By Dapo George
Social distancing, hand washing, facemasks and lockdowns. These are guidelines recommended by the World Health Organisation (WHO), Presidential Task Force on Covid-19 and the Nigeria Centre for Disease Control (NCDC) to curb community transmission of the pandemic.
Rich and poor countries of the world, including Nigeria, have adopted wholesale these safety guidelines irrespective of the local socio-economic-conditions of some poor economies.
These poor economies, like Nigeria, do not have the required financial resources to effectively enforce these safety guidelines, to purchase protective gears for health personnel and provide necessary palliatives at least to the most vulnerable members of the society on a continuous basis for months, especially in total or partial lockdowns.
The federal and state governments have only been trying their best in these regards within the limits of available financial resources. Hence there may be need to adapt these safety strategies to local socio-economic conditions and financial capabilities.
We need to ask ourselves in Nigeria the following pertinent questions: Is social distancing possible in densely populated slums of big cities like Lagos and Kano – especially in shared houses of one-room apartment (face-me-I-face-you) buildings, each with an average of 10 rooms and each room housing at least four to five occupants totalling a shared population of 40/50 people who share at best two toilets, two bathrooms and two kitchens?
What then happens if it’s a multi-storeyed building with an estimated 120 to 150 people in the building? Is social distancing possible in such environment?
Will social distancing be effective in our private and public transportation system operated by mainly 18-seater buses, with the best available being the BRT buses in Lagos? During this period, there will be shortages.
Will these transporters break even, or the passengers be patient enough to wait for these buses without struggling for spaces if social distancing is enforced? Social distancing is more practicable in prosperous climes where trains carry at least 3,000 passengers on one trip, and double-decker buses with at least 100 passengers.
Will hand washing for personal and community hygiene be possible and enforceable in houses, communities, markets and public places without public water supply? Even major cities in Nigeria lack public toilet facilities, with only petrol stations and eateries providing succour to people when pressed.
The usual alternatives in densely populated areas, slums and highways are pit latrines and open defecation in bushes and abandoned houses.
How is social distancing possible when Okadas (motorcycles) are used as means of public transportation? The rider or the passenger may be asymptomatic to the virus.
Will facemasks alone be enough to protect the rider and the passenger? As the rider carries many passengers daily, what happens if he is infected? Will his subsequent customers not be infected, thereby increasing community transmission? Will contact tracing be possible in that situation?
Is social distancing possible in our five-day markets, with people mingling in chaotic and uncoordinated movements, without knowing who is infected or not? Will there be continuous supply of soap and running water in these rural markets?
With a conservative population estimate of 200 million Nigerians, and with a capacity of fewer than 50,000 that have been tested nationwide so far, the signs are ominous that we have not reached the zenith of the infection, talk less of flattening the curve.
The United Kingdom, United States of America, Italy, France etc. continue to test an average of 20,000 to 50,000 people daily with plans for 100,000 people per day. With this testing capacity, the U.S. has been able to identify over one million infections and recorded over 80,000 deaths, yet it has not reached the peak.
The U.K. has been recording 600-800 deaths daily and the U.S. a daily average of 2,500 deaths. So, if gold rusts, what will iron do?
If the recent revelation by the Presidential Task Force and the NCDC is that out of 100 samples recently collected in Kano, over 80 tested positive, is this not alarming?
There is therefore need to improve on our mass testing of the population, especially in densely populated cities and satellite states of Lagos and Kano in particular, both of which now appear to be the epicentre of the pandemic in Nigeria.
To stem the rising tide of Covid-19 infections, in addition to more testing and isolation centres, the federal and state governments should address our infrastructure deficit, especially in areas of water supply, provision of recommended safe materials like soaps, facemasks and sanitizers at all times, at least to densely populated areas that are uniquely vulnerable to Covid-19, along with continuous palliatives in event of another lockdown.
It is not enough to decree the use of facemasks, soaps, sanitizers, hand washing when people’s livelihoods have been jeopardized by the pandemic.
These materials should be provided free and at all times during this period of health emergency – if not to everybody, at least to vulnerable groups in densely populated settlements and slums. This is the least any responsive government should do, in addition to providing palliatives.
Also, it is suggested that all Okada operations should be suspended in this period until there is a decrease in the infection rate as has been done in Lagos and Kano states.
As alternative, the federal and state governments should subsidize Okada riders to purchase tricycles that should carry just one passenger at any point in time. Since a tricycle has small enclosure, carrying two people along with the rider violates the principle behind social distancing.
More importantly, federal and state security agencies should continue to enforce strictly the president’s order banning inter-state travels except for exempted purposes.
Cases of complicity by security agencies in violating this directive should be investigated and culprits punished. All federal, state and local government borders, including motorable, unmotorable and bush paths, should be monitored by security agencies and local vigilantes in the different communities.
However, the president and most of the state governors should be commended for their proactive decisions that has helped in mitigating the Covid19 pandemic.
It is also suggested that all state governments should embrace community or household testing to ascertain the enormity of the problem, in order to make adequate provisions for its curtailment. Where there are insufficient funds and testing kits, random samples of households could be tested.
Finally, for an appropriate response to the Covid-19 pandemic in Nigeria, we need to have adequate data on the magnitude of infections and the health outcomes of government interventions.
Such data could be obtained by our numerous public health practitioners, epidemiologists, health economists and other relevant social scientists.
Such data can be used to design models that take account of our socio-economic realities to predict the incidence of Covid-19 and other viruses, and the effectiveness of safety response measures and treatment outcomes.
- George, a professor of economics, and public policy analyst, writes from dapgeeo@yahoo.com
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