Category: Niyi Akinnaso

  • Covid goes  to school

    Covid goes to school

    Niyi Akinnaso

     

    Since the COVID-19 arrived in Nigeria on February 27, 2020, the virus has continued to spread by jumping from one person to the other in droplets emitted by an infected person through the nose (when sneezing) or mouth (when speaking, shouting, crying, or singing). As the infection spreads, some are killed, while others are spared.

    Everyone is at the risk of infection but the elderly and particularly those with pre-existing conditions (such as, heart, lung, and kidney disease) are most likely at the risk of death from the virus.

    For three months, from February 28 to May 31, 2020, as many as 10,162 persons had been infected in the country, resulting in 287 deaths. This shows that the figures had been rising steadily, hitting 553 on May 30, 2020. By this time, contact tracing was getting complicated as it was clear that community spread had already set it.

    Unfortunately, this was precisely the time when the Federal Government eased the lockdown, allowing more places, including churches and mosques, to reopen, subject to existing protocols. Notable features in the month of June include: (1) the prevalence of youth and middle age infections; (2) the recording of 15,500 cases within a single month, indicating an astronomical rise in the number of infections and confirming the scale of community spread; and (3) pushing Nigeria to the third most infected country on the continent after South Africa and Egypt.

    These figures show that there were more cases in June alone than in the preceding three months! Besides, half of all coronavirus fatalities so far occurred in the month of June.

    Yet, by July 1, 2020, the Federal Government bowed to pressure from road transport workers, domestic airline operators, private school proprietors, and, of course, the deteriorating economy to approve, among others, (1) movement across state boundaries outside curfew hours of 10pm-4am; (2) the commencement of domestic aviation services; and (3) the resumption of graduating classes (Primary 6, JSS3, and SS3) to prepare for their final examinations.

    True, the Presidential Task Force on COVID-19, which announced the commencement of these activities, provided guidelines, emphasising necessary measures to mitigate infections, it did not provide information about monitoring and evaluation to ensure that the necessary measures were in place and remained in place in schools that were reopened. Worse still, no exact date was given for school reopening against which states should prepare their schools.

    Similarly, nothing was said about what the rate of infection should look like in any state that wished to reopen schools. It will be recalled, for example, that the American Center for Disease Control recommended at least 14 days of declining infection rate for states to relax their lockdown.

    The southern states, which flouted this recommendation by reopeing early are not rueing the consequences of their action as they are struggling to cope with high positivity and hospitalization rates.

    The discussion about school reopening has not even started. Even President Trump’s suggestion that schools should reopen in the Fall (that is, September) has been rebuffed or totally ignored.

    The gaps discussed above were there to explore by wayward governors, such as the Oyo State Governor, Seyi Makinde, who went ahead  to reopen schools for graduating students on Monday, July 6, 2020, even as the infection rate spiked in his state, pushing it to third position among highly infected states in the country.

    Neither his and six other Governors’ positive tests and treatment for COVID-19 nor the painful death of his predecessor due to the virus could make him pause for the coronavirus graph in his state to start falling. It will be recalled that it was in Oyo that over 100 workers in a single factory tested positive for the virus.

    Makinde also learned nothing from the proactive stance of the Lagos State Government, which decided on August as the tentative date for the resumption of graduating students. Nor did Makinde learn anything from international cases (China, South Korea, Australia, Germany, France, the United Kingdom, Israel), where schools had to close again shortly after reopening, because school children and teachers were infected by the virus. These are countries in which the guidelines for school reopening were strictly followed.

    What is even more worrisome in the Nigerian case is the absence of a monitoring and evaluation measure to ensure that the guidelines for school reopening were followed.

    Although made-for-TV images on Monday indicated some level of compliance with necessary guidelines in an ill-equipped school in Oyo state, the overgrown shrub around the school was being mowed even as classes were going on in a classroom. It is unclear what would happen after the press crew has left.

    To further complicate the politics of school reopening, the PTF confirmed on July 6, 2020, that the spread of the virus in Nigeria may not peak until September.

    If that is the case, why rush school reopening now,?  If nothing else, this information about the possible peak of the virus in September leads us to consider a few facts.

    First, as indicated above, schools have had to be closed again in many countries, where they were reopened, because not only were school children infected, they got really sick and some of them died!

    Second, the risk of infection in school is very high, because children, teachers, and otherworkers often come from different homes with varying conditions.

    Some might bring the infection to school and transmit it to others, who, in turn, will take it home and infect adults, including elderly parents or grandparents.

    Third, with poor facilities in public schools and lack of essential personal protective equipment for teachers, it is difficult to guarantee that infected teachers will not transmit the virus to others in school in the midst of high community spread as at now.

    Fourth, it is dangerous to put the economy and politics over public safety in the face of a pandemic. The world is witnessing the fallout of such a mistake in the United States, where President Donald Trump pushed for early reopening the country, leading to the ongoing dangerous spikes in infections, hospitalizations, and deaths in over 30 states!

    Finally, although testing centres are expanding in Nigeria, hospital beds are not keeping pace with the rate of infection. As infection cases rise, the tracing, tracking, and treating protocol will collapse. This is, therefore, not the time to allow Covid to go to school.

  • How Coronavirus kills its victims

    How Coronavirus kills its victims

    By Niyi Akinnaso

    This essay has two apparently contradictory messages. On the one hand, it affirms that the coronavirus disease, otherwise known as COVID-19, is not necessarily a death sentence.

    There are countries, such as Uganda and Vietnam, which have recorded no deaths so far, despite confirmed cases of coronavirus.

