COVID-19: Nigeria may hit millions of infections by June

Stephen Adewale

Given a frightening April that saw more than 2,000 Nigerians infected with the novel coronavirus pandemic, coupled with first-day behaviour of Nigerians after easing of lockdown, it is fair to ponder whether the country will cross a million marks of infected cases in June.

Yielding to public pressure, President Muhammadu Buhari had on April 27 signed a proclamation easing the lockdown he had imposed on the FCT, Lagos, and Ogun states on March 30 through the COVID-19 Regulations 1, which he renewed with the second regulation on April 14.

The president had, in a nationwide broadcast, eased the restriction replacing it with a country-wide curfew from 8 pm to 6 am effective from Monday, May 4. He banned inter-state travels as well as social and religious gathering and compelled the use of face mask in public places.

He, however, locked down Kano State, which is rapidly becoming the new epicentre of the rampaging virus.

Although he noted the rising cases of the pandemic despite the four-week lockdown, the president appeared helpless in the face of restiveness of the citizens who were complaining of hunger due to lack of livelihood. The business owners were also complaining and warning of the potential danger to the fragile economy if the lockdown persisted.

But inferring from the figures turned in in the past week, analysts foresee disaster ahead. How much worse will it get? At a point, the federal government has projected reduction in the number of cases upon the end of the lockdown, but the expectation has since been dampened as the recent results have raised the country’s caseload considerably.

As the overwhelming majority of the states reopened in one form or another on Monday, the first-day behaviour of Nigerians after easing of lockdown point to the dangers that lie ahead.

As roads in Lagos, Ogun and FCT were busy again, in states considered to be hotspots of infections, Nigerians failed to adhere to the social distancing measures as they besieged motor park and commercial banks in different parts of the country. Banks witnessed a huge crowd of people who gathered as early as 7 am ahead of resumption.

Private security personnel attached to the banks had difficulty in controlling the surging crowd. While many were seen struggling to use the Automated Teller Machine installed within the banks’ premises, others were eager to gain access to the banking floors to transact business. In virtually all the banks, large canopies were erected outside for bank customers to sit down and wait for their turns.

This is where the analysts are concerned, wondering if the infected are this high during the lockdown, what would happen now that the restriction is eased. From the actual field data provided by the NCDC, Nigeria is trending at 13% COVID-19 infection rate. If the trend remains steady by June, then the county can expect to have a million positive cases.

Researchers and medical historians are hard at work struggling to come up with an answer but there is no clear consensus. However, one telling fact stands out: The number of cases Nigeria witnessed in the latter days of April is larger than the combined total during the entirety of February and March.

According to experts, who spoke to KAFTAN Post, with Nigeria’s failure to observe social distancing guidelines, coupled with an infection rate of 13 per cent and a death rate of three per cent, the figure could become huge when testing is ramped up to two million as projected by NCDC.

“What this means is that at the present rate of 13 per cent and with the reckless and nonchalant behaviour of Nigerians, we would be looking at about 1,000,000 infected persons and 25,000 deaths when the testing increases to two million in three months,” said one of the analysts.

Using NCDC’s statistics, KAFTAN Post reports that Peter McClintock, a professor emeritus of Biomedical Physics and Nonlinear Dynamics and Low-Temperature Physics who leads Yusuf Maitama University’s COVID-19 Modeling Consortium, projected “about 2,038 and 1,444 total cases of the virus in Lagos and Kano with a peak coming in mid-June and early June respectively”.

He said those figures rely on the states keeping the current restrictions in place. Following the ease on the restriction of movement, however, he argued that:

“With just a 50 per cent increase in mobility – people leaving their homes, shopping, going to work and socializing that number would leap to 102,600 and 645,500 in Lagos and Kano states, respectively. Meaning, if measures are relaxed by 50 per cent in these states, our model projects that the number would skyrocket to these figures. Lifting restrictions entirely would bring 868,700 and 919,900 total cases in Lagos and Kano respectively”.

Saying this is a disaster waiting to happen, many analysts said various state governments may have to start preparing for another lockdown in case the virus jumps back.

For now, the widely cited coronavirus pandemic provisional model from the World Health Organisation (WHO), often used as a reference across Africa, projects that Coronavirus cases could surge from just thousands now to 10 million within three to six months.

However, in a press conference on Saturday, WHO’s top emergencies expert, Dr Mike Ryan said it was a tentative projection that could change. He noted worst-case predictions for the Ebola outbreak had not come true because people changed their behaviour in time.

To prevent the projection from coming to reality, he advised African countries to lift lockdowns gradually while still being on the lookout for the plague.

“It’s really important that as countries ease those measures that they are constantly on the look-out for a jump in infections and in particular are dealing with the transmission in special settings,” Ryan told a news conference.

