers.

When the pandemic hit the world from Wuhan, China, it was like a rude shock – COVID-19 shook the foundation of society and the world may never be the same again. The measures we took at the onset to contain the spread of the virus did not include a swift closure of our international ports of entry after the index case was reported. Many passengers on those flights did not quarantine themselves for the mandatory 14 days before joining family members and colleagues. Since then, we have constantly witnessed an increasing number of confirmed cases and the concern expressed by Task Force on COVID-19 and the health authorities was that we should avoid a situation whereby frontline healthcare workers and medical facilities are overwhelmed with coronavirus cases.

According to a recent PTF briefing, we have 112 treatment and isolation centres with 5,324 beds in the country. Only five states and the FCT have at least 300 beds each which are like a drop in the ocean. To win the fight against the disease, we need more isolation centres and beds, in addition to scaling up our contact tracing and testing capability. Although some Nigerians boasted that there was no coronavirus infection out of ignorance, awareness campaign that was launched by the PTF, health authorities, state governments and other organisations dispelled coronavirus myths that circulated widely on social media.

But how can one explain the situation in Kogi state where the governor, Yahaya Bello, has been living in denial about the transmission of the deadly virus in his backyard? The attitude of the governor is unhelpful — it gives a false sense of hope to his people even when healthcare practitioners have been ringing the bell loudly that there is evidence of the disease in the state. Bello’s act of tyranny during his initial encounter with NCDC officials in the state leaves much to be desired.

If the PTF daily briefing on COVID-19 does not mean anything to him, Bello should follow the example of his colleagues in Lagos, Ogun, Bayelsa, Ekiti and Kaduna states – just to mention a few states — and learn useful lessons on COVID-19 outbreak and management. The breaking news from Kogi state is that Bello has ordered a two week lockdown on Kabba Bunu local government area after two cases of COVID-19 were recorded in the area by NCDC. The lockdown, according to the governor, will take effect from June 2 to enable health workers carry out contact tracing of the two cases, and no house to house or street movement will be allowed during the period.

As if the mixed messages from Yahaya Bello on COVID-19 were not enough, Dr Osagie Ehanire, the Health Minister, was another fly in the ointment –he entertained a bewildered nation by his own hubris over the “Chinese medical experts” episode. He masked up and headed all the way to the international airport to personally welcome the “experts” who apparently did not have any business with our anti-coronavirus efforts.

If the number of infected cases is going up, it is because the control of community transmission has not been effective. The compulsory stay at home orders and restriction protocols on inter-state movements turned out to be a huge joke; they were breached without consequences. Law enforcement officers shamefully cashed in on the lockdown order by extorting money from the violators — sometimes forcefully — for themselves on a daily basis. When President Muhammadu Buhari eased the lockdown effective May 4 due to the economic reality of survival, Nigerians took to the streets as if the virus had disappeared. Boss Mustapha was forced to sound a note of warning on the implications of abusing the safety guidelines.

The strange deaths in Kano state and how the number of coronavirus cases sky rocketed in the ancient city created panic for Task Force, NCDC and the health authorities. It looked as if Kano was going to upstage Lagos as the new epicientre of the disease, going by media reports at the time. It prompted President Buhari to order a two weeks total lockdown in Kano state during his second nationwide broadcast on COVID-19. President Buhari in his wisdom released N10 billion to Lagos state and N5 billion to NCDC during the early days of the pandemic in the country but even that gracious intervention was politicized in certain quarters.

As the compulsory isolation continued in the federal capital territory, FCT; Lagos and Ogun states, many state governments were also forced to introduce lockdown scenarios with the primary objective of containing the spread of coronavirus. Unfortunately, it was reported that several private hospitals admitted COVID-19 patients, knowingly or unknowingly, for treatment at the risk of their doctors, nurses and other health workers. This situation led some high profile hospitals in Lagos to issue statements concerning the risk posed by coronavirus in their hospitals having compromised the case management protocol issued by NCDC.Such COVID-19 cases ought to have been referred to the isolation centres in the first place but it looked like some “VIP patients” who tested positive to the disease did not fancy the idea of heading to an isolation centre.