    Although over 500 deaths have been recorded in Nigeria, nearly double that number has recovered from the disease. But that is only one side of the story.

    On the other hand, the coronavirus disease is a death bomb for certain individuals who are infected. That’s why over half a billion people so far have died of the virus worldwide.

    True, people with pre-existing conditions, such as heart, lung, or kidney disease, are at greater risk of death, the data so far show that the virus can kill just about anybody.

    Yet, there is neither a certified cure nor a vaccine against the virus as of today.

    In the search for cure or vaccine, researchers have studied the behaviour of the virus in the last six months, while others have studied selected autopsies of dead victims, in order to understand why so many people have died of the virus. Such knowledge is necessary in order to develop an effective cure or vaccine.

    Three findings stand out. First, there is no doubt that the coronavirus is capable of laying its victims to waste as it can cause massive devastation of various organs.

    When the virus enters through the mouth, nose, or eyes, its first home is the upper respiratory tract. The virus binds to particular receptors and begin to replicate itself.

    The receptors, technically known as Ace-2, help in regulating blood pressure. They are common in the upper respiratory tract but are also found in the lungs, heart, kidney, intestine, blood vessels, and even the brain.

    Research shows that the virus may migrate from this initial binding to the receptors in the other organs listed above.

    The presence of the virus in these receptors, especially those in the blood lining, may be the reason for the unusually excessive clotting of the blood and why patients with hypertension and diabetes are at very high risk.

    Worse still, Ace-2 receptors may help the virus reach as far as the brain, where it binds to the Ace-2 receptors in the brain.

    This may well explain some of the bizzare symptoms of the virus, such as loss of taste and smell, erratic breathing, irregular heartbeat, seizures, stroke, and even nervous breakdown.

    Second, it has been found that it is not the virus alone, which kills its victims. The body’s defence mechanism deployed in fighting the virus can overreact and cause death.

    Here, in a nutshell, is how it happens. When a pathogen (virus, bacterium, or any other microorganism) enters the body, immune cells are attracted to the point of infection to destroy the intruder.

    A protein, technically known as cytokine, is released by the body to coordinate the body’s response to the intruder.

    In the process, excess white blood cells are produced, which rush to the point of infection to fight it. Inflammation follows as part of the process of healing the body from the infection.

    Unfortunately, however, the body’s immune system can overreact, leading to a “cytokine storm”, whereby excess immune cells are produced, leading to hyper-inflammation.

    In the process, the body is destroyed along with the virus. The patient may get better and even test negative for the virus, while still in hospital.

    However, multiple organs may have been destroyed and blood pressure may drop to dangerous levels. When a patient gets to this level, death often follows.

    A third major finding helps to explain why individuals vary in their reaction to coronavirus infection, that is, why some die while others survive, even in old age.

    First, although humans share the same genes, the ways in which the genes are regulated in the body differ from person to person.

    Therefore, many victims of coronavirus may weather the storm and survive the infection, while others succumb to it, depending on their genetic makeup.

    Genetic variation may also explain why Ace-2 receptors are expressed differently in different organ tissues, depending on the individual.

    As indicated earlier, the underlying condition of the various organs is also a critical factor. That’s why those with preexisting conditions are at much greater risk.

    However, as the above findings and the data on coronavirus deaths show, there have been people with no preexisting condition, who nevertheless still died of the virus. Not just old people, but young folks as well.

    It is natural for readers of this essay to ask: What’s the treatment or what’s the best treatment? The simple truth is that, as of today, there is no cure for coronavirus.

    Each case is often managed as it comes and as the patient’s condition deteriorates. This is not to say that there are no treatment options.

    The naked truth is that no option has been found to completely prevent death in all patients or even in the majority of patients.

    That leaves you and me with the non-pharmaceutical option of following the WHO-sanctioned guidelines, provided by the Nigeria Centre for Disease Control and echoed repeatedly by the Presidential Task Force on COVID 19:

    • Stay at home, if you are not working or on essential service.
    • Wear face masks, if you go out. You should even wear one at home, if you are coughing or sneezing or if someone in your household is.
    • Maintain physical distancing of at least six feet (ese bata mefa) whenever you go out.
    • Avoid touching your mouth, nose, or eyes.
    • Wash your hands frequently with soap or alcohol-based sanitizer.
    • Main good overall hygiene at all times, including occasionally wiping door handles, remote controls, and your phones, with disinfectant.

    In addition, the oga among us must ensure that their aides, drivers, cooks, gardeners, and other dependents or co-workers follow these guidelines.

    They must work with leaders in their primary or secondary communities to educate people about the existence and prevalence of this virus and to let them know that it can kill.

    For now, following these mitigation measures is our best bet. To put it in another way, the best cure for coronavirus for now is NOT to catch the disease at all.

  • JAMB since 2016

    JAMB since 2016

    By Niyi Akinnaso

    In a country where underachievement is pervasive and the government treasury continues to leak, it has become customary for journalists and armchair columnists to focus on negative developments. Yet, there are one or two trailblazers deserving of attention. The Joint Admissions and Matriculation Board is one such institution. Yet, much less has been written to highlight the Boards achievements, because the Nigerian press has typically interpreted its role of holding the government and its institutions accountable to mean that we must look for something to criticise or condemn.

    To be sure, JAMB has been the focus of media attention for various reasons since its establishment in 1978. Up until 2016, when Professor Ishaq Oloyede was appointed as the new Executive Secretary of the Board, much of the report on JAMB had been negative. That negative focus welcomed Oloyede into office and continued through his first year in office.

