Year Ender: The Trajectory of COVID-19, Need to Intensify Non-pharmaceutical Measures



The outbreak of Coronavirus (COVID-19), as 2019 was winding down in Wuhan, China, has overwhelmed medical institutions across the world, forcing global change in lifestyle, economies, socialising, and other facets of human lives.

In Nigeria, the index case of the outbreak was brought into the country by an Italian businessman. It was confirmed by the Federal Ministry of Health (FMOH) on Feb. 27, making Nigeria the third country in Africa to recognise an imported COVID-19 case after Egypt and Algeria.

The index case was managed at the Infectious Disease Hospital (IDH), Lagos, while the Lagos State Ministry of Health, Nigeria Centre for Disease Control (NCDC) and FMOH, swung into action in contact tracing the possible infection, isolating and testing of suspected cases in order to reduce spread of the virus, which World Health Organisation (WHO) later classified as pandemic.

 

 

 

 

 

 

 

However, the Lagos State Government, through its Commissioner for Health, Prof. Akin Abayomi, advised the public against panic.

Abayomi encouraged them to embrace precautionary measures of regular handwashing, good respiratory hygiene, avoid touching of the eyes and nose to reduce their risk of infection.

To further protect lives of the citizenry, the Federal and State Governments intensified public awareness and sensitisation on the case definition of the virus, with admonition to anyone exhibiting any of the symptoms to isolate and call the state’s or Nigeria Centre for Disease Control (NCDC) emergency number for test.

 

 

 

 

 

 

Worried by the raging spread of the virus in Nigeria, President Muhammadu Buhari, in a precautionary move aimed at curtailing the spread of the virus, through the Federal Ministry of Education, on March 19 ordered the immediate closure of all educational institutions, tertiary, secondary and primary schools nationwide.

Thereafter, it ordered closure of its international airports to travellers coming from countries where the virus was endemic.

Although, this move was applauded, it came a bit late, as many believed that governments should have been more proactive before the virus finally became endemic in the country.

 

 

 

 

 

 

 

On March 30, President Buhari took a bold step, and subsequently ordered restriction of vehicular and people’s movement in Lagos, Ogun and Abuja for an initial period of 14 days, extending it for an additional 21 days, and later added Kano State.

With gradual spread of the virus in the country, Lagos soon became the epicentre of the pandemic due to fast spreading of infection in the state.

The state government, thereafter, implemented an aggressive response to COVID-19, leveraging on its existing epidemic preparedness during the Ebola outbreak and learning from other parts of the globe where transmission began earlier.

 

 

 

 

 

 

 

Lagos State Government utilised various strategies in its COVID-19 response, ranging from expanding its testing and sampling collection capacity, increased numbers of isolation centres, introduced telemedicine, accreditation of seven private laboratories to boost its testing capacity and three private hospitals for case management, among others.

On April 25, Gov. Babajide Sanwo-Olu of Lagos State, announced compulsory use of face masks by residents as part of the measures to stem the spread of COVID-19 pandemic in the state.

Sanwo-Olu said the rise in confirmed cases of COVID-19 in the state indicated a fast spread of community transmission.

 

 

 

 

 

 

 

By May 4, when the ‘gradual easing’ of COVID-19 lockdown imposed by the Federal Government on Lagos, Ogun and Abuja started, Lagos’ confirmed COVID-19 infections had increased to 1,199, with recovered and discharged patients put at 261, while 31 fatalities were recorded.

At the peak of the virus in June, the state grappled with challenges of bed space at its isolation centres, thus the introduction of home-based treatment for COVID-19 patients.

 

 

 

 

 

 

Patients that were asymptomatic and those with mild symptoms qualified for home-based treatment, while those with moderate to severe symptoms received treatment at the isolation centres.

Telemedicine was used to monitor patients under the home-based care, and COVID-19 packs containing medication, while thermometer for temperature measurement and tools to check oxygen level were given to each of the patients.

On Aug. 22, Lagos recorded 404 confirmed cases, which was one of its highest daily infection figure, increasing the state’s infection figures to 17,764.

