Gaps in Nigeria’s COVID-19 response fuelling transmission of cases

By Sola Ogundipe

Nigeria’s handling of the COVID-19 outbreak since the confirmation of its index case has been received with mixed feelings.

In the early stages of the declaration of COVID-19 as a global pandemic, there was much to be desired about the quality of the prevention, preparedness, public health and political leadership in the National response to the COVID-19 pandemic.

Findings by Good Health Weekly reveal that the level of response in four key areas of  preparation and readiness; detection, protection and treatment;  reduction of transmission, and innovation and learning, all elicit concern. Among  widespread complaints are the following:

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Delay to shut  the ports of entry despite advice from  health professionals

Following the confirmation of the index COVID-19 case in Nigeria, there were calls on the Federal government by concerned Nigerians to shut down the nation’s airports and to close the land borders and impose travel restrictions. But the calls went unheeded.

Despite evidence that early confirmed cases comprised mainly of foreign travelers and Nigerians returning from high-risk countries, the Federal government did not limit incoming international flights until  March 18, when it announced indefinite restricted entry for travellers from 13 countries (China, Italy, Iran, South Korea, Spain, Japan, France, Germany, the US, Norway, the UK, Switzerland, and the Netherlands).

The restriction took effect on March 21.  The  Federal government also suspended the issuance of visas on arrival to travellers from these countries.

For most purposes however, the restriction was belated as numerous travellers from high-risk countries had been allowed access into the country, posing a great risk of widespread COVID-19 contamination to Nigerians.

The slow pace and poor adherence to calls by the WHO to detect and treat cases as well as protect persons

Nigeria’s slow pace and a low number of tests are large as a result of lack of capacity. Almost a month after the country confirmed its index case, the country had conducted less than 200 tests.

The low number of tests remains worrisome to date, but the Nigeria Centre for Disease Control, NCDC, said it adopted a strategy of limiting tests to only people already showing symptoms of the disease or those who had come in contact with confirmed cases.

The approach, although similar to that adopted in the US and the UK, has much lower test numbers.

Tests can be conducted locally, but there is a lack of manpower or capacity to do so on a large scale even as the nation’s public health infrastructure is hampered by critical equipment and facilities.

Quarantine of suspected cases for nationals and residents coming from high-risk countries was largely advisory and only became mandatory later.

Poor distribution of palliatives

Although fiscal and economic stimulatory measures were introduced to ameliorate the impact of the COVID-19 lockdown in the country, there was no database on which the distribution of the cash and food relief (palliatives) provided by Federal and state governments was based.

As a result, much of the packages in the direct food and cash distribution excluded the poor and did not reach the vast majority of the most vulnerable households across the states of the Federation.  The sharing was chaotic and often hijacked for partisan interests as a result of which it did not go around all households.

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Locking down only Lagos, Ogun and the FCT instead of the whole nation

The initial approach to lockdown in Lagos, Ogun, and the FCT were defective.  What the government should have done at the critical moment should have been to lock down the entire country.

Such a lockdown would have placed a premium on the closure of interstate borders. As a result of the oversight, the infection spread from the hotspots to other areas.

Inadequate awareness creation and public enlightenment about social distancing

The level of a public awareness campaign strategy that was engaged has not been effective in communicating the essence of social distancing and allied preventive methods.



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