    A retrospective analysis of JAMB’s activities since 2016 to date reveals several major achievements, which were unprecedented in the history of the Board. These achievements were neither foreseen nor understood when the new Registrar began a comprehensive overhaul of the Board’s activities. In the process, the media focused on the gaps and lapses, which the overhaul revealed, while also criticising the Board for innovations that would eventually be widely accepted because they are found to be extremely beneficial.

    The first major development was the reorganisation of the Board’s activities through the deployment of new technologies, which allowed the Board to streamline and speed up the processes of registration and verification of results; to detect abuse in Computer Based Test Centers both by Center owners and test takers; to administer the distribution of admission spaces in a fair, equitable, and transparent manner; to ramp up capacity building in specific areas for its staff; and to save operational and management costs.

    A few examples will suffice. First, by closely monitoring CBT Centers and test takers over the years, JAMB had discovered and delisted defaulting CBTs, while also cancelling the results of test cheaters and prosecuting them, where necessary. It is now nearly impossible for fake candidate to stand in for a genuine applicant. The ultimate goal is to make the UTME error-free, rigorous, fair, and reliable enough for tertiary institutions.

    A second development is the elimination of the old-fashioned methods of using scratch card, third parties, such as Cybercafes, and text messaging for checking UTME results. JAMB has now gone fully digital with the result verification process. Students can now check and even print their results for free from the comfort of their homes by logging on the Board’s website at www.jamb.gov.ng. After three simple steps, the result slip could be printed: One, click on QUICK LINKS. Two, click on E Facility. Three, provide your registration details and click on check my results. Bingo! Your result notification slip will be displayed for printing.

    A third major innovation is the Central Admissions Processing System. It is an automated system for all institutions in the country to conduct their admissions. This system has three major advantages. First, it takes JAMB out of the show and leaves the sole authority for recommending candidates for admission to the respective institutions—universities, polytechnics, colleges of education, and so on.

    Two, the system eliminates the institutions’ portals from conducting admission, which led to flagrant abuse of the admission process in the past. It also eliminates under-the-table admissions by ensuring that only candidates admitted through CAPS will be issued their admission letters on JAMB’s official letterhead.

    JAMB has developed JAMB CAPS Mobile App for students to be able to login in with the phone number they had used for the UTME registration. After logging in and following the appropriate prompts, an OTP code will be sent to the provided mobile number. Once the code is entered and verified, the candidate’s admission notification will be displayed.

    Some, including me, had argued in the past that JAMB’s duty should have ended with the conduct of the UTME and left the universities to make their own selections. There were even critical spats at JAMB for going beyond its mandate by policing the exams. Only those who have attended JAMB’s policy meetings in the last three years would appreciate the extent of exam malpractices and the extent of abuse of the admission process by various institutions. The truth is that the education system is not exempt from the endemic and systemic corruption in the country. That’s why, to some extent, JAMB has to continue to function more or less as the EFCC of the admission process. It may not be the best thing to do but it is the only option available for now. And it is working!

    Perhaps the most astonishing achievement of JAMB since Oloyede took over its administration is the return of billions of Naira to government coffers every year since 2017, in compliance with the mandate to MDAs to remit their operating surpluses to the Treasury Single Account. So far, in four annual tranches, JAMB had remitted over N28 billion. As reward for good service, the government gave the Board part of the refunds to overhaul its infrastructure. The government also gave part of the excess funds to the UTME applicants, by reducing the cost of application from N5,000 to N3,500.

    JAMB has wisely invested its own share of the money in enhancing its technology; building mega CBT Centers across the country; in developing a question bank; in staff training; and in creating several innovations to meet the COVID-19 contingencies, such as the e-facilities for checking results and for setting up appointments at zonal and state JAMB offices.

    Also as part of its own corporate responsibility toward combating COVID-19, JAMB has donated ventilators, PPEs, and other medical equipment, worth millions of Naira, to the University of Abuja Teaching Hospital. It also took care of its staff nation-wide by purchasing ventilators, environmental disinfectant safety sprayers, and vehicle-mounted disinfectant sprayers from the National Agency for Science Engineering Infrastructure to sanitise its workers daily across the nation.

    It is interesting to note that JAMB’s performance in the last four years has led ASUU and university authorities to shift the tune from talks of university autonomy to how JAMB could share the money it makes with the universities as intervention funds, for example, to improve Internet connectivity on campuses!

  • COVID-19 lessons from Vietnam

    COVID-19 lessons from Vietnam

    Niyi Akinnaso

     

    WHEN I arrived at the Noi Bai International Airport in Hanoi, Vietnam, on April 11, 2019, one thought dominated my mind: How far along the path to recovery has the country come after at least two decades of civil war (1955-1975), which eventually involved its immediate neighbours and, more importantly, the United States, China, and the old Soviet Union?

    This thought became dominant because of the devastating effects of the war on lives and property. Over 2 million Vietnamese were killed in the war; 3 million were wounded; and 22 million became refugees. The war also demolished the country’s infrastructure and economy. I could not but ask myself how such a country could recover from such a ruinous war, which lasted nearly seven times as long as the Nigerian civil war (1967-1970) and inflicted much less damage?

    It took only a few hours to realise the high quality of governance at every level and how disciplined a society Vietnam is. A tour of the country showed how much national improvement had resulted from these traits. To be sure, there are motor vehicles of different shapes and sizes, motorcycles (okada) are still the predominant mode of personal transportation. They dominate the streets, even in the biggest cities, such as Hanoi and Ho Chi Minh City. Yet, in nearly two weeks spent in both cities, not a single accident was reported.

