By Chioma Obinna
The World Health Organization, WHO, last Tuesday, announced that countries should begin to prepare for pandemic following the rapid spread of coronavirus in the world.
The announcement came just as COVID-19 landed in Africa, specifically in Egypt, Algeria and Nigeria, with one case each. In this interview, Director-General, Nigeria Centre for Disease Control, NCDC, Dr. Chikwe Ihekweazu, explains Nigeria’s level of preparedness to contain the virus.
How prepared is Nigeria for any coronavirus case?
The coronavirus disease (COVID-19) is caused by a new pathogen that had not been detected anywhere in the world, prior to January 2020 in Wuhan, China. Over the last two months, countries across the world including Nigeria have had to strengthen their systems to prepare for this new outbreak. We are learning a lot daily and strengthening our preparedness. With our large population, a large outbreak in Nigeria would have global health security implications.
Nigeria was one of the first countries to recognise the risk and start planning the response to COVID-19. In a massive effort of national coordination, a multi-sectoral National Coronavirus Preparedness Group was established by NCDC on January 7, 2020. This was one week after China first reported the cases and three weeks before WHO declared the disease to be of international concern.
The group includes representatives from Port Health Services of the Federal Ministry of Health, Office of the National Security Adviser, Federal Ministry of Agriculture and partners including World Health Organization (WHO), US Centers for Disease Control and Public Health England. In addition, Nigeria’s Minister of Health has convened inter-ministerial meetings with the Ministry of Information as well as the Ministry of Foreign Affairs to ensure collaboration across government. Our country has continued to adhere to advice and recommendations from WHO, including on travel and trade.
The preparedness group in Nigeria meets daily to review the risks, assess our capacity and interventions, and develop guidelines for the country among others. We would continue to invest resources to ensure Nigeria is prepared in the event of an outbreak.
How many isolation centres are in Nigeria and where are they located?
One of the most critical areas for COVID-19 outbreak response is providing appropriate care for large numbers of patients. Nigeria is also responding to a large Lassa fever outbreak with over 600 confirmed cases in seven weeks. We are working on improving our resilience in this area to be able to manage two large outbreaks if we have to.
In the last one month, NCDC has conducted rapid assessments of potential treatment centres. This assessment focused on identifying gaps and developing plans to rapidly ensure that we are prepared to manage all cases. These centres are in the five priority states with international airports- Lagos, Rivers, Enugu, Kano, and the Federal Capital Territory.
How equipped are these potential centres to handle emergencies?
Following the assessment of potential treatment Centres, we have begun a procurement process to equip these Centres with specialised equipment and supplies to manage cases.
In addition, NCDC is currently training health workers identified by the governments of these five states, on how to manage COVID-19 cases. These health workers would be responsible for the management of cases in the event of an outbreak. We have also developed case management guidelines to be used by health workers across the country.
In terms of diagnosis, how many laboratories in the country can diagnose COVID-19?
Within one month of the confirmation of the first case in China, diagnostic capacity was established at the NCDC National Reference Laboratory in Abuja on February 1, 2020. We were one of the first few countries in Africa to establish this capability, as we leveraged on our existing laboratory network with molecular diagnostic capacity for other viruses. The National Reference Laboratory only needed access to the new primers developed for COVID-19.
Currently, four laboratories in Nigeria can diagnose COVID-19. In addition to the NCDC National Reference Laboratory, this capacity has been developed at the Virology Laboratory of Lagos University Teaching Hospital, Irrua Specialist Teaching Hospital and African Centre for Genomics of Infectious Diseases in Ede, Osun State.
How equipped are these laboratories?
The laboratories to diagnose COVID-19 in Nigeria have the required equipment, reagents, and human resource to test cases with six hours turnaround time. We have also instituted a sample transportation network to ensure samples are transported from state capitals to the testing laboratories. This transportation network has been used during outbreaks of Lassa fever, yellow fever, monkeypox and we have continued to improve on this.
Are there other structures put in place to checkmate any eventuality?
At points of entry, the Port Health Services of the Federal Ministry of Health has increased screening measures. Specifically, new forms have been developed and are being completed by returning passengers to include details of travel history. Residents of the Nigeria Field Epidemiology and Training Programme (NFELTP) are working closely with staff at Port Health Services to review and analyse these forms. If there was a case imported to Nigeria, this would form the basis of our contact tracing.
To ensure coordination, NCDC quickly developed guidance for health workers on COVID-19 and circulated this widely through our coordination structure with the 36 states and Federal Capital Territory. We have supported 22 out of 36 states in Nigeria to establish state-level Public Health Emergency Operations Centres, EOCs, This structure of sub-national EOCs has improved our communication and coordination and will be activated further in the event of a COVID-19 outbreak in Nigeria.
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Since the beginning of the outbreak in China, NCDC has also focused on correcting misinformation and updating Nigerians. We have done this through many television and radio appearances as well as social media posts on Facebook, Whatsapp and Twitter. We are working with the National Orientation Agency to strengthen our nationwide communications campaign.
Next week, we would work with WHO and other partners to carry out a simulation exercise in Nigeria. The goal is to critically assess our level of preparedness, identify the gaps and develop urgent interventions to close these gaps.
The federal government has released some funds for preventive measures. What are you doing with them?
The government of Nigeria has provided funds that would be mainly used to rapidly scale up the capacity at identified treatment Centres. This includes renovation of these centres to manage cases of severe respiratory diseases, procurement of equipment and other medical supplies.
Now that the outbreak is closing up on Africa with a case recorded in Algeria, what is your advice to Nigerians?
Any new infectious disease is a cause for concern, and COVID-19 is no exception. The government of Nigeria is pushing hard to ensure that we are ready for coronavirus if it spreads to Nigeria.
Our advice to Nigerians is to remain calm and avoid the spread of fake news which causes panic. We advise against non-essential travel to countries with ongoing transmission which includes China, Italy, and South Korea. If you travel from China or any of the countries where there is ongoing transmission, please stay indoors and avoid contact with people for a 14-day period. If you feel ill and have recently traveled to any country with a confirmed case, please call the NCDC toll free line which is available 24/7 on 0800-970000-10.
Personal hygiene is also important, not just for COVID-19, but also to protect ourselves from other infectious diseases. Wash your hands regularly, avoid contact with sick people, cover your nose and mouth properly with a disposable tissue when sneezing or coughing and dispose appropriately after use.
- Interview conducted before the first case of Coronavirus was recorded in Nigeria last week