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Nigeria cannot handle a shutdown

Last week, I argued against lockdown as the only means of stemming the spread of the novel Coronavirus steadily spreading across the country. My reason is simply that it is virtually impossible to achieve a lockdown in Nigeria because the majority of the citizens are living in extreme poverty, live by the day and cannot afford or survive a lockdown. What is more, the urban poor mostly live in overcrowded squalid shanties with no access to electricity, running water or modern toilet facilities. Hundreds of thousands of others can’t even afford the luxury of shanties and live on the streets. Therefore, concepts like self-isolation, social distancing and quarantining make very little sense in such context.

 I criticised the mainly elite and middle class Nigerians who propose such options as unimaginative and even narcissistic for wanting to sacrifice the poor (who did not play any role in the importation or spread of the disease in the first place) to ensure their own survival. The touted solution of locking down the country is tantamount to giving the poor two unpalatable options: death by Covid-19 or death by hunger. I pointed out that rich countries currently ordering lockdowns have a very high standard of living and on top of that provide palliatives and pay out to their citizens to survive the lockdown. For example, the United States alone as at last week had a record 3.3 million people filing for unemployment claims and the Congress passed a $2 trillion economic relief package.

But Nigeria is broke. With oil now selling below $20 (below the production cost in Nigeria) and Nigeria facing another recession, it is clear the government cannot provide the needed palliatives to ease the sufferings of the poor during a lockdown. Nigeria is also grossly ill-equipped and ill prepared to handle a pandemic of this nature because of its decrepit and collapsed health infrastructure. If the health infrastructure of the United Kingdom, with a health budget of £140 billion, is overstretched and buckling under the strain of Covid-19, one can only imagine what will happen in Nigeria with three times UK’s population but with a total national budget of only £25 billion. We have neither the capacity for mass testing nor the capacity to care for those suffering for those with the disease. Besides, with little or no supply of public electricity, Nigeria cannot successfully compel majority of its citizens to remain indoors under the sweltering heat.

I therefore gave a hint of the strategy Nigeria can adopt to tackle the virus by pointing to its overwhelming young population. I avoided going into details because I believe this is a medical issue and as a non-specialist, I am reluctant to dabble into such matters. But my readers have challenged me to lay out an alternative plan for tackling the dreaded pathogen without lockdown, social distancing and all other borrowed Euro-American concepts.

I believe the choice must not either death by hunger or death by Covid-19. We can evolve a wholly Nigerian solution to this pathogen based on our unique circumstances and, above all demographic composition, which will allow the poor to earn their living and skilfully manage the pathogen until it goes away. In any case, as we would soon discover, poor Nigerians will not remain indoors and watch their children die of hunger. They will chose to rather contract the virus than die of hunger.

According to data from the World Health Organisation (WHO) and other countries battling the epidemic, the most vulnerable population are the old (70 years and above) and those with pre-existing medical conditions. Still, according to WHO, more than 80 percent of patients have mild symptoms and will recover withhold any medical intervention, 14 percent will have severe symptoms including pneumonia and shortness of breath, 5 percent will have critical symptoms including respiratory failure, and 2 percent of cases are fatal, with the risk of death increasing with age.

It is therefore clear that Covid-19 disproportionately affects the old. Luckily, Nigeria has an overwhelmingly young population with the median age being 17.9 years.  Compared to the median age in Italy of 45.4 years, of China – 37 years, of America – 38.2 years and of Spain – 44.9, this presents Nigeria with a clear advantage. Families can be urged to isolate and care for their old and infirm while the government and healthcare system concentrate on the few that might need critical medical attention. The government should roll out a comprehensive sensitisation campaign about how to prevent the infection of the old and infirm and also, about possible medications to take in cases one experiences mild symptoms. Since the results of a couple of scientific research show promise in the use of hydroxychloroquine sulphate and Azithromycin and the approval of the drugs as emergency treatments to hospitalised patients by the American Food and Drug Administration (FDA), and the availability of the drugs over the counter in Nigeria, Nigerians will surely self-medicate. It is left for the government to decide whether it wants to sensitize people on the effective and harmless use of medications where necessary or whether it will continue towing the Euro-American line even when it is obvious it cannot control public access to these drugs.

  If over 80 percent of those who contract the virus will have only mild symptoms and would not need hospitalisation, and if only 3.1 percent of Nigerians are 65 years and above, commonsense will dictate that government should concentrate its efforts at protecting the old and infirm from getting infected than shutting down a country of overwhelmingly poor and young people, who constitute 97 percent of the population, in the vain hope of arresting the spread of the virus when the horse has already bolted. The best time to shut the door was in January when there wasn’t any reported case in Nigeria or even in February when the Italian was diagnosed with the pathogen. But, of course, the government continued to indulge the peripatetic tendencies of the elite and middle class, who have now imported the virus into the country. Shutting down the country now does not and will not arrest the spread of the virus. It will only lead to consequences the government does not expect and cannot handle.

 

Christopher Akor

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