    What is most encouraging about Vietnam is the people’s entrepreneurial spirit, which mirrors the government’s enterprising adventures. After the war, the government embarked early on egalitarian land distribution and equitable economic policies aimed at improving living standards and reducing inequality. And the people seized the opportunity and worked the land. Once a poor country, the relative poverty rate in Vietnam quickly became less than that of China, India, and the Philippines. Today, Vietnam is a middle-level country.

    For quite some time, agriculture was the mainstay of the economy. Today, Vietnam is the world’s largest producer of cashew nuts; the largest producer of black pepper; and the second largest rice exporter in the world.

    However, the country has since moved beyond agriculture. Today, light manufacturing, information technology, and high-tech industries are a large and fast-growing part of the national economy due to huge investments in science and technology in recent years.

    Against the above backgrounds, I was curious to know how Vietnam has been coping with the coronavirus pandemic, especially given its shared border and trade ties with China. The findings show a country that is proactive, plans well, executes its plans, has the trust of the citizens, and strives to be self-sustained in its COVID-19 containment and treatment strategies.

    As of June 15, 2020, the total confirmed cases in Vietnam is 334 out of which 303 have been treated and discharged. Not a single death has been recorded. Yet, Vietnam is a country of about 95 million people. How did this happen?

    There are several major factors. First, Vietnamese authorities were aware of the pandemic very early and started planning before they even had their index case on January 23, 2020.

    Second, after monitoring the situation in China for a few days after the index case, Chinese tourists were quickly banned from entering Vietnam and all foreign nationals were later banned from entering the country. Strict quarantine and testing measures were put in place for returning nationals.

    Third, drastic and people-centric strategies were developed and strict quarantine measures were enforced, especially in communities with even a single reported case.  Each local administration meticulously traced every single person who may have been infected with the virus and quarantined entire streets as well as villages even over a single case.

    At the same time, hospital capacity was beefed up to cope with possible cases. Bed spaces, health workers, and Personal Protective Equipment were meticulously monitored to prevent overflow or shortages.

    Fourth, the authorities effectively mobilized the strength and the participation of both the government and the citizenry in making COVID-19 prevention a priority. Wearing face masks, washing hands with soap or sanitizer frequently, maintaining physical distancing, and avoiding large gatherings quickly became the new normal. Both the government and the people did not mind sacrificing immediate economic benefits to protect people’s health and lives.

    Fifth, rather than rely on China for medical supplies and testing kits, the Vietnamese authorities turned to their scientists and factories as early as January. Testing kits were developed by Military Medical University and Viet A Company. The Ministry of Science and Technology funded the projects and the kits were licensed by the Ministry of Health. They also produced their own PPEs

    The COVID-19 testing kits they produced provide result within an hour with a 90 percent accuracy. The testing kits use the Real-Time reverse transcription polymerase chain reaction (RT-PCR) method, and have passed European Standards. They also have been recognized by the Emergency Use Listing procedure of the World Health Organization.

    The testing kits, which are said to be adaptable with multiple types of testing equipment, went into mass production in March. The kits are exclusively ordered by a distribution partner and are now being used in many countries, including the UK, the US, India, and Mexico. Over 20 countries and territories are said to be negotiating for the purchase of the testing kits from Vietnam.

    What is particularly significant about the Vietnamese approach is the early decision to decentralise the containment and treatment efforts. Local communities have been in the forefront of the fight against COVID-19 in Vietnam, quickly identifying infected persons, tracing, tracking, and treating them, where necessary.

    The high degree of compliance with appropriate mitigation measures also played a major role in Vietnam’s success. It is most unfortunate that Nigerians still have to be educated about how deadly COVID-19 is when the number of Nigerians killed so far by the virus far exceeds the total number of infections in Vietnam.

    With infections rising and killing more and more people, it is high time to mount widespread public education to reduce the level in public ignorance and increase compliance with mitigation measures. Without a doubt, the Presidential Task Force on COVID-19 has preached the necessary sermons. The situation is now beyond sermonisation. It is now time for real grassroots education at the community level.

     

     

     

  • How schools may reopen gradually

    How schools may reopen gradually

    Niyi Akinnaso

    I argued last week why schools should not reopen until September 1, 2020. The basic reason is that the transmission of COVID-19 in various communities across the country is on the increase. Worse still, the outcome is at present so unpredictable that no permanent arrangements can be made about the immediate future, not least about reopening schools.

    Here’s how the Secretary to the Government of the Federation and Chairman of the Presidential Task Force on COVID-19, Boss Mustapha, put it to a Senate Committee barely 48 hours ago: “I must say that the virus is still very dangerous. We have not peaked; we have to meticulously plan. There is no timeline; that is why money is not being thrown at it just because it has been released … We don’t know how long this will take us. Even the budget that the National Coordinator mentioned is for a period of six months. We do not know how long it will take us”.

    Knowing what we know today about the behaviour of the COVID-19; the incredulity of many Nigerians about the virus; and the non-compliance of most Nigerians with the WHO-supported mitigation measures established by the Nigerian Centre for Disease Control, it will be foolhardy to think of reopening schools earlier than September. Neither the science not the data of COVID-19 in Nigeria today leads us to think of reopening schools soon.

    Even in advanced countries, such as the United Kingdom, which hurriedly reopened some primary schools, have had to recant. Many of Britain’s primary schools vowed not to reopen, while the discussion about reopening secondary schools have not even started.

