A shortage of testing capacity at government-run laboratories has failed many Nigerians seeking diagnosis for COVID-19, and their only solace as tests at private labs is out of the reach of many.
A deadlier variant of the virus has caused a second wave of infections. The contagion is spreading at a faster rate, sending more people into hospital wards but access to testing is hardly catching up.
Some medical facilities in major cities of Lagos, FCT and Kaduna are overwhelmed, with patients competing for ambulance services, oxygen supply and ventilators already short in supply.
The government has maintained the approach it adopted during the first wave of restricting free testing to symptomatic people – that is, people who show signs associated with the virus. And those confirmed to have been in contact with positive patients. Health experts consider this a disservice to the current situation at hand.
Richard Ajayi, board chairman, Synlab Nigeria, one of the approved private laboratories, argues that the government should be providing testing for everybody in the face of an escalating public health crisis.
But, “I think we are dealing with a significant resource challenge. The amount of tests is clearly limited and the private sector should be there for succour. It is not an ideal situation but I think the government is trying to make the best of a bad situation,” Ajayi informs BusinessDay.
To reduce the pressure on public facilities, asymptomatic people – those who don’t show signs they have the virus – and those who want to be tested before travelling were restricted to private laboratories where a test costs N50,400 ($132), one of the priciest COVID-19 tests in Africa.
Nigerians pay 59 percent higher for COVID-19 test than peers in South Africa; 43 percent more than what is paid in Senegal; 24 percent above Kenya and Ghana, and 75 percent higher than India’s.
Read also: Nigeria, South Africa take diverging paths to Covid vaccination
As the second wave rages with roughly 7,000 cases confirmed so far in 2021, many asymptomatic people who are potentially super spreaders are not getting tested due to the high cost of testing.
Meanwhile, some critically ill ones who the public labs are meant to serve have been forced to turn to private labs to avoid dying while waiting.
The chairman of Synlab also says with the lack of facilities to isolate, the government must do better to ensure that sick people at least gain access to testing and treatment.
“We need to be careful of how we select those at risk which are the people with significant comorbidity,” he states.
Chris Bode, chief medical director (CMD) at Lagos University Teaching Hospital (LUTH), has raised alarm over the surge in the rate of people treating malaria instead of going for the COVID-19 test.
A managing director of a private hospital in Lagos has described the second wave as a tsunami. In a LinkedIn post she says patients are both unable and unwilling to pay for treatment, despite requiring it.
“My phones have been ringing off the hook, with patients crowding in and around our holding bay for COVID-19 positive patients. Making tough calls: who to take into the treatment centre and who to put on one of our four ventilators are ethical decisions I’ve never had to make in over 38 years,” she wrote.
As of late December, sources familiar with Nigeria’s first licensed private hospital to treat COVID-19, First Cardiology, told BusinessDay that the hospital’s capacity was being overstretched.
Hotels such as Sheraton Ikeja have been stepping into the role of isolation centres for wealthy Nigerians and expatriates, following increased importation of the virus by inbound travellers.
Nigeria has tested slightly over 1 million people, less than 1 percent of its population estimated at 206 million by the World Bank.
Within a year since the virus outbreak, the number of government-run labs has increased from five to 71 across the country. Though the country expanded its capacity for testing shortage still persists.
So far, the largest African country by population and economy is ninth on Africa’s testing list, as South Africa leads with a total of 6.8 million tests, Morocco with 4.5 million and Ethiopia 1.8 million.
Lagos, Nigeria’s economic capital and home to over 20 million people, has run over 236,212 tests, 45 percent of which the private laboratories account for despite coming late to the testing party.
Need for change of tactics
According to a BusinessDay source at one of the private laboratories in Lekki, Lagos, the cost of running a laboratory from importation of reagents under high exchange rate to purchase of protective gears and rising electricity cost among others adds to the cost of providing adequate service.
With the resurgence of the pandemic, the laboratories in December saw 45 percent positivity rate from 300 samples tested in a day.
“We make use of reagents that have to be brought in from South Korea. When we buy from Korea, we pay legal fees including freight, custom duty, NAFDAC registration fee. Across the entire supply chain, you are parting with money all along. By the time you do this across the entire value chain and somebody is telling you to test for N5,000 or N10,000? It is not feasible,” he told BusinessDay.
“Is it okay to do business and make a loss? We don’t even go for home collection without a complete new set of PPE that costs N10,500 per person,” the source said further.
Certainly, Nigeria needs to decentralise and increase the testing centres and get them closer to the people, Oyewale Tomori, professor of virology and former vice-chancellor of Redeemer’s University, said in an interview with BusinessDay.
“But that is not enough. The labs must be provided with adequate test kits to meet the demand, and these labs should operate 24 hours with well compensated lab workforce working in shifts. Through these steps we can reduce the turnaround time for lab tests,” he said.
