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OPINION
Year : 2020  |  Volume : 18  |  Issue : 3  |  Page : 210-212

COVID-19 in Nigeria: Matters arising


1 International College, University of Chinese Academy of Sciences, Beijing, University of Chinese Academy of Sciences, Beijing, China; Department of Microbiology, Osun State University, Osogbo, Nigeria
2 Department of Microbiology, Osun State University, Osogbo, Nigeria

Date of Submission08-Apr-2020
Date of Decision12-Apr-2020
Date of Acceptance29-Apr-2020
Date of Web Publication22-May-2020

Correspondence Address:
Mr. Greater Kayode Oyejobi
Department of Microbiology, Osun State University, Oke-Baale, Osogbo 230212

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cmi.cmi_51_20

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How to cite this article:
Oyejobi GK, Olaniyan SO, Awopetu MJ. COVID-19 in Nigeria: Matters arising. Curr Med Issues 2020;18:210-2

How to cite this URL:
Oyejobi GK, Olaniyan SO, Awopetu MJ. COVID-19 in Nigeria: Matters arising. Curr Med Issues [serial online] 2020 [cited 2020 Oct 24];18:210-2. Available from: https://www.cmijournal.org/text.asp?2020/18/3/210/284736




  Overview Top


In a short time, COVID-19 has grown to become a household name. An infectious disease caused by a severe acute respiratory syndrome coronavirus 2, COVID-19 has been reported in 210 countries and territories around the world with a total of about 1,856,798 confirmed cases and 114,312 deaths as at the last update: April 13, 2020.[1],[2] The viral disease which was first reported as an outbreak in December 2019 in Wuhan city, Hubei province of China, has found its way across the globe and was declared a pandemic by the World Health Organization (WHO) on March 11, 2020.[3] The USA replaced China as the country with the highest coronavirus cases on March 26, 2020, while more than 92% of the global coronavirus cases are currently outside China. The ten most affected countries as on April 13, 2020, include the USA (560,566 cases, 22,125 deaths), Spain (166,831 cases, 17,209 deaths), Italy (156,363 cases, 19,899 deaths), France (132,591 cases, 14,393 deaths), Germany (127,854 cases, 3022 deaths), the United Kingdom (84,279 cases, 10,612 deaths), China (82,268 cases, 3343 deaths), Iran (71,686 cases, 4474 deaths), Turkey (56,956 cases, 1198 deaths), and Belgium (29,647 cases, 3600 deaths).[2] Scientists and public health officials around the globe have risen to the task of containing the rapid spread of the virus as much as possible.

Africa has also welcomed this “visitor” in a number of her countries, including Nigeria. Sub-Saharan Africa reported its first case in Nigeria on February 27, 2020, in an Italian man who had traveled to Nigeria from Milan. According to the Africa Centres for Disease Prevention and Control (Africa CDC), 14,524 COVID-19 cases have been reported in 52 of the 54 countries in Africa, with 788 deaths and 2570 recoveries, as on April 13, 2020.[4] The ten countries in Africa with the largest number of COVID-19 infections are South Africa (2173 cases, 25 deaths), Egypt (2065 cases, 159 deaths), Algeria (1914 cases, 293 deaths), Morocco (1661, 113 deaths), Cameroon (820 cases, 12 deaths), Tunisia (707 cases, 31 deaths), Ivory Coast (574 cases, 5 deaths), Ghana (566 cases, 8 deaths), Niger (529 cases, 12 deaths), and Burkina Faso (497 cases, 27 deaths).[2],[5]

Coronavirus crisis calls for concerns especially in Sub-Saharan Africa. According to the latest Africa's Pulse, the World Bank's twice yearly economic update for the region, growth in Sub-Saharan Africa has been significantly impacted by the ongoing coronavirus pandemic, and it is predicted to fall sharply from 2.4% in 2019 to between “-2.1% to -5.1%” in 2020, which may suggest the first recession in the region over the past 25 years. Hafez Ghanem, World Bank Vice President for Africa said “The COVID-19 pandemic is testing the limits of societies and economies across the world, and African countries are likely to be hit particularly hard.”[6]

Although there are no scientific evidence yet to confirm the role of the tropical conditions in Africa in the spread of COVID-19, among the several environmental factors that influence the survival and spread of respiratory viral infections, air temperature is important, which is a reason for more respiratory infections during cold (harmattan)/winter seasons.[7] Despite the uncertainties surrounding its spread, the COVID-19 may be following this pattern. A look at the temperature data of the most affected countries aside China – South Korea, Italy, Iran, and Spain – shows that the mean monthly temperatures between January and March of 2020 range between 6°C and 12°C. In Sub-Saharan Africa, most countries that have recorded cases of COVID-19 – such as South Africa, Nigeria, Senegal, Togo, Cameroon, and Benin – had mean monthly temperatures of 20°C to 32°C in this same period.[8] This suggests that there are marked temperature differences between the most affected (colder) and least affected countries (warmer) in the COVID-19 pandemic. However, this pattern alone cannot fully explain the current low number of cases in affected African countries.

