History
The virus SARSCOV-2 is now known the world over as the cause of the pandemic disease known as COVID-19. The effect of the virus was first noted in Wuhan, China, in December 2019. A pattern of illness characterized by fever, cough, difficulty in breathing, severe weakness and body pains as well as a variety of other possible symptoms was observed in increasing numbers. Over time the source was traced to a corona virus that appeared to have ‘jumped’ from an animal host to infect a human victim. There were two possibilities – that the virus had mutated to a more harmful variant before it made the ‘jump’, or that it mutated after getting into the human body, becoming capable of human to human transmission.
The suspected animal hosts were bats and pangolins.
It would appear that the Chinese authorities were slow off the mark and initially reluctant to admit the full scale of the COVID-19 problem when it started in Wuhan. China, despite the friendly face it seeks to present to the world, is an authoritarian society where information flow to Chinese citizens and the outside world is closely controlled by the ruling Communist Party.
In the event, the approach of the Chinese New Year became a complicating issue. The New Year is the largest celebration in the Chinese calendar. It is the time when Chinese on the mainland as well as Chinese from all across the world travel home to celebrate with their families. The world at large was only just becoming aware that something big and bad was going on in Wuhan and threatening other districts of China when the New Year mass movement began.
Eventually the government of China went into overdrive, locking down Wuhan and scaling up medical services by dramatic gestures such as rushing through the construction of two mega hospitals in a matter of days. The scale of the response opened the eyes of the world to the fact that a major crisis was unfolding, and the international community began to take notice.
On 30th January 2020, the World Health Organization (WHO) declared the outbreak of CoVID-19 as a Public Health Emergency of International Concern (PHEIC).
It was meant to highlight concern about the spread of the disease, but also to let it be known that it still fell short of the criteria for a pandemic.
Meanwhile, with uniquely deadly efficiency, COVID-19 proceeded to seep its way – first into China’s Asian neighbours, then eventually into the European mainland and the Americas.
By the time the WHO Director General, Dr Tedros Adhanom Ghebreyesus declared the disease a pandemic on the 11th of March 2020, the horse had bolted from the stables, and all the world could do was scramble frantically to catch up with it.
COVID-19 has to date led to the greatest social, economic and health disruption the world has seen in peacetime in living memory. It has established a presence in 195 countries.
While it has not yet reached the cataclysmic proportions of the so-called ‘Spanish Flu’- the influenza pandemic which devastated the world (including four year old ‘Nigeria’, which lost an estimated 500,000 dead from a population that was less than one tenth of its present population!) from January 1918 to December 2020, infecting a quarter of the world’s population and causing an estimated 50 million deaths.
But in an age where human beings have walked on the moon and man is inclined to see himself as the master of the universe, armed with a solution to everything, COVID-19 has brought man’s Ego to heel in a way which even the Spanish flu never did. It has the most powerful nation the world has ever seen, the United States of America, quaking in its grip, with a leader who is forced every new day to eat the blustery words he uttered only yesterday in a vain effort to reassure his people.
The global order is in shambles. The most economically successful nations in the world are facing recession, and the behemoths of Big Business are facing bankruptcy. More than two billion of the world’s population, including India, are in partial or full lock-down.
COVID-19 in Nigeria
On the 22nd of February, an Italian national, who had recently arrived in Lagos became the first documented patient with the virus in Nigeria. Despite the fact that Lagos, the host state had been preparing for the possibility of just such a development and had activated an Incident Command Centre four weeks before the index case, it was a bit of a rude awakening for the nation when the pandemic finally arrived on its shores. The patient was admitted to the Isolation Unit at the Infectious Diseases Hospital in Yaba.
In time, he made a full recovery from the illness, and he was discharged after several days of treatment.
Since the index case, the numbers of ‘Persons of Interest’ (POI) and ‘Confirmed Cases’ have risen, but perhaps not as steeply as some people might have expected given the figures elsewhere on the continent and in the world at large.
Interesting emerging trends (as at the end of March, 2020) included the fact that 82% of total confirmed cases were people who had recently returned from nations known as hotspots of the disease, including China, the UK and the USA. 16% were persons who had not travelled, but who had been in contact
with others who had. The origin of infection for 2% of the cases could not be ascertained. 16% of all confirmed cases were foreign nationals, and 84% were Nigerians.
According to a situation report from the office of the Honourable Commissioner for Health in Lagos State, as at the end of March, 2,645 persons had been kept under Surveillance since the arrival of CoVID-19 as ‘Persons Of Interest’. Of these, 352 had gone beyond the Incubation Period of the disease and their follow-up had been discontinued.
Lagos has clearly learned from experience and deepened the infrastructure it developed since 2014 when it efficiently contained a threatened epidemic of Ebola Virus Disease. From the NCDC analysis, the virus has already spread to at least 13 of the states in the nation, and possibly more. Lagos (with 98), Abuja (38) and Osun State (20) are the epicentres.
THE RESPONSE SO FAR
From the outbreak of the pandemic and its first incursion into Nigeria, Lagos State, through the agency of its Incident Command Centre, led by the Governor, Mr. Babajide Sanwoolu, and the Ministry of Health, led by the Honourable Commissioner, Prof Akin Abayomi have, directly and in close alliance with the Nigeria Centre for Disease Control (led by the Director General, Dr Chikwe Ihekweazu), been working assiduously to treat confirmed cases, as well as to contain the disease and stop or slow its spread into the Nigerian
population. The elements of this Containment strategy include screening of passengers coming into the country, especially those coming from countries where the disease is already widespread. People coming in from affected countries were routinely monitored during a prescribed period of self-quarantine.
They proceeded to scale up human and physical capacity in the isolation centre, and to train staff from other parts of the country who, unlike Lagos, had not previously been tasked with dealing with such a major public health challenge.
In the course of time, travel restrictions were imposed on the recognized ‘hot zones’ of CoVID 19.
Confirmation of the presence of CoVID 19 to date has been through the taking of nasal swabs and running the test through a PCR machine.
There are currently fewer than ten functioning units of the equipment in Nigeria, but there are said to be plans to scale up in short order.
The major Isolation Centre in Lagos is located at the Infectious Diseases Hospital in Ebute Metta. A collaborative private initiative with Guaranty Trust Bank delivered a 100 Bed Isolation Centre, built
in the space of one week, on the grounds of the Mobolaji Johnson Stadium in Onikan.
There are contingency plans to build other Isolation Centres in Stadia and other public grounds as the need arises. A private initiative by a group of professionals by the name of Young Presidents Organization, led by Mrs. Fola Laoye, Dr Richard Ajayi and Dr Ola Brown has set up a field hospital on the grounds of Landmark Centre in Victoria Island and is shortly to commence operations. Some other states in the federation have created Isolation facilities for the use of their citizens.
Femi Olugbile
Femi Olugbile, a well respected doctor and health administrator, is also a prolific essayist. He pioneered the renaissance of the Lagos State Teaching Hospital where he was chief medical director for years and also served as permanent secretary for Lagos State Ministry of Health.