    Some universities in the UK, such as Cambridge University, have even cancelled in-class meetings (save for a few exceptional cases) and moved classes wholly online for the 2020/21 academic session. Some American Universities, such as the 23 campuses of the California State University system, have followed suit.

    There are three problems with reopening schools in Nigeria, where many dormitory rooms are as overcrowded as classrooms. First, the infrastructure for maintaining physical distancing and washing hands with soap every now and then is not available in most schools.

    Second, parents, teachers, and students often come from different parts of the country to many of the nation’s schools, especially in the cities. With the confession of the PTF that Nigerians are refusing to show up for testing, who knows what many of them will bring to the schools, if they were reopened while the infections are spiking without an end in sight?

    Third, apart from talking about planning for a staggered reopening of schools at some point in the future, what exactly has the federal and state ministries of education done in terms of preparations? Are there enough masks for the schoolchildren? What about PPEs for the teachers, administrators, and other school aides?

    What role are teachers playing in the government’s plans to reopen schools, whenever it happens? Have federal and state governments discussed with teachers and parents the social, psychological, and financial needs that should be met before schools are reopened?

    As for the universities, the idea of online learning is nothing more than self-deception on the part of government and many universities in the country, because neither the infrastructure nor the trained personnel is available in most public universities. Even in private universities, such as Elizade University, which boast of successful online classes during the ongoing pandemic, the percentage of students who are able to participate effectively ranges from 30 to 70 percent.

    If the situation could be that bad in the universities, imagine how poor it could be in primary and secondary schools. That’s why the idea of radio, TV, or online learning for primary and secondary schools during the ongoing pandemic is nothing more than a big joke. Of course, the government’s good intention should be acknowledged. Nevertheless, it is an intention that was never backed by necessary and appropriate resources. For students to learn profitably online, they should have been trained to do so during normal school time, not dumped on them in an emergency.

    A critical step toward reopening the universities is being taken by the Joint Admissions and Matriculation Board this month. The 2020 Policy Meeting for all tertiary institutions will hold online this year on June 16, 2020 out of respect for the NCDC’s COVID-19 protocol that prohibits large gatherings. The process of admission for 2020/21 follows the policy meeting and it traditionally takes three to six months from that date. It is at that meeting that heads of various institutions will agree on cut-off points for admission into various categories of tertiary institutions.

    The critical question now is about those who have to take final exams, especially school-leaving and graduating exams. These are the ones I had in mind for a September reopening, and that only if it is possible. Schools could be open between September and December for such students to study for, and write, their exams, while the 2020/21 in-class academic session could begin in January 2021, with a modified school calendar of not more than 12 weeks per semester. In that case, the 2019/20 academic session would have been extended to December 2020 for final year students and lost by others to the COVID-19 pandemic.

    However, this is a special circumstance to be negotiated with parents, teachers, and students by federal and state governments as well as proprietors. It will be unwise to simply assume that we should just move on like that as we are wont to do in Nigeria.

    At this juncture, it is necessary to address a lingering question on many parents’ and students’ mind regarding this year’s WASSCE and NECO exams postponed owing to COVID-19. To the extent that in-class meetings are required for these exams. I don’t see any of them taking place before September 1.

    A similar question is also on the minds of many University Vice Chancellors and Registrars. Some of them have been contemplating online final exams for their students. This is possible for those who have the infrastructure for mass video coverage, such as Webex, Zoom, Google Suite, and so on, to monitor the students. The problem, though, is that no one can guarantee that all students will have the necessary resources at their end to write online exams.

  • Why schools should not reopen too soon

    Why schools should not reopen too soon

    Niyi Akinnaso

     

    THE term school is used here as a cover term for all institutions used for the formal transmission of knowledge and skills, particularly primary, secondary, and tertiary institutions. Much as I would want learners in these institutions to go back and resume their studies, I cannot dismiss my concern for the safety of the teachers, the learners, and the parents, who drop them off and pick them up. I define safety here in terms of data and scientific information about the coronavirus infections and not in terms of politics, economics, or emotions alone.

    The arguments for reopening schools, even tomorrow morning, must be acknowledged. First, no one can deny the learning losses of pupils and students arising from the disengagement from their learning for over two months. There is a high probability that they might have forgotten much of what they learned before the disengagement.

    Although federal and state governments as well as private proprietors have set up radio, TV, or online platforms for continued learning, poverty and poor infrastructure have deprived the majority from participation. Therefore, going back to school will provide the most advantageous forum and level playing field for all students to learn.

    Second, there are also social reasons for reopening schools. Children miss their teachers, friends, and school routines. It cannot be denied that the school provides a clear support system for schoolchildren and plays a major role in their socialisation. That’s why the social network established in school, from primary to tertiary level, often lasts forever.

    Third, many poor pupils in public primary schools have been missing out on good nutrition from free school lunch. For such children, extended lockdown may prolong their nutritional deprivation. It is doubtful if the federal government’s controversial provision of “dry food” to the homes of such students can substitute for prepared hot lunch served in schools.

    Fourth, in the absence of day care centers, many working parents, for whom schools function as care centers, were in a fix as to where to keep their young ones as they resumed work after easing the lockdown. For now, some have been able to get by with the assistance of relatives and others, such as teachers, who are not yet back at work. However, the problem will escalate, when the lockdown is fully removed, without reopening schools.

    Finally, there are pressing economic reasons to resume work and reopen schools. The damage caused to the economy and to education could cancel out the benefits of continued lockdown and school shutdown. Conversely, however, the damage caused by premature school reopening could cancel out the health safety being secured by the lockdown.

