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Published On: Wed, May 13th, 2020

COVID-19: Challenges of compliance and public confidence

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WEDNESDAY COLUMN by USSIJU MEDANER

info@medaner.com, justme4justice@yahoo.com

This is the eight piece I am writing in succession since the global outbreak of coronavirus. Then, it was China at risk, later an epidemic and now a pandemic. We have gone through stages of reactions and actions as a people and as a country. We closed our borders; though, a little bit late. We had hope the number would stay low; though we are disobedient to accompanied rules as a people. We claimed to be on top of the situations, donations flow in from all ends; yet the number of infection has conveniently grown to 4,399 and still counting
We have come this far because we have confused the situation we are in currently with regular and peculiar Nigerian situations. As citizens, we have been embolden to take rebellion against government orders as the only means of venting our disdain for the government and perceived government underperformance. But we are in a different time and situation now; no one is spared the implications of the ravaging virus; not the government officials , any individual or corporate body and so our only way out is to shelve our many differences and work in harmony, for once to defeat the virus.
There is only one way to defeat the virus: obedience or to use its common, modern term, compliance with COVID-19 protocols. From the onset, it has been marked that the grouping of mass testing, social/physical distancing, regular hand washing and self-isolation is a proven way to stay aloft the situation. The World Health Organisation(WHO) rolled out the instructions; NCDC has used and is still using every media to sing the instructions. There is nothing about the virus peculiar to any nation; we are all equally affected and have the same rules to follow.
I presume we have passed the era of doubt; COVID-19 is real and is a reality living with us currently. We must shelve all personal or religious views that tend to slow down efforts at bringing the pandemic to an end in Nigeria. Our first challenge would be that, individually, we must begin to take it as a responsibility and to the nation to protect ourselves by adhering strictly to basic protective rules.
At this period, a crucial moment, the government has the largest chunk of responsibility. I assume Nigerians have been disobedient to rules mostly because they see it as a way to express dissatisfaction with government performances overtime. And so, the government can begin by helping the citizens to develop trust in constituted authority; the government should probably help the citizens by evolving a proactive policy that would bring about cost reduction of essential consumables such as food items, electricity, transportation, petroleum, healthcare, etc.
Then, the government must be open to NNigerians through those saddled with the responsibility; meaning, the NCDC and PTF on COVID-19 should consider developing the practice of facing Nigerians with full and latest updates and developments regards the nation’s actions and reactions as events concerning COVID-19 unfold. It is advisable that the operational procedure of PTF/NCDC be amended to encourage citizens’ participation in the nation’s responses to the pandemic. It doesn’t make much sense that all we are being told every day is the new number of infected people, discharged patients and deaths. Nigerians deserves to know more, at least, specific locations and basic information on travel patterns of infected persons in the last few days before admission.
This set of information does not only make the pandemic real to everyone but to a larger extent force everyone to compliance. If I got the news that someone in my street or my community is infected, it would become easier for me to stay indoors and obey all safety rules if I need to go out because the reality of danger is a better check on behaviours. We would begin to see Nigerians willingly coming out and submitting themselves for testing because they are within proximity of infected persons.
Creating grounds for suspicion would not help our collective fight against the virus. It becomes utterly suspicious when states without testing laboratories are turning out figures of infection cases at speed that do not suggest the sample could have travelled to and fro nearest state with testing facilities. This creates doubts and if not quickly addressed would serve as a serious obstacle to our winning the battle. We have often times say that this is one time we must all together jettison selfish interests for the sake of the nation’s survival.
Improvement on PTF/NCDC response to the pandemic is yet another way to create the needed unity and synergy. For as long as there are perceptions that the developed capacity of PTF/NCDC to fight the pandemic is below standard as compared to fund availability, criticism is likely to replace needed support, and naturally people will become more uncooperative. Corporate bodies, institutions and individuals have demonstrated a high level of social responsibility by committing immense to the nation’s attack chest against the pandemic; Nigerians would want to see commensurate capacity building that shows accountability and seriousness on the part of the government.
