COVID-19: One Year After Nigeria’s Index Case

Yesterday, February 27, made it a year since Nigeria confirmed its first case of Coronavirus (Covid-19).

The case was an Italian citizen who worked in Nigeria and returned from Milan, Italy to Lagos on February 25,2020.

The 44-year-old Italian citizen had arrived the Murtala Muhammed International Airport Lagos aboard Turkish Airline and travelled to his company site in Ogun State before developing symptoms which was confirmed as COVID-19 on February 27.

Confirming the case, Minister of Health, Dr Osagie Ehanire, said “He was confirmed by the virology laboratory of the Lagos University Teaching Hospital, part of the laboratory network of the Nigeria Centre for Disease Control (NCDC). The patient is clinically stable, with no serious symptoms, and is being managed at the Infectious Disease Hospital in Yaba, Lagos.”

In the following weeks, the COVID-19 cases grew sporadically with the return of Nigerians from abroad through  Lagos and Abuja airports.

Since the index cases was recorded, the number of cases in the country had grown to 154,476 (with 20, 863 active cases) as of Friday.

Out of the number, 131,699 cases have been discharged and 1,891 deaths recorded in 36 states and the Federal Capital Territory (FCT). Out of the country’s about 200 million population, 1, 489, 103 samples have been tested.

The country has also witnessed two waves of the pandemic since then.

Twelve months after the pandemic, the country is witnessing low testing, delay in test results, lack of compliance to safety protocols and also battling new variants of the virus among others.

The country is also awaiting delivery of its COVID-19 vaccines.

Early days of the pandemic and spike in cases

Experts say the country did not prepare enough for the pandemic, and did not also do enough during the early days.

According to the Chief Executive Officer of the institute, Dr. Patrick Dakum, during a virtual conference on COVID-19, lack of preparedness for the COVID-19 pandemic resulted in an exacerbation of the already frail health system.

After the federal government announced the index case of COVID-19 in Nigeria, the country witnessed a steady rise in the number of daily cases for about five months.

However, in August 2020, the country began to record occasional decreases and occasional rise in cases. From the first week of September till October, the country continually recorded low number of new COVID-19 cases daily ranging from 50 to 250 cases unlike between May, June and July when the country was recording between 150 to 800 new cases daily.

In December, the Presidential Task Force on COVID-19, confirmed that the second wave of the pandemic has begun in the country. The country had begun to witness another spike in cases from November.

Experts said factors that contributed to the spike in cases include delay in closure of international borders by the federal government, inadequate testing centres and low testing rate in the country, inaction by some state governors, delay in ordering a lockdown as well as violation of lockdown, lack of belief in the existence of COVID-19 and flouting of preventive measures among others.

Unlike China which declared a total lockdown of the Wuhan Province immediately, Nigeria failed to take early actions. Although Lagos began contract tracing immediately, the arrival at the international airports had continued in Lagos, Abuja, and Kano.

The Nigerian Civil Aviation Authority (NCCA) announced the shutdown of Lagos and Abuja airports on March 23, 2020, which was 26 days after the index case in Nigeria through the Murtala Mohammed International Airport Lagos.

Prof. Oyewale Tomori, a renowned virologist and immediate past chairman of the Nigeria Academy of Sciences, said Nigeria should have closed its borders right from the first day it recorded its index case.

“On that day, we should have sealed and closed all our borders to all travellers from COVID-19 affected countries. But no, we waited until 23rd March, almost a month later and by which time we had at least 40 cases,” he said.

Testing centres and low testing

Lack of test centres were also an issue for NCDC as fewer centres existed as at March 25, 2020. NCDC had only five testing centres at the beginning of the outbreak.

It however grew to over 70 centres within a few months. During the initial days, many states had to bring samples to Abuja for test.

The country did not also test enough people or engage in mass testing like other countries. Several states in the country have not done enough testing of the populace till date.