While recognising the difficulty for governments to maintain lockdown during the pandemic, Ryan said the world health organisation wants to avoid a situation where measures are relaxed too easily “and then we bounce back into the intense transmission and we have to do it all over again,” he said.

“Even as some countries begin easing lockdowns, there are worrying trends of spread in countries from Haiti to Somalia and Yemen, Sudan, South Sudan, Syria, Yemen, Afghanistan, Sierra Leone, Central African Republic and a “serious cluster” in Kano, northern Nigeria”.

Unconnectedly, new research modelling sponsored by the UN Economic Commission for Africa and published by the Imperial College London had already projected that Africa could see 300,000 deaths from COVID-19 under the best-case scenario.

Under the worst-case scenario where the African caseload may get out of hand, the researchers projected that Africa could see 3.3 million deaths and 1.2 billion infections by July.

While the world’s poorest continent has seen 44,874 confirmed cases and 1,806 deaths so far, relatively few compared with other regions, there are fears that considering the recent spike in South Africa, Ghana and Nigeria, the numbers could balloon and overwhelm shaky health services.

“We are concerned that the virus continues to spread geographically, within countries,” said Matshidiso Moeti, director of WHO’s Africa region.

“The numbers continue to increase every day,” he said.

Yet, after this series of research from renowned health institutions suggested such a spike in the number of infected cases across the continent, the Nigerian government has decided to ease the lockdown measures. Some analysts who spoke to KAFTAN Post observe that the impact of such policies means a second peak, far higher than the first, is now a near certainty.

This prognosis indeed has far-reaching implications for how the most populous black nation on earth must exit the lockdown phase if such a catastrophe is to be avoided.

Speaking with KAFTAN Post, Simidele Odimayo, a Professor of Microbial Pathology/Infectious Diseases at University of Medical Sciences said: “The second wave of COVID-19 in Nigeria is likely imminent,”

Odimayo, the Dean, Faculty of Basic Clinical Sciences warned that the second wave in many of the states across the country could be more severe than what the country has witnessed so far, especially if the country fails to increase its testing capacity.

Speaking to KAFTAN Post, Gbolagade Isola, an Economist, describes the Nigerian government’s situation as a survival dilemma. He said the federal government is in dilemma between the need to restart the economy and the need to sustain the social distancing policy in order to prevent spreading the plague further. He said that the only possible solution is to test as many people as possible and open the economy up to those who are not infected with the disease.

However, the testing capacity of Nigeria is abysmal, to say the least. While South Africa has tested 207,530 people, Ghana has tested 113,497, Egypt has tested 90,000 citizens, Nigeria is far behind with 13,689 tests.

While some experts are indicating that at least 30,000 people would need to be tested daily in order to restart the economy, available evidence shows that the figure may be difficult to achieve given the current lack of resources. With 2,000 tests daily, Nigeria has one of the worst testing coverage in countries with over 1,000 cases in Africa and anywhere in the world, based on data from world meters.

Nonetheless, the Director-General of NCDC, Chikwe Ihekweazu, has insisted that the 30,000 tests daily are achievable.

“The laboratory strategic group that is responding to this outbreak has set itself a target of testing two million people in the next three months. This is a very ambitious target,” he said.

If the testing capacity is not increased, there may be trouble ahead for states reopening without knowing whether the virus has been contained.

In addition, determining whether the infectious rate is on the rise or decline has been an easy proposition as the daily cases of infected people have not been steadily declining. The past six days are an illustration of that. April 27 infectious rate was 195, but the next day the new cases shot back to 195. And on 29 April, 196 cases were recorded, it increased again to 204 cases on 30 April. On Friday 1 May, 238 cases were recorded, and on Saturday, 220 new cases were recorded before the figure came back to 170 new cases on Sunday.

Looking at the numbers through the prism of states caseload presents a worrisome picture of what may lie ahead. Lagos reported cases of 176 within four days. And Kano added 203 new cases within the same period.

It is also worth noting that the official figure being released daily by the NCDC fails to take into consideration the number of people who may have been infected and died for reasons indirectly related to coronavirus pandemic. In Kano State, the preliminary report of the Presidential Task Force on COVID-19 sent to investigate the high incidence of deaths in Kano State yesterday linked the deaths to COVID-19, saying the results of 80 per cent of the tests conducted were positive for the disease.

Academic scholars and medical researchers are already keeping a close eye on developments as the country loosen restrictions.

Professor Odimayo said whether the pandemic resurges will hinge on several factors: the public’s efforts to limit contact and take precautions; the country’s ability to increase its testing capacity network and government’s effectiveness in contact-tracing and isolation.

“If this pandemic does start spreading in places like Lagos, Ogun and Abuja, it will take several weeks before we notice the effect on the country’s mortality data,” Odimayo said. “Since the carrier of the disease can move freely without showing symptoms for several days, an increase in transmission around May 4 may not be apparent until the end of May.”

Those are daunting words for those who feel the worst was over in April.