As the number of cases with Covid-19, the novel coronavirus, rises in Nigeria implementing measures required to contain the deadly virus such as rapid testing and social distancing will test how fast government authorities and health facilities can stop it from spreading. Because there is no immunity and no vaccines yet, the best means to prevent it from spreading is to reduce close contacts.
Social distancing strategy which delays and reduces person-to-person transmission of the virus is applied on the individual and community level. For individuals, it involves non-contact greetings, keeping a one metre distance between people, staying home if ill. At the community level it involves closure of events where people gather together: schools, sports, entertainment, parties, churches and mosques.
Some measures have been taken such as shutting international air travel (which began yesterday) limiting social gatherings to no more than 20 people and the closure of schools, bars and nightclubs. These actions were taken swiftly after 9 of the 10 new cases announced on Saturday, 21 March arrived Lagos within the week.
Lagos, the commercial nerve centre of Nigeria, is densely populated. Millions live in cramped slums, have no access to water and have to work daily to earn a living; basic hygiene is a luxury. Add to that the misinformation about the virus and the lack of trust in government authorities. It will take a well thought out plan to enforce social distancing.
To counter public distrust the government must find credible people to lead its campaign to inform people about how contagious and lethal covid-19. It must work with religious leaders to communicate the benefits of community social distancing – large mass gatherings were people are close contact for hours are the perfect vehicle for spreading the virus within the community.
But time is running out. A community outbreak will overwhelm the already stretched officials of the Lagos State Ministry of Health, and the Nigeria Centre for Disease Control and health professionals.
During the Ebola outbreak in 2014, Africa’s biggest city quashed its spread through tracing (18,500 face-to-face visits), contact tracking (989 in total) testing and isolation. The World Health Organisation commended the state government for “a piece of world-class epidemiological detective work.”
Repeating the feat with covid-19 is possible but on an entirely different scale. Currently, 22 of the 30 cases reported – 2 discharged cases – are in Lagos. More tracing, tracking and testing will need to be done and faster than the current pace. A 10-minute test kit for coronavirus, developed by Mologic, a UK-based company, is weeks away from being produced. The test kits which will manufactured in Senegal as well will be sold at cost for $1 – the project is being funded with a grant from the UK government. Medical supplies donated to African countries by Jack Ma, Chinese billionaire and founder of Alibaba, arrived in Ethiopia over the weekend. Their distribution to other parts of the continent will be coordinated from Addis Ababa.
The logistics of getting the test kits to everyone and medical supplies to health workers will be daunting. In a race against time, the Lagos state government should shy from recalling Max, Gokada and Oride, the banned okada operators to help distribute the kits. It should work closely with the private sector, especially the telecommunications companies and the coding community in Yaba to develop a digital tracking system. Some kind of USSD code that Nigerians are familiar with to help monitor infected patients with varying degrees of symptoms so that attention and scarce medical resources can be devoted to those who need it most.
The joint effort of everyone is required to successfully contain the spread of Covid-19; we are all in this together.