Nigerians still flouting safety protocols 12 months after

Findings by our reporters revealed that many Nigerians don’t observe the preventive measures instituted by the federal government to protect them against the virus even with a policy and risk of jail term enacted.

A Professor of Public Health at the University of Ilorin Teaching Hospital, Prof. Tanimola Akande, in his score card for the nation’s response to COVID-19 in the last one year said due to low awareness, myths and conspiracy theories, the adherence of individuals to the non-pharmaceutical interventions (NPI) is low.

He noted that the pandemic has significant effect on the fragile health system in the country and also led to economic hardship as well as social system disruptions.

In addition, the epidemiologist said government’s response to the pandemic initially was sub-optimal due to low laboratory capacity for testing, and lock downs with little palliative to provide relieve for its citizens.

Prof Akande, who is a past National Chairman of Association of Public Health Physicians of Nigeria, emphasized that, “There is so much inequity in vaccine availability to developing countries. With 225 million doses given globally, African countries are far behind. Nigeria will soon receive its supply of COVID-19 vaccines through support from COVAX facility, African Union and other donors.

“It is hoped that vaccination will start soon and Nigerians will take the vaccine. Vaccination is a major strategy to control the pandemic,” he said.

How Nigeria is tackling the pandemic 12 months after

Prof. Oyewale Tomori said the country has tackled and is still tackling the virus poorly, noting that the only way to really tackle the virus is to limit the transmission from person to person by strict compliance with the non pharmaceutical interventions.

“We have failed woefully to comply and the epidemic remains with us. We were lulled into complacency because the disease was not as severe as it was in Europe.

Asked what has changed since the COVID-19 outbreak in the country, Prof Tomori said nothing much has changed, adding that there is still widespread community transmission.

“Perhaps the discovery of new variants of the virus could be one of the undesired change. Whether these variants will lead to more transmissible or more virulent viral activities, we do not yet know.”

He said what is expected to change in the way the country handles the outbreak is the attitude of Nigerians,” by appreciating that we have a major pandemic in our hand and behave in a more responsible manner to limit its spread. But that is not likely to occur.”

He said there is hope that when the vaccines finally arrive, there would be ready acceptance by Nigerians.

COVID-19 spurred manpower development in heath sector

An epidemiologist, Dr Ola Ilesanmi, explained that Nigeria has made some progress in the management of COVID-19 especially in the area of diagnosis, training of health-care workers through manpower development,

He said, “At the inception of the outbreak, the country only had four laboratories for testing, but as at today, there are almost 70 laboratories and 40 private labs. Also, a lot of health care workers now know how to identify, treat and manage infectious diseases.

“There are some countries in West Africa that are already responding to Ebola disease outbreak, so, we don’t have anything to fear. Through COVID-19, Nigeria is now better prepared to fight all diseases be it communicable or non-communicable disease.

Ilesanmi insisted, “When we compare Nigeria with some other countries, we have done pretty well. The NCDC, Federal Ministry of Health, National Primary Healthcare development Agency (NPHCDA) and other agencies and organizations including in the private sector, have contributed in their own little way to manage the situation.”

COVID-19 variants

Director General of the Nigeria Centre for Disease Control (NCDC) Dr. Chikwe Ihekweazu last Friday said there are about 55 variants of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) circulating in the country.

He said that a total of 29 cases with the B.1.1.7 variant strain, which was first described in the United Kingdom and shown to be linked to increase in transmissibility, have so far been detected in Nigeria.

He said that on the 11th of February, some recent SARS-CoV-2 genomes were seen to have distinct mutations and characterised as a new variant B.1.525, adding that so far, this has been detected among cases in five states in the country.

A medical expert with the Wuse District Hospital, Dr Kwaifa Ibrahim, said the infectious rate of the second wave was higher than the first wave, adding that it could as a result of more tests conducted this time around.

The consultant said the way forward is to keep to the universal measures that are prescribed and also continue to look forward to the vaccine because it is the ultimate.

“Even when the vaccines come and they are administered, we must still continue to practice the measures, that is the only way we can be protected,” he said.