    Against the above backgrounds, the argument really is not whether schools should reopen. The question is when and how. If it is agreed that the reopening of schools should be contingent on health safety, then there is no sign at the moment that we have reached the safe level of COVID-19 infections to warrant reopening schools.

    For one thing, the data on infection rates in different parts of the country do not support reopening schools any time soon. The Minister of State for Education, Dr. Chukwuemeka Nwajiuba, admitted on Moday, June 1, during the Presidential Task Force briefing, that the scientists still do not support the reopening of schools, but without providing the data for their conclusion.

    The data suggest (1) that the country has entered the community transmission phase of the COVID-19 infections; (2) that the rate of infections is growing at an exponential rate; and (3) that the country has not even reached the peak of infections.

    Here’s why: At the end of February, 2020, there was only one case in a single state. By the end of March, the infections had spread to 11 states with 139 cases. Alarmed by the growing rate of infections, the first phase of lockdown was imposed on the hotspots of Lagos, Ogun, and the Federal Capital territory. Other states soon followed with variations of the lockdown to suit local circumstances.

    The lockdown notwithstanding, the cases grew to 1,932, covering 34 states, by the end of April, 2020, forcing an extension of the lockdown. However, by May 3, 2020, when the cases were at 2,388, the federal government decided to ease the lockdown, even as hundreds were dying in Kano in what were described as “mystery deaths”, but later found to be consistent with COVID-19 infections.

    Phase-1 of the lockdown was extended on May 20, while infections stood at 6,000. However, by May 31, just 11 days later, Nigeria had surpassed the 10,000 mark. This made Nigeria (10,162) the third most infected country in Africa, after South Africa (32,683) and Egypt (24,985). As of the time of writing (Monday, June 1, 2020), infection cases stood at 10, 578, with 299 deaths.

    The above data show that nearly 10,000 cases occurred within the month of May alone, with the highest single day infections of 553 occurring on May 31, 2020. Besides, nearly half of all cases since February occurred within the last two weeks alone. These data confirm that the infection rates in Nigeria are on the rise and have yet to peak.

    Clearly, the rationale for further easing of the lockdown and for allowing churches and mosques to congregate begs for explanation. True, the PTF provided guidelines; but the same PTF had often lamented the noncompliance of Nigerians with necessary mitigation measures.

    If adults have problems complying with mitigation measures, imagine what chaos will be on display in schools and universities if they were to reopen as infection rates are rising. If, as elsewhere, passing the peak for new infections is the first hurdle for reopening schools, then it is clear that Nigeria is not yet there.

    Fortunately, in the middle of composing this piece, the PTF acknowledged the foregoing and has deferred the reopening of schools until further notice. Whatever the PTF means by “further notice”, it should not be earlier than September 1, 2020. How this should be done will be addressed next week.

    The point should not be lost that educational institutions are sites of convergence, bringing together teachers, students, and parents from different parts of the country. This creates potent sites for community transmission, especially as infections are spiking. Even in South Korea, where infections were down, the reopening of schools led to another spike, which sent the country into yet another lockdown.

     

     

  • Franklin Ibukun Akinkoye  (1955-2020)

    Franklin Ibukun Akinkoye (1955-2020)

    Niyi Akinnaso

    It is customary for Idanre elders to mourn silently and operate in the background to rally and console the survivors, when a younger person dies. That would have been my role were I in the United States, when Franklin Ibukun Akinkoye passed on on May 7, 2020.

    I now use this medium to console his immediate family in the United States—his wife, Jumoke; his children, Kemiade, Olukayode, and Ayodeji; and his granddaughter, Riley—and his extended family in Nigeria, especially his older sister, Ademoji. I also use this medium to record Frank’s legacies for posterity. He was a role model, too professional, too successful, too kind, and too friendly to be buried unsung.

    His was a true success story of rising from humble origins to the pinnacle of his profession. But the profession for which he became famous was not his first choice. He had planned very early to be a drummer. His inspiration came from Asilu, a talking drum expert, who mesmerized the youths with dexterous performances during funerary precessions in Idanre in the 1950s and 1960s. Name any tune and Asilu’s talking drum would “sing” it for you with rich cadence. Convinced that he was going to be another Asilu, Frank would abscond from school and follow the master drummer on funerary processions, literally forcing himself on the drummer as an apprentice.

    Thanks to a vigilant teacher and a family member, who intervened and got him back to school, we would never have been exposed to the managerial astuteness of the well groomed financial management expert and outstanding human being that Frank eventually became.

    Once he knew his drumming ambition was no longer feasible, Frank focused on his studies and still completed his primary and secondary education in record time. After secondary education, his next target was further education in the United States. This is where his financial planning began.

    He needed to raise funds, and the surest way to do so was to get a job. Fortunately, he landed one with the Nigerian Ports Authority in Lagos. He worked there for three years and saved enough funds to get him to the United States in 1979.

    After initial struggles in New York, Frank eventually settled in Maryland, where he attended the University of the District of Columbia in Washington, D.C. He enrolled in the School of Business and Public Administration, majoring in Business and Finance.

    His training at UDC prepared him for his eventual career as a financial management expert. He was first hired in 1990 as Financial Advisor by the Prudential Insurance Company of America and later became President of Continental Insurance and Financial Services Company. He was also Chairman and Chief Executive Officer of Black Rock Corporation.

