When should the lockdowns be released?

By Nneka Eze

There have been varied responses to COVID-19 globally including immigration restrictions, and full and partial lockdowns of movement at the local and national level. For those with the most stringent measures, state, local, and federal officials are reflecting on when lockdowns can be eased. In order to do so, three questions must be asked:

1. How well are we tracking the spread of COVID-19?
2. How well can we support our economically vulnerable populations?
3. When will there be a vaccine for COVID-19 or curative treatments for the virus?

In reflecting on the case of Nigeria, the government has put some of the most stringent measures according to the Oxford COVID-19 Government Response Tracker, even in comparison to its neighbouring countries. The stringency index calculates on seven policy indicators: School closing, Workplace closing, Cancel public events, Close public transport, public information campaigns, Restrictions on internal movement, and International travel controls.

In Ghana, the government announced a lifting of its partial lockdown orders earlier this week. However, schools will still remain closed, large gatherings are banned, and social distancing measures will continue. Further, the border will remain closed for two more weeks. Similarly, in Switzerland, the government announced a step-wise process to easing the lockdowns: first, small businesses providing services will reopen, and then a few weeks later primary/secondary schools and other shops will open.  Finally, other schools and entertainment facilities will also be re-opened. The lockdowns are planned to be eased over a six-week period, and these plans may change.

How well are we tracking the spread of COVID-19?

The Government of Nigeria has implemented several measures to track COVID-19 across the countries, including investing in ramping up its testing capacity – through additional laboratories, testing facilities, and testing kits – and has increased its contact tracing capacity. Nigeria has tested 7,153 samples as of April 21st, or 0.04 tests per thousand people. Earlier this week 26 COVID-19 testing centres were introduced covering Lagos State, and additional laboratory facilities are coming online across the country. Private sector coalitions, research institutes, foundations, and the military are donating supplies and facilities to increase Nigeria’s testing capacity.

In comparison, Ghana is ranked number one in Africa in terms of the number of tests administered per thousand people, having tested nearly 70,000 samples to-date (or 2.23 tests per thousand people) and having activated 100 laboratories across the country and using drone technology to support testing reach. 

The virus is contagious as demonstrated by exponential growth rates in cases, there are asymptomatic carriers of COVID-19 – those who do not exhibit symptoms, and the virus lasts on surfaces and in the air. Understanding who has the virus and how many people they have contacted, and keeping those people in self-isolation or quarantine will help to allow the rest of the population to move more freely. 

If we cannot urgently ramp up testing and contact tracing, releasing restrictions will lead to further spread of COVID-19. 

How well can we support our economically vulnerable populations?

The economic burden of the lockdowns has been a primary concern in Africa. Mobility data suggests that the partial lockdowns in Nigeria have already had significant impacts on economic activity: restrictions have led to reductions of 52% in retail and recreation movement (restaurants, cafes, malls, etc.), 35% reduction in grocery and pharmacy movement (grocery markets, farmers markets, drug stores, pharmacies), and a 48% reduction in the movement at transit stations compared to historical averages according to Google’s COVID-19 Community Mobility Report of April 11th. 

While the Government of Nigeria has launched several significant stimulus programmes at the Federal and State levels, including direct cash transfers and food aid, the reach of these programmes has been constrained. Unlike other countries, Nigeria does not have a deep or well-establish social safety net. Further, prior to COVID-19, many Nigerians were not saving and could not access credit according to Enhancing Financial Innovation and Access, a Nigerian NGO supporting financial inclusion. 

Financial inclusion is limited compared to other countries. As of 2018, only 3% of Nigerian adults used mobile money and 48.6% of adults had accounts with formal financial institutions. In comparison, 58% of adults in Ghana had accounts with formal financial institutions in 2017. 

The increased philanthropic activity from individuals and organisations highlights the deep inequality in Nigeria and may provide an opportunity for significant and direct transfers of wealth. However, the level of financial exclusion in Nigeria means that cash transfers are more difficult to execute – the formal financial sector cannot deliver cash to the most vulnerable population electronically, so other measures are required. 

Given these constraints, public and private sector measures to provide food through locally organised food drives and food voucher programmes in partnership with grocery stores will help support acute food security concerns. However, the ability to reach massive scale is still to be seen, and the need is significant. Nigeria has the largest population of people living in extreme poverty in the world. 

If we cannot provide cash to households in need and cannot deliver food to them, strict lockdown measures may lead to unrest, malnutrition, and potentially loss of lives.

When will there be a vaccine for COVID-19 or curative treatments for the virus?

Globally, there are over one hundred vaccine candidates in development including some that have started expedited Phase I and Phase II clinical trials in humans. Estimates suggest that it may take up to 18 months before vaccines can be produced at scale. Further, producing enough vaccines for the world’s population and distributing the vaccine to all countries will require widescale and challenging supply chain and logistics coordination.

If we cannot vaccinate the majority of the population, easing lockdowns will lead to further spread of COVID-19.

What does this mean for Nigeria?

Answering these three questions points to the difficulty of making decisions to ease the lockdowns. Many organisations, including our own, have run models on the potential impacts of COVID-19 on the Nigerian economy and jobs, as well as on the population given constraints in treatment, beds, and staffing for critical care. These models cannot decide how we place value on our lives – and we should not value the lives of poor people less than others. 

We have to be realistic about what we can do in addressing COVID-19 while managing Africa’s largest economy through an impending global recession.

If we do release lockdowns in Nigeria, I repeat recommendations from articles published in March, with further explanation:

• • The way we interact with one another must change until there is a vaccine readily available in Nigeria. At an individual level, we must consider

 

• Limit social interactions and protect the most vulnerable

 

• • • “Cocooning” – limit our direct contact with our elders and those with pre-existing conditions. They are in the highest risk bracket for exhibiting severe COVID-19 symptoms and will be most affected when lockdowns are released
    • Stop shaking hands, snapping, or holding hands. Stop hugging. Keep a distance to people, 2m is advisable 
    • Stay at home if you can. Do not go to the market except once per week. Work from home if this is an option.
  • Make changes to our daily behaviours
    • Wear face masks while in public. Given the shortages, non-medical masks should be worn in public, at all times.
    • Wash your hands for at least 20 seconds with soap water or else use alcohol-based hand sanitizer if the water is not available.
    • Stop touching your face, eyes, mouth, nose.
    • Keep everything clean. Do our small part to keep our workplaces and homes clean. Use Sapele water, other disinfectants. 
• Without a significant social safety net, practising social distancing will be especially difficult as people need to earn an income. At the country level, we should
  • Upscale testing capacity significantly, alongside contact tracing (to the second and third level)
  • Deploy technology, artificial intelligence that already exists to help detect potential high impact locations, to support decision-making
  • Deploy existing research and models on releasing restrictions, which normally require protecting the elderly and those with pre-existing conditions, continuing to limit large gatherings, considering how to re-open schools in the least affected areas, and requiring increased personal protection and hygiene at high-traffic locations
  • Deploy water and sanitation solutions in high-density areas that lack reliable solutions – hand washing stations and toilets, with involvement from communities on how to manage them sustainably
  • Develop relief funds that reduce the economic impact of any measures that restrict movement, using existing channels and digital financial services where possible, with a focus on the elderly and high-risk communities

Nneka Eze is Partner and Nigeria Director at Dalberg Advisors, a global group working to build a more inclusive and sustainable world.