By Ibrahim Abdulwasiu
According to Nature, the spread of coronavirus disease 2019 (COVID-19) is becoming unstoppable and has already reached the necessary epidemiological criteria for it to be declared a pandemic by WHO, having infected more than 3 million people globally. Therefore, a coordinated global response is desperately needed to prepare health systems to meet this unprecedented challenge. Countries that have been unfortunate enough to have been exposed to this disease already have, paradoxically, very valuable lessons to pass on.
Although the containment measures implemented in China have at least for the moment reduced new cases by more than 95%, this reduction is not the case in Nigeria and other countries.
After the index case of Italian man on 27th of February 2020 and other infection cases in Lagos and Abuja, the Nigerian Government implemented extraordinary measures to limit viral transmission including restricting movement in the region with numbers of infection that intended to minimise the likelihood that people who are not infected come into contact with people who are infected, this was also implemented by various state government with exception of some. This decision is certainly courageous and important, but it is not enough. At present, our national health system’s capacity to effectively respond to the needs of those who are already infected and those to be infected require admission to an infectious care centre or isolation centre largely due to SARS-CoV-2 pneumonia, is a matter of grave concern.
Specifically, the percentage of patients admitted to infectious care centre reported daily in Nigeria, from April 22 up until May 10, was consistently between 873 and 4399 of patients who were actively infected.
In Nigeria, we have approximately FCT and 34 state with infected cases. Of these, as of May 10, 4399 are already patients with SARS-CoV-2 infection, and in the near future this number will progressively increase to the point that thousands of beds will soon be occupied by patients with COVID-19.
The number of people infected in Nigeria will probably impose a major strain on critical care facilities in our hospitals, some of which do not have adequate resources or staff to deal with this pandemic. In the state region, despite extraordinary efforts to restrict the movement of people at the expense of the Nigeria economy, we are dealing with an even greater fear that the number of patients present at the infectious care centre will become much greater than the system can cope with. The number of intensive care beds necessary to give the maximum number of patients the chance to be treated will reach several thousand, but the exact number is still a matter of discussion.
Health-care professionals have been working day and night since the first cases and in doing so some of them have become infected, and some have died. Some state are responding to the lack of PPE for Health workers seeking support from federal government and philanthropists.
However, the following predictions are presented to prepare our political leaders and those who bear the greatest responsibility for national health systems and the government at the local level, as well as local health authorities for what is predicted to happen in the days and weeks to come. They can then implement measures regarding staff resources and hospital beds and PPE to meet the challenges of this difficult time. Official numbers of infected people during the COVID-19 virus outbreak in Nigeria are indicative of the spread of the infection, and of the challenges that will be posed to Nigerian hospitals and, in particular, infectious disease control facilities. The number of patients who are infected has been published daily since Feb 27, 2020.
The most difficult prediction is the maximum number of infected patients that will be reached in Nigeria. This prediction is of crucial importance to plan for new facilities in Nigerian hospitals and to calculate the time period in which they need to be available. On the basis that the region in China or America cities that has a slightly similar population with Nigeria cities, we tentatively assumed that the trend for the maximum number of patients who are actively infected would be similar in the two territories. In doing so, we cannot overlook the fact that the effect of travel restrictions on the spread of the COVID-19 outbreak and the extraordinary community measures taken within and outside of Wuhan is unlikely to be replicated elsewhere. Therefore, it might not be unrealistic to assume that what is going to happen in Nigeria soon might mirror what happened in Italy, America, and China. Of course, it would have been more appropriate to directly compare Greater Wuhan with Lagos, the most seriously affected region in Nigeria at the moment.
In Nigeria, We do not currently have effective evidence to take into consideration to make more robust assumptions regarding the exact number of patients who will be infected in the future days or weeks as the daily active cases keep increasing. The aim now is to increase this number to safely meet urgent future needs. According to piece, we have only a few weeks to achieve this goal in terms of procuring personnel, technical equipment, and materials.
However, the Nigeria Centre For Disease Control should establishe Molecular Testing Lab in all the state of the Federation. Transportation of samples from state to state is wrong, numbers of factors can affect the standard of the samples before reaching the testing centre, ranging from environment fact, sample container or enzymatic reaction which can have effect on the sample negativity. Sample mixed up can also occur due to some reason at the time of analysis.
Lastly, to ensure better delivery of health services. It is expected that all the 774 Local Government should have their own Isolation Centre with the support of the State and Federal Government respectively. Transporting of patients with Covid-19 from a particular location to another may expose others to the virus.
Ibrahim Abdulwasiu is a Public Affairs Analyst.