    These positions prepared his elevation to membership of the National Association of Insurance and Financial Advisors; the President’s Council; the Masters Council; and the Million Dollar Roundtable. In the course of serving in the finance industry for at least three decades, Frank established a wide network of business associates and friends across various professions and government circles.

    He deployed this social capital and his personal fortune to the services of his immediate family, his social and business associates in Maryland, and his home state of Ondo in Nigeria.

    Frank was a pioneering member of two major umbrella entities in the Maryland area, each of which he once chaired . One, the Alliance of Yoruba Organizations and Clubs, brought together various Yoruba associations, while the other, African Business Owners Forum Incorporated (ABOFI-USA), provided a forum for business owners from Africa to pool their resources and expertise for more profitable services.

    He used his leverage with the Maryland state government and rallied other indigenes of Ondo state to forge a sister state relationship between the Maryland state government and the Ondo state government. He also served on the Advisory Board of Maryland Sister States.

    Using the platforms of ABOFI-USA and Black Rock Corporation, Frank was central to the reception of the 25-member business delegation of Maryland State, led by then Secretary of State, John McDonough, to Ondo State for the signing of the friendship agreement between the two states in November 2012. This agreement paved the way for the official Memorandum of Understanding, signed by the two state Governors, Dr. Olusegun Mimiko and Mr. Martin O’Malley, on June 7, 2013.

    Frank also led two successful medical missions to Ondo state, bringing doctors, pharmacists, and nurses from the United States and the United Kingdom to join their counterparts in Nigeria in providing free medical services throughout Ondo state. He also got various pharmaceutical companies in the United States and Nigeria to donate free drugs and medical supplies during the missions.

    Before turning attention to the state, Frank played a leading role in bringing the Owa of Idanre, Oba Frederick Adegunle Aroloye, Arubiefin IV, and some of his High Chiefs to the United States in 2007. In return for his unique contributions to his hometown, Frank was rewarded with the chieftaincy title of Atunluse of Idanre Kingdom.

    Frank had hobbies to which he turned for relaxation. His brief escapade with Asilu ingrained in him the love of music, which stayed with him throughout his life. Frank was also a sports enthusiast. But his favorite sport was the game of life: He enjoyed connecting with people as well as connecting people with people. He also enjoyed providing assistance and advice to people in need. Only those who knew him closely would know that, beyond health problems, his real pain in the last three years was inability to perform his usual bit of connecting with people.

    I participated, often as patron, in the medical missions; the Owa’s visit; and the signing of the MOU between Ondo and Maryland states. I also covered the events on my column in The Punch newspaper. Frank and I exchanged visits in the United States and he never came to Nigeria without visiting me. On one occasion, shortly after I was discharged from hospital in 2011, Frank drove all the way from Upper Malboro in Maryland to visit me at home in Franklinville, New Jersey, in the company of then Governor Olusegun Mimiko and his entourage. True to character, Frank opted to pick up our bills at an expensive restaurant.

    Thank you, Frank, and do rest in perfect peace.

     

  • Community transmission: Individual and community  responsibility

    Community transmission: Individual and community responsibility

    Niyi Akinnaso

     

    MOST readers of this column are aware of the existence of the coronavirus strain known as COVID-19; but some of them may not fully appreciate its possible impact on their immediate community. They learn about the daily infection figures released by the Nigerian Centre for Disease Control, quite alright. However, such statistics are just figures to those whose relatives, friends, or close acquaintances have not been infected by, or died from, the disease.

    Yet, the virus now lives in various communities, possibly including yours, because there already could be local vectors, that is, transmitters, of the virus who were infected by some other persons they may or may not know. The infection could have come from passengers on buses; from sellers and buyers in open markets; from relatives or friends recently engaged in face-to-face conversations with others, and so on.

    The problem with the coronavirus is that the vectors could be asymptomatic for a while, that is, they may not manifest any symptom of the disease or even know they have been infected with the virus. Yet, once infected, they could easily infect others without knowing it. It is this phase of the transmission that is known as community transmission. The community may be a local government area, a small neighbourhood, an isolated ship, or an area set apart from others by some physical or social boundary. Some examples will suffice.

    In 1911, experts learned a lot about measles from its rapid community transmission on Rotuma, an isolated Polynesian island. The failure to isolate the first few vectors of the disease led to high fatalities on the island. Similarly, much was learned about influenza in 1979 from how quickly it spread among passengers stuck on a grounded plane in Alaska.

    Even more recently, we learned about how the coronavirus infection spread very quickly among passengers on various cruise ships. Similarly, as many as 50 sailors were infected by COVID-19 in April, 2020, aboard a French Navy’s Aircraft Carrier. On a much wider scale was the rapid spread of COVID-19 infection of 600 sailors on USS Theodore Roosevelt about the same time.

    Perhaps, by far, the most dramatic case of close community transmission is the one reported by the US Center for Disease Control and Prevention. It was an outbreak of COVID-19, which affected as many as 52 of 61 people at a 3-hour choir practice in March in Skagit County in Washington state in the United States. In each of these cases, it took one or two infected persons to infect the others. In the case of the choir group, it was just one person with mild respiratory symptoms, who triggered the outbreak.

    These rather isolated examples are symbolic of community transmission on a large scale, which is now the situation with COVID-19 throughout the world. The Nigerian case is particularly significant, partly because of its large population and high urbanisation, partly because of inadequate testing, and partly because many people are in denial, including the leadership in hotspots in the North, such as Kano, and many slum and rural dwellers across the country.