According to the Nigeria Centre for Disease Control (NCDC), Nigeria has reported 323 cases with ten deaths as at the last update, April 12, 2020, with a fear of more cases in the coming days.[9] The WHO has outlined some basic protective measures for the public against the new coronavirus.[10] The Nigerian government has taken necessary steps to control the spread of COVID-19, which include campaigns through mobile short message service, radio and television programs to enlighten the public on best practices, social distancing, discouraging large public gatherings including closure of religious (worship) centers and schools, and a total lockdown in all the states of the country.[11] Other African countries have also adopted a number of strategies to contain the spread of the virus. For example, Rwanda, in its capital, Kigali, has set up portable sinks in public areas to encourage handwashing. The Government of Ghana has also imposed a ban on all public gatherings including conferences, funerals, festivals, political rallies, Church services, and Islamic worship since March 16, 2020.[12] Several countries in Africa, including Egypt, Ghana, Kenya, Morocco, Nigeria, Senegal, South Africa, Sudan, and Tunisia, have also suspended all international travels from the most-affected countries.[13]

As with other continents of the world, Africa is also experiencing high demand and global shortage of personal protective equipment (PPE) such as gloves, masks, and hand sanitizers. However, the WHO has been very active in the distribution of PPEs to countries with confirmed cases. The Chinese government has also been providing assistance, especially in the supply of ventilators and PPEs to African countries to help them contain the virus.

This review further outlines some public health concerns that relate to the use of masks, especially among rural dwellers and the reported number of COVID-19 cases in Nigeria.


  Reuse of Disposable Masks as a Protective Measure Against Covid-19: a Hidden Threat of Public Health Concern Top


Masks, being disposable, are to be worn for a short time and then disposed. Although masks contain filters that prevent germs from being spread, their use for a long time could jeopardize the protective effects and even increase the risk of other infections.

Although the WHO actually recommends the use of masks for healthy individuals only when taking care of a person with suspected COVID-19 infection,[14] it is only logical for everyone to use it when outside to reduce the risks of exposure to the infection, especially exposure to asymptomatic individuals.

Different nationals including Nigerians have been seen to wear masks in an attempt to protect themselves against COVID-19. However, the authors are concerned about the many Nigerians, especially rural dwellers who have little or no access to adequate supplies of masks to protect themselves. According to the National Population Commission of Nigeria, approximately 64% of the population lives in rural areas.[15] As it may also concern dwellers of urban areas, there is the fear of limited supply of masks, especially with the fact that there is no factory for the production of masks in Nigeria. The available quantities would hardly cover a population of about 200 million of Nigerians, coupled with the high cost of the available masks owing to limited supplies. We, therefore, hypothesize that people could be forced to use masks for a longer time than required, and therefore, fear that they could expose themselves to a number of other infections.

Breathing into masks provides a moist and conducive environment for microorganisms to thrive; thus, long use could result in other secondary infections, especially in immunocompromised individuals (elderly; people with underlying diseases, etc.). This is a public health concern.

We, therefore, suggest that awareness be raised about the proper wearing and use of masks among Nigerians. Furthermore, they should be made to understand that the use of masks is to be complemented by regular washing of hands, use of hand sanitizers, and other protective measures. This also calls for the government and other relevant agencies to look into making masks available in a quantity large enough to go round the people, and if sold, at a reasonable cost. We also suggest that some textile companies or related companies help to produce masks, as done in some other countries including China.


  There Could Be More Cases Than Reported: a Concern of Limited Testing Facilities Top


Unlike developed countries where there are large number of testing centers and facilities, Nigeria, as with some other African countries, is short on adequate facilities which have limited the number of people being tested. We, therefore, hypothesize that if more people had been tested, there could be more cases detected. In other words, no tests mean no positives, small tests mean small positives, and small positives result in small intervention plans.

According to the NCDC, there are just nine laboratories where COVID-19 can be tested,[9] to serve 36 states (and a federal capital territory) of the country. We fear that there are more cases, especially in areas where there are no testing facilities nearby, and this calls for concerns. Many key personalities (including elites and political class) in the country have been reported to test positive; a situation which could also suggest that such people have better access to the available testing facilities and can have themselves tested.