Whereas each state is responsible for case management, NCDC has continued to support them with sample collection;increasing access to testing to diagnose people with the infection and conducting training to upgrade skills of frontline healthcare workers. Dr Chikwe Ihekweazu, Director General of NCDC, says the longest viability period of the virus is 10 days and real time PCR (polymerase chain reaction) tests are used to directly detect the presence of the virus.

The test uses a sample of mucus taken from the person’s nose or throat; the test could also work on saliva. PCR technology amplifies the viral genetic material if present in the body. On the other hand, “antibody tests identify people who have been previously infected with the virus; they do not show whether the person is currently infected – it is a good way of tracking the spread of coronavirus through a population,” wrote Richard Harris, science correspondent of NPR, an independent nonprofit media organisation.

The search for local remedies to COVID-19 was discussed by the Task Force at one of its briefings in Abuja with traditional and herbal practitioners, relevant agencies and stakeholders. While the Ministry of Health and our medical professionals worry about safety and toxicology issues; efficacy tests and clinical trials, available reports indicate that the traditional and herbal practitioners are concerned about funding and protection of their intellectual property rights.

“Although we’re anxious to find a cure,” said Dr Olorunnibe Mamora, the Minister of State for Health at the briefing, “we will not do trial and error with human lives.”In other words, fitness for human consumption will not be taken for granted and the remedy must state precisely what it claims to do. Will be it be a cure for COVID-19; remission of sickness or shortness of patient hospitalization? PTF agreed to continue with the collaboration and engagement but the practitioners were told to validate their procedures and list their products with the National Agency for Food and Drug Administration and Control (NAFDAC).

A major and commendable initiative,the Coalition Against COVID-19 (CACOVID),was launched as a private sector task force in partnership with the federal government, NCDC and World Health Organisation (WHO) to fight COVID-19 in Nigeria. CACOVID, according to information available on its website, is tasked with pulling resources across industries to provide technical and operational support while providing funding and building advocacy through aggressive awareness drive.

With more than 100 partners listed on its website working very hard for us to “stay alive together”, CACOVID has so far raised N27 billion to fight COVID-19 in Nigeria but there is no report on the website indicating how the fund is being spent.However, one critical area of intervention by most organisations has been the provision of PPE (personal protective equipment) for healthcare workers, medical ventilators, and so on. It is also noteworthy to mention that several religious organisations and amazing philanthropists donated their properties to be used as isolation centres.

As we have seen in other parts of the world, the way forward is the deliberate strategy by the federal government to gradually re-open the economy in view of the devastating effect of the global pandemic on the economy. So many jobs have been lost and many businesses, especially SMEs, may never be able to bounce back.

The easing of the lockdown continues for another four weeks beginning from June 2, according to the PTF on COVID-19 announcement approved by President Buhari. It means the ban on religious gathering has been lifted – churches and mosques can now resume their religious services based on each state government’s safety protocol. Hotels may also re-open but they must observe non-pharmaceutical interventions (use of face masks, sanitizers, hand washing, 2 metres distancing and capacity limits).

The curfew will now be from 10.00 pm to 4.00 am; inter-state travel remains prohibited except for essential goods and services and the financial services sector can now go back to their normal working hours.However, all schools, bars, gyms, cinemas, nightclubs and parks are to remain closed until further evaluation. The June 21 date for domestic flights to resume is still tentative until certain conditions are fulfilled.

It is evident that quarantine will not last forever, but as we prepare for the transition thoughtfully, every little act of kindness and empathy will go a long way in giving family members, colleagues, associates and workers hope as we try to overcome the climate of fear and worry.

Braimah is a public relations consultant and marketing strategist based in Lagos (ehi.braimah@brandimpact.ng)