 

 

 

 

 

 

 

Impressively, the various strategies deployed by the state was able to flatten the curve by September, as it had few cases in its isolation centres, making it to shut most of the isolation centres in the state.

However, the Presidential Task Force (PTF) on COVID-19, set up in the wake of the pandemic, further relaxed the COVID-19 restriction to allow religious bodies to hold congregational services. Such services should have half of the population of the mosques or churches in attendance, while others should be encouraged to continue to worship online.

Schools were also allowed to resume in September, after six months of closure.

 

 

 

 

 

 

With the relaxation, many citizens began to disregard COVID-19 safety protocols with the erroneous belief that COVID-19 was no longer in the state or Nigeria in general.

Ironically, if someone was seen adorning facemask in public, people look at the person strangely, while some will shout, “Corona is no longer in Nigeria, don’t suffocate yourself with the mask you are wearing”.

By October, as earlier predicted by medical practitioners, countries like UK, France and Germany, announced emergence of the second wave of COVID-19, and declared another lockdown to mitigate the effect of the pandemic.

 

 

 

 

 

 

With the second wave of the virus comes the discovery of a new strain of COVID-19 that have a high rate of transmission being reported in the UK and South-Africa.

In Nigeria, the PTF, at one of its meetings in December, warned of the imminent second wave of the COVID-19 in the country.

Its Chairman, Mr Boss Mustapha, also the Secretary to the Federal Government, advised the citizens to continue to follow all COVID-19 guidelines and protocols to reduce the spread of the virus.

On Dec. 17, the country recorded 1,145 confirmed cases, being the highest numbers of daily infection figures since inception of the pandemic.

 

 

 

 

 

 

In spite of the spike in daily record, and several public health warnings, most people continue to flagrantly disregard COVID-19 safety protocols as large religious gatherings, parties in celebration of the Christmas season continued unabatedly in Lagos, and some other states.

A Public Health Physician, Dr David Johnson, said that with the new strain of COVID-19 and the second wave comes the urgency for people to take personal responsibility and embrace non-pharmaceutical measures to protect themselves and the loved ones, pending when the vaccine will be deployed to the country.

Johnson said strategies that assisted to flatten the pandemic curve during the first wave of COVID-19 should be intensified.

 

 

 

 

 

 

 

Also, Dr Tunji Akintade, former Chairman, Association of General and Private Medical Practitioners of Nigeria, said governments should walk the talk by leading the way through enforcement of penalties and sanctions to defaulters of COVID-19 safety protocols, irrespective of the status or connection of defaulters.

Akintade also tasked the state government on the reintroduction of compulsory wearing of facemasks in public transport, especially Bus Rapid Transit (BRT), provision of functional water system at all Primary Healthcare Centres, General Hospitals and teaching hospitals to reduce rate of transmission of the virus.

 

 

 

 

 

 

The health expert noted that some ministries and agencies of government lacked water, sanitation and hygiene, thus increasing their risk of exposure to diseases, adding that government should address such issues.

He cited that policies that would make people converge like the NIN registration at NIMC should be suspended to protect citizens against infection, while attempting to register.

Akintade, however, expressed optimism in Nigeria’s ability to flatten the curve of the second wave of COVID-19 without much disruption to health and socioeconomic activities.

 

 

 

 

 

 

 

 

As Lagos continue to record an increase in COVID-19 infections in recent weeks, Abayomi said that residents would need to make lifestyle adjustments to living with the pandemic.

The commissioner stressed that living with the pandemic involves adhering to all non-pharmaceutical interventions, which include, proper and regular use of facemask, physical distancing guidelines and avoiding mass gatherings.

 

 

 

 

 

 

Others, according to him, are imbibing and practising regular hand and respiratory hygiene, submitting for tests, if symptomatic, self-isolating, if positive and presenting to an isolation centre for follow up.

The commissioner said that the state would continue to educate and engage citizens on safety protocols and the need to take responsibility against the infection, while also enforcing various guidelines and directives given by the government. (NAN)