The authors, therefore, call on the NCDC to hasten to make more testing facilities available, at least one in each state of the country and also start conducting more tests at random for common citizens. We also suggest that the number of individuals being tested should be made available to the public, especially scientists/researchers, to keep us abreast of such parameters as the rate of spread, case per population, case per test ratio, and especially the rate at which preventive measures have been helpful.


  Conclusion Top


The authors call on the Nigerian government to focus on saving the lives and livelihoods of its citizens by improving on the current health systems and taking quick actions to minimize disruptions in food supply chains. We also recommend implementing social intervention programs, including cash transfers, distribution of food, and other relief materials to support citizens, especially those working in the informal sector.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Hui DS, Azhar EI, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health-the latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis 2020;91:264-6.  Back to cited text no. 1
    
2.
Worldometers. COVID-19 Coronavirus Pandemic; 2020. Available from: https://www.worldometers.info/coronavirus/?utm_campaign=homeAdUOA? [Last accessed on 2020 Apr 13].  Back to cited text no. 2
    
3.
World Health Organization. Opening Remarks at the Media Briefing on Covid-19; 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19-11-march-2020. [Last accessed on 2020 Apr 13].  Back to cited text no. 3
    
4.
Africa Center for Disease Control (Africa CDC). COVID-19; 2020. Available from: https://africacdc.org/covid-19/. [Last accessed on 2020 Apr 13].  Back to cited text no. 4
    
5.
Agency A. 10 Sub-Saharan African Nations with Most COVID-19 Cases; 2020. Available from: https://www.aa.com.tr/en/africa/10-sub-saharan-african-nations-with-most-covid-19-cases/1795554. [Last accessed on 2020 Apr 13].  Back to cited text no. 5
    
6.
The World Bank. COVID-19 (Coronavirus) Drives Sub-Saharan Africa TowardFirst Recession in 25 Years; 2020. Available from: https://www.worldbank.org/en/news/press-release/2020/04/09/covid-19-coronavirus-drives-sub-saharan-africa-toward- first-recession-in-25-years. [Last accessed on 2020 Apr 13].  Back to cited text no. 6
    
7.
D'Amato M, Molino A, Calabrese G, Cecchi L, Annesi-Maesano I, D'Amato G. The impact of cold on the respiratory tract and its consequences to respiratory health. Clin Trans Allergy 2018;8:20.  Back to cited text no. 7
    
8.
Inter Press Service. COVID-19 in Africa: Fewer Cases So Far, and More Preparation Needed; 2020. Available from: http://www.ipsnews.net/2020/03/covid-19-africa-fewer-cases-far-preparation-needed/. [Last accessed on 2020 Apr 13].  Back to cited text no. 8
    
9.
Nigeria Center for Disease Control (NCDC). Case Summary in Nigeria as at; 12 April, 2020. Available from: https://covid19.ncdc.gov.ng/. [Last accessed on 2020 Apr 13].  Back to cited text no. 9
    
10.
World Health Organization. Advice for Public; 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public. [Last accessed on 2020 Apr 13].  Back to cited text no. 10
    
11.
Cable News Network. Nigeria Bans Entry for Travelers from 13 Countries as it Announces Five New Cases of Coronavirus; 2020. Available from: https://edition.cnn.com/2020/03/18/africa/nigeria-coronavirus-travel-restrictions-intl/index.html. [Last accessed on 2020 Apr 13].  Back to cited text no. 11
    
12.
British Broadcasting Corporation (BBC). Coronavirus - Virus: Ghana Schools Closed, Religious, Sports Activities Chop Ban to Fight Covid-19 Disease; 2020. Available from: https://www.bbc.com/pidgin/tori-51904164. [Last accessed on 2020 Apr 13].  Back to cited text no. 12
    
13.
Quartz Africa. Africa's Largest City is Trying to Shut Down to Beat Coronavirus-that's Easier Said Than Done; 2020. Available from: https://qz.com/africa/1821361/coronavirus-lagos-nigeria-shuts-schools-ban-public-gatherings/. [Last accessed on 2020 Apr 13].  Back to cited text no. 13
    
14.
World Health Organization. When and How to Use Masks; 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks. [Last accessed on 2020 Apr 13].  Back to cited text no. 14
    
15.
National Population Commission (NPC), Nigeria and ICF Macro. Nigeria Demographic and Health Survey 2008. Abuja, Nigeria: National Population Commission and ICF Macro; 2009.  Back to cited text no. 15
    




 

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