Nigerians expect that by now there should be standard testing facilities in each of the 36 states and FCT. The current less than 30,000 total cumulative tests carried out, so far, in the country do not speak well of our readiness to combat the virus. How do we explain that Ghana with a population in the range of that of Lagos state would have developed capacity to carry out 160,300 tests in the space of time that we have done less than 30,000 tests and yet we claim we are doing great against the virus. Absolutely, that is an irony. The idea of transporting samples across states for testing till today points to maladministration of the COVID-19 chest and non-readiness of the PTF/NCDC to attack the pandemic in full force.
Media reports from some of our isolation centers are not palatable also; patients escaping from treatments while others are protesting poor conditions and services of the centers. There’s the viral video clip of one Susan Okpe, a visiting diasporan to Benue state who has been making repeated claims that she has been mistakenly identified as a Covid-19 positive and detained against her wish for 43 days. She claimed in the viral video that the information contained in the test result given to her – after over 15 days – were not correct and that NCDC has taken yet three additional samples from her without given her the corresponding test results; but is scheduling another test on her which she is protesting against. Now, these are a weighty allegations against the Nigerian COVID-19 response team. The public deserves to know what is going on as it does not speak well of us. How would Nigerians freely submit themselves for testing – with or without symptoms – when they see in the news and social how badly they would be handle at the treatment centers or the uncertainty that may follow. We should have gone beyond this, the resources are readily available; the president must demand active responses from PTF and NCDC. That is the only way the support and confidence of the masses could be guaranteed. It is however relieving, as reported, that the president has ordered for the collection of the acclaimed Covid-19 cure, gifted by the president of Madagascar.
Again, the worrisome issue of health care workers’ safety and welfare needs to be effectively addressed and resolved. We heard the news of health care workers absconding from hospitals in Kano and a few other states. We cannot totally blame them for their actions; even in the developed nations with almost sufficient facilities and provisions for health care givers safety, coronavirus has claimed lives of doctors, nurses and other medical and associated workers in the frontline in hundreds.
The first line of protection against incidents and fatalities in workplace is provision of adequate safety measures. It should be the priority of the government to give these workers maximum sense of safety. Availability of protective gears and wears; gloves, nose mask, goggles, sanitisers, head covers, gowns, medical scrubs, N95 face masks and the rest for these workers are not optional but a necessity.
As I write this piece, almost all hospitals and clinics in Nigeria are partially or totally closed to patients, because safety of their workers cannot be guaranteed. Nigerians are now dying from other ailments because there are no hospital to receive them. The government must wake up; not just COVID-19 frontline workers but all medical workers must be provided with needed and sufficient safety gears to allow free flow of medical care deliverance in the country.
Another responsibility of the government is the need to put our house in order and assemble manpower to design a framework for the development of indigenous capacity to respond to critical issues as the COVID-19 pandemic. Across the globe, nations are sponsoring local research efforts; countries are developing unique test kits; there are currently promising number of vaccines and retroviral drugs coming from a good number of nations. All we do in Nigeria right now and ever before is waiting for help and discovery from outside. We cannot continue like this. The last time I checked, we have a register of hundreds of professors and researchers in the field of medical sciences, ranging from virologists, microbiologists, biochemist, epidemiologists and the whole list of them, yet our universities and research laboratories are observing lockdown just as our churches and bars. This is an x-ray of what Nigeria’s education system has become. We have been complaining ever since that the system is rotten and absolutely non-productive. What is the use of an education system that cannot solve problems?
Then, we have to review our concept of lockdown relaxation. Outrightly, I have submitted that it is too early a time for us to attempt a relaxation of the lockdown because we have not seen or evolve a data feature that suggest grounds for relaxation of the lockdown. Our number is increasing and the risk is increasing and I hope the government would do the needful before the consequences of rushed relaxation hit us.
If eventually as it is becoming now, the government bows to economic pressure to relax or as well commence a systematic reopening of the economy, it would be important that we develop a feasible and enforceable lockdown exit strategy that would to a large extent minimise the chances of reprisal attack from the virus. The China model provide an insight to what is practicable. The entire Asian nations are deploying the same and currently the United Kingdom is understudying it for implementation. It represents a series of actions and achievement deliverables that leads to gradual and eventual relaxation of the lockdown. To begin with, the implementation of social distancing measure and lockdown must be absolutely effective in all affected states of the country. For China, effective lockdown over a period of 70 days led to the country’s figure peaking and the curve flattening out. There were arguments they were successful at that because the nation was authoritarian; but we have Italy, UK and a number of other countries getting promising results from the same measures. We need to re-clarify our social distancing and lockdown measures as a startup before we can comfortably ease out of the lockdown.
