New cases of coronavirus infections being recorded in Osun, Ekiti and other states indicate that community spread is rising in Nigeria, underscoring the increased need for social distancing which some government activities may even compromise.
Akin Abayomi, Lagos State commissioner for health, while briefing journalists on March 31 said that cases of community transmission were rising.
Community transmission means people have been infected with the virus in an area, including some who are not sure how or where they become infected, says the United States Center for Disease Control (CDC).
Large crowds converging at centres chosen by state governments to distribute food may soon become COVID-19 vectors unless smarter ways are devised to distribute critically needed provisions for lowly Nigerians.
Nigerian prisons have always been inadequate to house all the inmates sent there such that overcrowding has become a norm. Though there has been a directive from the minister of interior to decongest custodial centres, many are still overcrowded.
“Kaduna Custodial Centre was built to house 540 inmates. It currently has well over 1,200 inmates. Urgent decongestion is better than a jail break. A COVID-19 outbreak in there would be catastrophic,” said
Oluwafunke Adeoye, who works for a non-profit devoted to human rights, in a social media post.
Adeoye also said that the Ikoyi Custodial Centre was built to house 800 inmates but “there were 3,360 inmates locked in there” as at March 2020. “Social distancing or self-isolation would be impossible.”
As the Nigerian police begin a crackdown on defaulters of the lockdown directive issued by the president, their characteristic overzealousness and brutality will lead to a boost in the numbers of people detained, further helping community spread of the virus.
The remark by Hakeem Odumosu, Lagos State commissioner of police, in a television programme that official ID cards are not sufficient proof that a person is engaged in essential services opens a path for unscrupulous police to abuse Nigerians.
Already, there are social media posts of residents being abused, including an unconfirmed fatality in Ikorodu. Our correspondent witnessed several people detained and led into a police station for violating the restrictions imposed on movements.
Health officials warn that community spread elevates the need for more precautions like social distancing. The droplets that someone creates when he sneezes or coughs can remain in the air and infect someone else for 30 minutes, increasing the risk for community spread, experts warn.
Nigeria’s response to the coronavirus threat has largely been reactive as suspected cases have been patients who observed symptoms and presented themselves for evaluation.
According to the Nigerian Centre for Disease Control (NCDC), there are close to 1,000 suspected cases of coronavirus in Nigeria. 151 people have tested positive of which nine have been discharged, with two deaths recorded.
NCDC is also trying to trace the contact of over 6,000 people who may have returned to the country from high-risk areas and those who may have had contact with them.
New cases being announced may indicate that infected people are now reaching the final stages of their incubation, unravelling challenges with tracing contacts of individuals who tested positive for coronavirus after returning to the country.
“Contact tracing is one of the major problems the country is going to have,” warned Francis Faduyile, president, Nigerian Medical Association, while answering questions on a programme on Channels Television recently.
According to information from the Ministry of Health, officials have been unable to trace the contact of those who had returned abroad relying on people to voluntarily heed their counsel to self-isolate.
Contact tracing is the process of identifying, accessing and managing people who have been exposed to a disease to prevent onward transmission. During the Ebola epidemic of 2014, contact tracing was helpful for rapid identification of people at the onset of symptoms and promptly isolating them.
According to the WHO, experience from previous Ebola crises demonstrated contact tracing had posed serious challenges.
The factors, according to a WHO study, include wide geographical expanse of the EVD outbreak (involving urban and rural areas), insufficient resources (human, financial and logistics), community resistance and to some extent limited access to affected communities.
Health officials engaging in contact tracing need to be skilled in the assessment of the COVID-19 symptoms, interviewing techniques and counseling, according to experts. It is not clear how much efforts have been in place since the last Ebola outbreak to re-skill officials.
Contact tracing in Nigeria is further beset by familiar challenges with inadequate data, dishonest documentation, and fear of stigmatisation which may prompt some to keep their symptoms quiet and increase the likelihood of the disease spreading.
Nigeria has shut down economic activities in Lagos and Abuja, and Ogun State will soon follow. Other states have similarly started a lockdown and creating social distancing guidelines.
Medical experts say this is not the time to be complacent, especially as Nigeria lacks healthcare facilities that can contain a wide spread of the virus.
The United States prevaricated when the first community spread case was unravelled with government officials calling experts alarmists. Within days the disease grew in geometric proportions and now there are over 3,800 deaths and over 185,000 infections at the time of this reporting.
Faduyile reassured that a diagnosis of the coronavirus does not translate to a death sentence considering that case-fatality ratio is between 2 and 4 percent, indicating that those infected have a higher chance of recovering from the virus than it killing them.
ISAAC ANYAOGU
