The Presidential Task Force on COVID-19 last week Monday announced a new strategy to impose “precision lockdown” – or precisely targeted lockdown measures – in areas recording high rates of coronavirus infections in the country while the rest of the economy slowly reopens.
Boss Mustapha, head of the task force, said nine undisclosed local government areas have been identified for the new measure which would be complemented with the provision of palliatives.
Nigeria has as at Sunday reported 7,526 confirmed cases of coronavirus, with 2,174 recoveries and 221 deaths.
But what could precision lockdown look like in Nigeria and what is its implication for the country’s COVID-19 fight?
“My understanding is that it would be a data-driven approach, and likely targeted, rather than merely a small scale. So, that could mean (lockdowns on) a local government or a town – rather than a state,”
Ibraheem Abioye, an epidemiologist at Harvard School of Public Health, told BusinessDay.
The targeted lockdown will likely be implemented in settings where people necessarily have high contact with each other, and are in close proximity, increasing infection risk. This could be places of work or places of gathering.
“I expect that information from abroad would be considered as well. For instance, Nigeria has not had any outbreak cluster related to a church or mosque, but ample evidence from everywhere else suggests that these could be hotspots,” said Abioye. “Reopening those would be ill-advised.”
The epidemiologist said local information could also be adapted – “For instance, Oyo had an outbreak cluster with 30+ cases in one day from one company. (Nigerian journalist) Fisayo Soyombo suggested that infections could have occurred on the company bus. I don’t know his sources, but that sort of information is critical to guide the response.”
Abioye said the numbers of new cases in a place, as well as the numbers of people identified as persons of interest from contact tracing, could inform a decision to impose a lockdown on that local area or group. He was, however, unsure about the number of new cases that could trigger a precision lockdown.
The measure would require more resources from Nigeria’s frontline defence, NCDC.
“Obviously, this is potentially harder to implement. It would also need robust testing, tracing and isolating – which we are doing better at, but still struggling,” he said.
In India, the government’s containment strategy involves the identification of ‘hotspots’ into red, orange and green zones for implementing perimeter control, quarantine, contact tracing and other measures to stem the spread of the pandemic.
Indiatvnews.com explains that hotspots are further divided into large outbreaks, i.e., more than 15 cases within a geographical area or multiple clusters and clusters, those with less than 15 cases.
Based on the progress of disease and time of last reported case, the hotspots are graded by colour codes.
Red zones are districts/cities reporting a large number of cases/high growth rate.
Inclusion criteria are highest caseload districts contributing to more than 80 percent of cases in India, as a whole or a particular state, and/or districts with doubling rate less than four days (calculated every Monday for the last seven days, to be determined by the state government), the Indian news outlet said.
If containment measures work and there are no new confirmed cases after 14 days, the hotspot is categorised as orange and then green after another 14 days without new incidence.
For Nigeria, this could be similar and could incentivise groups or LGAs, as the case may be, to ensure the risk of spread within their communities are minimised.
For instance, if employees know their offices could be shut down due to an outbreak, they may be more inclined to prevent such by ensuring staff adhere strictly to safety measures.
But the risk is not eliminated and Nigeria is not in a comfortable place yet.
“Personally, I think one of the more important ways to respond is to continue to look at internet access for companies and to expand the ability of companies to work remotely,” said Abioye. “Let everyone who can work remotely do so. Decongest company buses.”
Abioye believes the recent decisions by the FG could be due to the economic toll of the lockdown, “despite the fact that the universal lockdown was not correctly implemented, and therefore only partly effective”.
One challenge that beset the country and still remains is testing – not capacity this time but the willingness of the public to get tested.
Abioye said the key issue is that people feel stigmatised by the response to the disease.
Isolating centrally, the white-masked men (in PPE) transporting people, the fact that this is a disease with considerable fatality – all of those are potentially stigmatising and people are refusing to get tested, as a result, he said, asking for more efforts to be put into reducing related social stigma.
Oluwaseun Ayodeji Osowobi, who recovered from the virus, told Aljazeera in April that she is advocating for the end of (COVID-19) stigmatisation because she “realised there is still a sort of stigma attached to the issue”.
“If we don’t address stigma, our testing capacity will not save us,” said Abioye.