Till today, those measures are mere theories and rhetoric in Nigeria; except in few states and areas, life is as usual in most locations across the country. Earlier today, I drove around Abuja as a member of the FCT COVID-19 response team and I saw enough reasons why relaxing the lockdown was a mistake.
China maintained its lockdown till after the cases peaked, continued delaying mass gathering, and using tech to track COVID-19 patients.
Analysts at JPMorgan recently warned of risk of infection rebound when western countries ease out of the enforce lockdown. The analysts advised against relaxing social distancing measures too quickly. These effort, they submitted, should continue few weeks after concrete evidence that the infection rate has peaked. We see what is becoming of Ghana as a result of, permit me to say, over confidence leading to ease of the country’s lockdown and reopening. Today, the country is leading the pack of infected nations around the continent.
It is equally advised that countries shouldn’t relax their social distancing measures until they have provided enough intensive care units and hospital beds to respond to a possible second wave of infections.
Continue testing, including accurate antibody testing is also necessary to speed up our return to normalcy. There is no way we would be testing below 100,000 samples a day and consider ourselves safe considering our large population. If and when we get to this level of daily testing, then we can conveniently begin discussion on easing out the lockdown.
For now, I want to suggest that our current day time relaxation and night curfew is a wrong move. It lacks rational explanation; people are free to move about in the day, mixing up and possibly transmitting and contracting the virus but cannot go out in the night.
The only thing and the best thing for Nigeria currently is the brief Wednesday and Saturday market place relaxation while enforcement of social distancing and wearing of face mask are effectively enforced.
Arguments for religious centers re-opening right now are childish and should be ignored completely. We cannot afford under any guise any form of mass gathering as at now. Just last week, between Wednesday and Thursday, in a fish factory in Tama, Ghana, 533 workers returned positive to the virus – all. These 533 infection was traced to a single source; an infected worker who innocently came to work without knowing his status. Anyone suggesting a premature opening of the church or any space capable of congregating people is an enemy of the nation and selfish. It is definitely not in the interest of the nation. Just like politicians, some unscrupulous clergies must say something because it is needed for the survival of both their political and theological control values.
Schools should remain closed until the experts advise otherwise. The decision to open government offices for level 14 officers and above must be properly managed to prevent a backlash. The government must design proper identification of affected officers, their safety and continuous protection.
It is very important that the federal government as well as all state governments through the various ministry of Agriculture, must urgently design a robust measure for farmers to return to the farms. This should fall under essential services and must be treated accordingly. Post COVID-19, one thing we will need most to utterly pick up our life and return to normalcy is the availability and affordable access to food. Anything that successfully disrupt harvest later in the year might portend greater danger than the COVID-19 pandemic to the nation; as such we should proactively prevent such from happening.
We have all gone through difficult times in the last 7 weeks. As Christians, the churches have not been opened for worship; even in the month of Ramadan, the Muslims could not offer their necessary congregational prayers but have to pray in the confines of their homes. Our businesses are mostly closed; customers and incomes are lost; many jobs have been lost as a consequence of the lockdown, yet we have no other option but to only flow with the measures on ground and believe that is the only way we could be guaranteed of our safety and quick return to normalcy. Definitely, this condition is not permanent; if we all do what is individually expected of us, in no time, sooner, we will be out of this unpalatable situation. The only way we can all help ourselves and the country to speed up our return to normalcy is to realise that to get rid of COVID-19 in Nigeria is a collective responsibility. It is not what the government can do alone; as citizens, we must equally do our part. Social distancing, wearing of face mask, regular hand washing and obedience to all other stated precautionary measures are not mere suggestions but a necessity and an obligation on all of us.
Let us all look out for one another. We are fighting a common enemy and we cannot allow politics, religion or any other differences derail us from the part of unity required for us to win this war together. We had fought much more difficult wars in the past history of our dear nation; and so, I am optimistic that like ever before, we will overcome this present predicament and together we will come out as victors.
God bless the Federal Republic of Nigeria!

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