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Nigeria under attack by two epidemics

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Death toll: COVID -19: Two; Lasser fever more than 100 this year, 1,150 since first diagnosed

By Sola Ogundipe

Nigeria and new economic status in Africa
A map of Nigeria

What should a country that is caught between two tribulations do? Should it stick to the one that it is
familiar with or should it engage the one it has never tried? Nigeria is caught between two debilitating disease epidemics – Lassa fever and coronavirus disease 2019 a.k.a COVID-19. To millions of Nigerians, Lassa fever is a “home disease”. The COVID-19 – a deadly viral disease that has sickened more than one million worldwide and killed more than 50,000, is the newcomer.

Unarguably, Africa’s most populous nation has had its fair share of disease outbreaks, including the debilitating 2014 West African Ebola Virus Disease. In January 2020, several weeks after the outbreak of the novel coronavirus disease (COVID-19) in the Hubei province of the Chinese city of Wuhan, the World Health Organisation, WHO, declared the outbreak a Public Health Event of International Concern, PHEIC. Nigeria, on the other hand, has been struggling with Lassa fever for more than five decades. but has not declared the disease a public health event of national emergency and concern.

READ ALSO;BREAKING: Nigeria announces 20 new cases of coronavirus

The detection of the COVID-19 index case in Lagos late in February 2020, was not the first time that Nigeria would be confronted by a viral disease outbreak of pandemic proportions threatening fragile health systems in the country as the infection increasingly spreads.  The country did not immediately swing into necessary action when it ought to have done so but it later did.  The nation is now almost completely on total lockdown.

In the last two months, Nigeria has seen a gradual daily increase in COVID-19 confirmed cases and it has matched the development almost stride for stride. The dedication and commitment with which the national response has been implemented leaves health watchers wondering why the same could not have been extended to the age-long Lassa fever malady.

As at 11:00 am on 3rd April there were 190 confirmed cases reported with 20 discharged and two deaths .  As at 11 am yesterday,  the numbers were: Lagos- 98; FCT- 38; Osun- 20; Oyo- 8; Akwa Ibom- 5; Ogun- 4; Edo- 4; Kaduna- 4; Bauchi- 3; Enugu- 2; Ekiti- 2; Rivers-1 and Benue- 1.The disease has invaded the country’s highest level of governance and also infiltrated its social strata to the extent of threatening national security.

But even as COVID-19 saga takes firm foothold in after wreaking havoc on over 200 countries  this is not the only viral outbreak  Nigerians have encountered in recent times although it is most frightening especially going by the number of lives it has ravaged globally. To say Nigeria is currently dealing with the world’s largest Lassa fever epidemic would not be exaggeration. In several respects, Lassa fever – an acute, annual, viral haemorrhagic fever – for now has caused Nigeria more havoc  than COVID-19. Prior to the debut of COVID-19, outbreaks of Lassa in Nigeria had already killed more than 100 people within the first few weeks of the year.  That number is higher than the number of reported cases of COVID-19 as at last week.

The Lassa fever outbreak in Nigeria is permanently active and outbreak is an annual ritual that has killed more than 1, 150 people since it was first diagnosed five decades ago. The number of cases usually climbs around the start of the year linked to the dry season.

For several decades, Nigeria has been under pressure to declare a national health emergency as it struggles to contain annual episodes of Lassa fever outbreaks.

Since Lassa fever was first reported in Nigeria in January 1969, an estimated 20,000 suspected cases have been reported with more than 1,200 deaths.  Between 1969 and 2007, the disease was reported in only Borno and Plateau states, but from 2008 to 2012, it spread to eight other states. From 2013 to date, at least 28 states have reported the disease annually.  Over the 50-year period of Nigeria reporting 20,000 suspected cases, 11,195 were reported between 2016 and January 2020, while 632 of the total deaths were reported during the same period.

Laboratory confirmation of suspected cases has been of great concern. Of the 3,498 suspected cases in, 2018, only 633 were confirmed positive, while in 2019, only 833 of the 5,057 suspected were confirmed.  Over the past five decades.

While a drug exists for treatment of Lassa fever, there is no approved drug or vaccine for COVID-19. Problems of inefficient laboratory diagnoses and late hospital admission of patients, combine to make treatment of Lassa Fever patients cumbersome.

Of concern during Lassa fever outbreaks in Nigeria is the high proportion of deaths. In the view of the Director General of the NCDC, Dr Chikwe Ikheweazu, there would always be cases of Lassa fever until “we are able to prevent it’’.

Over the years, the Federal Ministry of Health assured of high level of alert to eliminate the disease. But it has largely remained unfulfilled as Lassa fever remains endemic in Nigeria. Resources are only just becoming available for setting up special facilities, enhancing the surveillance mechanism, and boosting adequate human resource to address the challenge.

As declared by the Nigeria Academy of Science,  the Federal Government should declare Lassa Fever disease a public health event of national concernü attaining an emergency status.

COVID-19 is a completely different matter. Before the discovery of the index case in February 2020, Nigeria swung into action strengthening surveillance at the country’s five international airports in Lagos, Rivers, Kano, Enugu and the FCT. A Presidential Task Force on COVID-19 headed by the Secretary to the Government of the Federation, Boss Mustapha, was set up

The NCDC had set up the Coronavirus Group to mitigate the impact of the virus even as the World Health Organization listed Nigeria among 13 African countries at high-risk for the spread of the virus.
The Presidential Task Force announced a ban on travelers from 13 countries with over 1,000 cases domestically before it finally shut the airspace for all foreign flights. All travelers returning from the affected countries prior to the restriction were to be on supervised self-isolation just as the Federal government announced the closure of international airports in Enugu, Port Harcourt and Kano.  Soon after, the COVID-19 Regulations, 2020 was signed into law by the President, just as the lockdown on Lagos, the FCT and Ogun state kicked off.

As the coronavirus outbreak spreads across the nation, various terminologies entered the Nigerian vocabulary courtesy of public health officials. They include:  practice social distancing; work from home; stay at home; avoid public transportation and crowds; keep space between yourself and others and, where necessary, self-isolate. These are good measures to curtail the spread of the disease. But which are the measures to contain Lassa fever that has killed more Nigerians? The country is under attack by two epidemics. Health officials maintain that the two should be equally attacked by the authorities

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