In the last few weeks, there’s been a growing number of confirmed number of persons infected with COVID-19 in Nigeria. Compared to the figures the Nigeria Centre for Disease Control (NCDC) usually published in March and early April, the number has since increased exponentially in hundreds.
To the shock of many, On Friday, May 8, the NCDC recorded its highest daily figure since February 27 when Nigeria’s first coronavirus case was confirmed, as the number of confirmed cases jumped from 3,526 to 3,912, an increase of 386.
To some, the increase was alarming and pointing at an aggravated danger, but a critical look only shows that we are beginning to take the disease very seriously and doing the necessary to curb the spread of the virus with proactive measures.
Going by world trends, it was obvious that Nigeria was lagging behind in COVID-19 surveillance, contact tracing and testing when compared with its peers in other African countries. Ghana, for instance, had conducted over 100,000 tests while South Africa had conducted close to 200, 000 tests. At the time these countries were reaching these commendable feats, Nigeria was grappling with a little over 12,000 tests.
This is not to diminish the effort the NCDC has committed to tackling the virus, given the peculiarities of a country such as Nigeria. The agency was established in response to challenges such as this, hence, the high expectation. It just so happens that Nigeria is one of the countries that were slow to react, and it’s perhaps one of the reasons the country was slow in initiating proper guidelines which may have limited the spread of the virus, hence, the explosion of an outbreak and COVID-19-related deaths in Kano.
Effectiveness of President’s order to scale-up testing
During the President’s broadcast of Monday, April 13, 2020, he assured Nigerians that the government has identified 92% of all identified contacts while doubling the number of testing laboratories in the country and raising the testing capacity to 1,500 tests per day. Days later, the NCDC Director-General, Chikwe Ihekweazu, disclosed during a joint national briefing of the Presidential Taskforce Force on COVID-19 that the President had mandated the agency to increase national testing to 4000 per day (Lagos -2,000; FCT – 1,000 and the rest of Nigeria – 1,000). Ihekweazu added that the agency is targeting testing 2 million people in the next three months.
A very ambitious target, you may say.
The projected testing capacity ordered by the President may not be truly achieved, but there has been no doubt an increase since the order. The recent spike in the number of confirmed cases is a manifestation of the increase in testing carried out by the NCDC. Before now, the NCDC had concentrated in chasing after returnees, but we now see that the agency has become more proactive and responsive in its attempt to contain the spread of the virus by tracing other secondary contacts.
An increased testing capacity can only mean that more contacts are being identified and contained before they can infect more people. When the cases are identified, traced, isolated or quarantined, they are prevented from further spread of the virus and also stand a chance of getting treated.
As of May 8, Nigeria has tested only 23, 835. With no cure or vaccine in sight, Nigeria’s best option to containing the virus remains to test and isolate confirmed cases to avoid more transmission, a situation which can take a heavy toll on the already suffering healthcare system.
Challenges of rapid scaling up COVID-19 testing
The NCDC’s test procedure for COVID-19 relies on a semi-automated real-time PCR process that delivers results between 3-8 hours. This usually involves the use of a sterile swab inserted to the back of a person’s nasal passage and throat to absorb secretions, which are then tested for the presence of SARS-CoV2 in a molecular laboratory.
Understandably, the process of testing is quite tasking. Nigeria is struggling with a deficit of test kits. The NCDC DG, Ihekweazu last week, lamented a desperate need for test kits, as they are grossly inadequate in the country. Ihekweazu said Nigeria needed to stock more of the RNA extraction kits to cater for the expansion of its COVID-19 testing capacity. Procurement of medical supplies has been difficult as a result of the slowdown in manufacturing of these supplies coupled with a high global demand.
In late February when the first case of the virus was reported, there were only five laboratories able to test for COVID-19 in the country. Today, there are now about 20 of them with plans of citing at least one in each of the 36 states and encourage private sector labs to also conduct tests.
Apart from the lack of adequate labs, isolation centres are already over-burdened. Some states are already experiencing difficulties accommodating patients in their over-burdened isolation facilities, especially in Lagos and Kano states where the number of cases currently outweighs the capacity of the centres, whether they are asymptotic, mildly symptomatic or severe. This has however led to revolts and public protests by patients in some of the centres.
There’s also the problem of how active our public workforce is in identifying samples, collecting and sending them for testing. The efficiency of collecting the right samples from the right patients and bringing them the labs is key.
Emphasising the need for more and more testing
With the partial lifting of the lockdown in some states, the need to conduct more testing cannot be over-emphasised. Experts strongly believe that many Nigerians are going about with full-blown coronavirus and such people remain asymptomatic. It is therefore in our collective interest to sort out these people and to timely recommend them to NCDC.
As Nigeria struggles to ramp up the number of COVID-19 tests, widespread testing sits at the heart of the battle. To drive mass testing and increased COVID-19 surveillance, every Nigerian should be a combatant in the ongoing war against the pandemic. We can continue to play our parts by strictly observing social-distancing and every other precautionary guideline prescribed by medical experts and the government.
Victor Enengedi is a social and public commentator and he writes from Lagos.
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