We are not sufficiently afraid and it may be our undoing. Nigerians still believe that less than 60 people have the virus and are therefore not observing social distancing guidelines. If we don’t act quickly and decisively, we may all get the virus. But a holistic response will be expensive. With oil revenue at record lows, our government is stretched and would soon need to start dealing with the economic fallout, this is why we are calling on Nigeria’s billionaires to step up fast.
African leaders are celebrating Jack Ma’s donation of 1.1 million testing kits, 6 million masks and 60,000 protective suits. This amounts to 20,000 test kits, 100,000 masks and 1,000 medical use protective suits and face shields for each of Africa’s 54 countries. The Bill and Melinda Gates Foundation has pledged to give $100 million. Giorgio Armani and 19 other Italian billionaires recently donated $44 million to the fight against coronavirus in Italy. These should challenge Nigeria’s wealthy to do more. If they don’t, there would be no one to buy their cement, use their banks or campaign for them when election season comes around.
There are little glimmers of hope however: from the Anap Foundation, initiated by the banker, Atedo Peterside, a pledge has come for a major civil society attempt to mobilise the Nigerian public good will for such an endeavour. Then the modest but salutary gesture of Guaranty Trust Bank to build a 100 bed hospital in Lagos as response to this pandemic also shows that some thinking is going on in little corners. It is time, however, for a show of massive national leadership and push.
In the last 24 hours, three members of our team have attempted to call Nigeria’s COVID 19 emergency contact numbers 080097000010 and 0800 026 7662 claiming to have symptoms and asking to be tested for the COVID 19 virus. The former line was perpetually busy, but thankfully the second line — the Lagos State COVID 19 Helpline — was set up as a call centre, with negligible wait time to speak to an agent. But that’s where the good news ends. The good natured and polite call centre agent struggled to provide a coherent response to the simple question: “I may have been exposed, I have symptoms, how can I get tested”? His answer was basically, ‘Lagos State has no testing centres (false information).’
At the time of publishing this Editorial, Nigeria has 51 confirmed cases from less than 200 tests, according to NCDC (South Africa has done more than 15,500). Authorities are using the modeling rule of thumb in putting a figure to cases; the actual number of cases could be about 51 times 50, and that’s 2,550 suspected cases.
But if no one can’t get tested, even when they show symptoms, then administrators intending to save face can continue to assume that the number of confirmed cases is in the tens, when if there is really prompt access to testing, the number of new confirmed cases could become overwhelming in one fell swoop.
Administrators, in the bid to not show up the weakness of the country’s health care system, rather than raise the alert levels, are artificially lowering the prevalence numbers. This is myopic. Because, delays in raising alert levels only give people false confidence – which prevents them from appropriately practicing social distancing.
Assuming we believe the 2,550 number, then If we don’t stop the virus from spreading, in 30 days we will have at least two to the 10th power more cases of infected people, because the infection count doubles every three days (the virus doubles every three days and there are 10, three-day periods in 30 days). That is 1,024 times as many cases as we have today– That is at least 2.6 million cases. Of these 2.6 million, about 15 per cent will need hospitalisation (392,000 beds) and about 5 per cent will need intensive care including ventilators (130,000 ventilators). This is a catastrophe!
The country is in dire need of help — from testing kits, to health care workers, to hospitals fitted with the right equipment including ventilators, to protective gear for our healthcare professionals, to cash transfers to our most vulnerable populations. Jack Ma’s 20,000 test kits would barely be enough for a day if we are to really tackle this scourge headlong. Our aspiration ought to be to follow the example of the Italian city that tested all its 3,000 residents, and then developed a clear roadmap to care for the sick and stop the spread. South Korea, which is now experiencing a decline in new infections, had more “than 66,650 people tested within a week of its first case of community transmission” and raised its testing capacity to 10,000 tests per day.
While testing everyone would be impossible for a city like Lagos, with its 20 million inhabitants, increasing access to testing to at least 10,000 per day, including drive by and mail in testing options, and having designated testing centres would go a long way in curbing the spread and caring for the sick.
Building testing centres and hospitals overnight would cost a lot, however Nigeria has a church or a mosque in virtually every street of the country. If Churches and Mosques donate the real estate, what would be left is furnishing the centres with test and treatment equipment. Testing can be open air, using large church parking lots. Five to ten lanes can be created, and drivers should stay in their cars to reduce the exposure of the testing volunteers.
Telecoms companies and banks can volunteer their call centre facilities to receive COVID calls to ensure that no call is dropped and adequate information is given to every call centre to be effective.
Such an endeavour would require a lot of coordination and cost, but we are up to the task. Most importantly, governments at all levels need to quickly set up and enable accountable and transparent structures and agencies that people can approach to make their urgent donations and contributions.
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