Nigeria, despite having reported its first case of COVID-19 nearly two months ago and having a population of over 190 million, still has fewer than two dozen confirmed cases– a stark contrast to the over 15,000 reported in the US, as of Sunday.
The first cases of COVID-19 were reported in the west African nation on 28 January 2020, with the country’s first death on Monday and a total of 33 active cases, with two people now recovered.
Ifeanyi Nsofor, is a senior New Voices fellow at the Aspen Institute and director of policy and advocacy at Nigeria Health Watch and he said tropical countries have the advantage of having built capacity over the years from managing frequent, smaller outbreaks.
Nsofor said the Nigerian Centre for Disease Control (NCDC) has been investing in epidemic preparedness for the past three years and has helped to set up Public Health Emergency Operations Centers (PHEOCs) in 23 out of the 36 states inside Nigeria.
“With hindsight, the U.S. should not have cut its Centres for Disease Control’s budget by 20% in 2018.”
“These PHEOCs help states to detect, prevent, monitor and respond to infectious disease emergencies,” he said, adding Nigeria’s experience managing the Ebola outbreak also helped it to be better prepared for COVID-19.
“Reporting the index case was done within 48 hours of the Italian’s arrival in Nigeria and since then the NCDC has been giving regular daily updates and also revising its public health advisories,” he said.
In a recent article, Nsofor was clear on the lesson that the US should take from Nigeria: preparation, transparency and lab testing.
“The US should have set up PHEOCs long before this Coronavirus pandemic,” he wrote.
He also added Nigeria’s federal and state authorities wasted no time in communicating clearly with the public and four testing centers spread geographically throughout the country were upgraded to serve as reference laboratories.
Adaora Okoli is a Nigerian doctor, currently working as an internal medicine resident at Tulane University in New Orleans and she said Nigeria’s experience with multiple infectious diseases including Ebola cut both ways.
“Dealing with multiple outbreaks has certainly helped with infection control and prevention techniques, however, there is a tendency towards desensitization,” she said, adding that Nigeria currently has an ‘out-of-control’ surge of Lassa Fever cases.
She also said that despite the low number of confirmed cases, there are still many aspects in which Nigeria could be doing better.
“Many believe we are immune to the virus due to claims that it doesn’t thrive well in tropical regions,” Okoli said, “This has led to complacency in government and individual preparedness.”
“We are not testing enough people because we don’t have enough test kits.”
Nsofor said a disadvantage for tropical countries such as Nigeria is the poor public transport network.
“Public buses are usually packed with people, so instituting social distancing then becomes very challenging,” he said, adding that another disadvantage is that there are huge portions of the economy that work informally, on a day-to-day basis, so asking people to work remotely would not make a dent to the overall risk.
According to Okoli, there is another factor that could complicate the response: doctors in Abuja, the Nigerian capital, went on strike after the third case of COVID19 in the country was announced.
“The resident doctors claimed to not have been paid their salaries for the last two months and did not want to sacrifice themselves for a country that is not ready to protect them,” Okoli said, “When the healthcare workforce does not think the country is looking out for them, when there is an outbreak, doctors will not volunteer.”
Scientists from across the world, including the global south, have been working day and night to better understand SARS-CoV-2, the virus causing the novel coronavirus disease COVID-19.
One of these scientists is Colombian researcher Javier Jaimes, who works at Cornell University.
Jaimes said his main project right now is to study the novel coronavirus spike (S) protein and how it is activated to enable the infection of human cells. If scientists can better understand this interaction, they can better understand the virus.
By Andrew Wight