Nigeria is quite a large country and what we have seen is chaotic responses largely by state governments; some state not waiting for coordination, taking the laws into their own hands and making rules and guidelines as they wish.
Executive Secretary of the Nigerian Academy of Science and former Chairman, Lagos chapter of the Association of Public Health Physicians of Nigeria, Dr Doyin Odubanjo, in this chat with SaharaTV explains how local capacity should be developed for testing kits and protective gears in the fight against Coronavirus
How do you assess the fight against Coronavirus by the Nigerian Government?
I’ll describe it as chaotic. Nigeria is quite a large country and what we have seen is chaotic responses largely by state governments; some state not waiting for coordination, taking the laws into their own hands and making rules and guidelines as they wish. Many of them are being done as knee-jack responses for which one will sometimes wonder where some of the evidence is coming from as they respond.
You go from good examples like Lagos to not-so-good examples in many other places. Ultimately, what we need is greater synergy and coordination because the virus doesn’t know international borders not to talk of local borders, so we need a lot more coordination and cooperation.
How severe do you think Coronavirus will become in Nigeria?
That’s difficult to predict actually. There are many factors that you really can’t say much about and things can change very rapidly. Things can look bad now and may start looking good, or they look good and start looking bad. It can be bad if we don’t take the right actions. One of the right actions is to ensure that we better coordinate what is going on nationally than to just allow things to be happening state by state.
For instance, when the Federal Government paid attention to FCT, Lagos and Ogun and decided to lock them down, that is by saying those were the epicentres of the outbreak in Nigeria. However, since that time, we have gone from about five or six states with cases over 20 in fact, almost 25 states now.
That tells you that the spread is going to be national and one of the things that people don’t get is that when there is a case in Abia or Borno, it doesn’t mean that there was no case in Borno before; it just means that you have only just made a diagnosis in those states. Borno might even have more cases than in Lagos but you have only diagnosed now, so we should have a better national response.
In terms of better national response, are we taking enough precautions this time?
It’s difficult to say across the board. We are taking precautions but are we taking enough precautions, even in Lagos that is doing the best work possible? The precautions we take are going to be equivalent to the enlightenment of the people. So, we know the things to do to reduce the spread of the disease, however, all of them depend on people doing those things.
No matter what you say, people have to do them and they will do them when they know what they are up against and they are committed to fighting against the virus themselves. So, the real point will be how educated or enlightened are the people across the board. The better we can get that to happen, the better it’s going to be for all of us.
What’s your best or worst-case scenario at this point in terms of our response?
The best-case scenario is to ensure that a lot of public enlightenment happens. People are always talking about testing and I always tell them to take into consideration that in this case, you are testing for a disease in which a very significant majority of the people are not going to show any symptoms or show mild symptoms and the mild symptoms they may show are similar to other things they experience when they have common cold.
That means that your chances of finding every single case even with available testing are still quite slim. Testing alone will not solve the problem, however, if we all keep social distance or wash our hands, or adopt some hygienic practices when we sneeze and then ultimately know that when we see certain symptoms and signs, then the person should go and be tested, then we are going to win that fight.
The best-case scenario is when we have a very enlightened population. If we ask the people in the village, can they tell you what is going on? Can they explain how to avoid it and show they understand it and are committed to stopping its spread? That is the best-case scenario. Second best case scenario is when we have testing centres available. Testing is not enough now and testing is challenged now on many grounds.
I’ll put it also this way because a lot of people like to bash the government to say they are not doing this or that. I agree that a lot more needs to have been done even in terms of testing.
However, I think one of the problems we have is that we came to the party late. So, in testing, there are lots of issues globally. A lot of countries are using rapid test kits and there are many reports about issues with the rapid test kits, for example on the accuracy of the result. You don’t want to get into something that gives you the inaccurate result, so, whatever test kit we are going to use, we must do a lot of work to ensure their quality and that they give us correct result otherwise, they complicate what is going on very terribly.
The one we are using, the PCR testing, again, there is a global competition for the testing reagents. While the virus is ravaging Europe, Asia, America and Africa are coming to the market looking for the same reagents. The reagents have become difficult to get just like when PPEs are difficult to get. Masks are also difficult to get because we are coming to the party late. Everybody is facing the same problem and they all need the same tools.
Even though there are a lot of efforts to increase the testing but the best-case scenario is when we can do testing across the nation. Many public facilities actually can do PCR testing. I know that some of them would be challenged because they do not have reagents to do that. You also have to ensure that all the staff in those places are trained and you have to be sure that when this person diagnosis the particular virus for you, you know that you can test the result they are sending from that lab.
So, all of that is a process and it takes time but I think that part of the challenge we are facing is because we came into the party late, so we are struggling because we did not prepare on time.
Could you help us demystify this moment and explain what the next few weeks of the pandemic might look like in terms of containing the virus as more cases are being recorded?
Life will not be normal, as we know it. It’s a new challenge for every world leader. They have to make decisions they never dreamt of making. Those decisions are very complex. They are facing issues around a pandemic where you know that people are going to die and you are looking at your economy in a state that you have never dreamt that it would ever be.
In the next few weeks, we have to find a balance between that health challenge and the socio-economic challenge because we cannot choose one over the other. We cannot go for solving the health and ignore the socio-economic challenge.
We have to allow enough socio-economic activities to keep the society going while we increase our surveillance and we increase our ability to find anybody who might have COVID-19 in the society and get them treated also quite effectively.
What could be done by the authorities concerning the shortage of reagents and PPE?
I think the answer ultimately lies in the development of local capacity because if we are struggling at the same market and there is not enough in the market, the best bet would be to be able to produce ours within Nigeria.
The truth is that if we look at it, this is not rocket science. The solutions are not completely out of this world. We have manufacturers and everybody sitting together can determine what the underlining principles of this particular protective gear that we need, and once that is defined, we have material scientists and they can sit with the manufacturers to look at local raw materials that can be used to produce all of these things.
Even beyond the present, if we struggle to buy it now, the truth is that in preparing for the future, we have to look into local production quite quickly both for them now because it's difficult to get. After all, it is scarce. The logistics for getting it is pretty difficult and also when we realise how difficult this has been this time around, it should not happen to us again. Many countries around the world are beginning to motivate their companies to get back to work. We need to use this opportunity to start producing local things that we need.
There are palpable fears that this could eventually become a full-blown public health crisis?
The potential is always there, we are quite hopeful because what we thought we would have seen by now, we have not seen.
However, there is a potential that it can still escalate and it can particularly escalate if everybody doesn't see this as their own responsibility.
It's not just going to be what about the government does. That is very important because the government has to lead and coordinate that. But it's going to be about what we all do at the end of the day. So, if people don't take it seriously or do their part we would be facing a major public health tragedy eventually but we sure hope it won’t get to that.