    Yet, the speed with which the infections spread in Kano and other Northern states in recent weeks should highlight the hitherto undetected spread of COVID-19 in many other communities across the country. Regardless of the authorities’ denials, the so-called “mystery deaths” in the North are believed to be related to COVID-19.

    The good news is that the opportunity to limit community transmission of COVID-19 is right at our disposal. An outline of the opportunity was provided at one of the Presidential Task Force briefings last week by the Minister of Interior, Ogbeni Rauf Aregbesola. Below s a modification of the model of community surveillance he suggested.

    The nucleus of the model is a Community COVID-19 Incident Management Committee under the leadership of a respectable community leader with the councilor in each ward and at least one healthcare worker as members. The Committee’s functions would include:

    Working with traditional, political, religious, business, market, and union leaders as well as local associations to identify and designate a Holding Centre within the community, such as a hall, school, church, mosque, or an unoccupied house.

    Mobilising community members at home and abroad to furnish the centre with basic living and welfare needs and the healthcare workers on the committee with adequate personal protection equipment.

    Working with community members to provide surveillance and identify those who either think they are infected by the coronavirus or are already manifesting symptoms.

    Encouraging the movement of such persons to the Holding Centre in order to save others from infection.

    Contacting the nearest public health officials for proper management of identified cases and their transfer to the nearest state Isolation Centre.

    This suggestion is particularly useful in crowded communities, where a state-designated Holding Centre is non-existent or far away. Of course, the community Holding Centre should be seen only as a stopgap, rather than a treatment centre. Its usefulness is in quickly pulling out infected members of the community before they spread the virus beyond control as we have seen in Kano.

    As Northern leaders have come to realise recently, the existence of COVID-19 can no longer be denied. Nevertheless, the masses still need to be convinced that it is a killer disease that can attack any and everyone. That’s why public education is still necessary at the community level.

    Therefore, the Community COVID-19 Committee should work with appropriate local authorities, community leaders, and associations to sensitise their people to the reality of COVID-19 and the need to enforce necessary guidelines provided by the NCDC and emphasised during the PTF’s daily briefings.

    Everyone should be educated to understand that lockdowns; staying at home; wearing face masks; washing hands frequently with soap or alcohol-based sanitiser; and maintaining physical distance of at least 5 feet from others are necessary mitigation measures adopted worldwide to protect citizens from spreading or contracting the virus. It is now time for community leaders to shoulder this educational responsibility.

    While a community committee is needed for surveillance, the education of the masses is also necessary if we want individuals to take responsibility for protecting themselves. As Aregbesola had suggested, the guiding philosophy should be: “One for all, all for one”.

     

     

     

     

     

  • You may host the Coronavirus soon

    You may host the Coronavirus soon

    Niyi Akinnaso

    Not my portion, as some Nigerians would say of this headline. Such denials, however, do not lessen the danger of this coronavirus, code-named COVID-19. The truth is that it is easily transmissible and, therefore, highly infectious. It has infected over 4 million people and killed nearly 300,000 worldwide. Although the figures still appear relatively low in Nigeria—over 4,000 infections and nearly 200 deaths—we must be very careful with the virus, because it is already lurking in our communities and infecting more and more people daily.

    This is what is meant by “community transmission” or “community spread”. There are vectors among us, that is, those who are already infected with the virus, having been infected by previous contacts. Some of the vectors may not even know, because they have no symptoms—that is, no signs of infection yet.

    Nevertheless, they transmit droplets of the virus, whenever they talk, sneeze, or cough within a meter or less of other persons. The droplets can then infect those other persons through the mouth, nose, or eyes. They eventually make the lungs their habitat, leading to fever (higher than normal bodily temperature), headache, sneezing, coughing, and other symptoms. As the virus takes over the lungs, breathing becomes more and more difficult. That’s why some infected patients need oxygen to help them breathe. In extreme cases, the lungs may fail, leading to the use of a ventilator to take over the breathing process.

    If you are not convinced yet that community transmission has arrived with full force, just look to the almajiri in the North. They are perhaps the largest most potent vectors of coronavirus in Nigeria today. Following their forced exodus from Kano by the vengeful Governor Abdullahi Ganduje, they’ve become itinerant vectors of coronavirus across the country, infecting people in Jigawa, Kaduna, Bauchi, Taraba, and Oyo among others.

    That’s why their attempts to cross state borders, in spite of government-imposed state border closures, have been met with stiff resistance, Thus, recently, food ferrying trucks, loaded with almajiri, have been turned back in Abia, Benue, Cross River, Ogun, Ondo, and Osun states.

    The guidelines provided by the Nigerian Center for Disease Control are intended to prepare the general public for preventing themselves against infection. The guidelines include

    • imposing a lockdown, especially on hotspots;
    • staying at home during the lockdown;
    • wearing a face mask on stepping out of the house;
    • washing hands frequently with soap under running water or using alcohol-based hand sanitiser;
    • avoiding touching one’s face, nose, and mouth, because those are the entry points of the virus; and
    • maintaining physical distance of at least 5 feet away from the next person. These guidelines are based largely on those provided by the World Health Organisation.

    Federal and state government have been assisting the most vulnerable members of society financially and materially in order to ease the economic effects of the lockdown. Businesspersons, communities, organisations, and individuals have also been assisting in the process.

    It is also the duty of the government to give hope to the people, by assuring them of their safety, while also telling them the truth about the handling of the virus. This, in fact, is the basis for the daily briefings on the progress made in containing the virus and the daily publication of infection cases and casualties. President Muhammadu Buhari may be missing in action, as usual, but the Presidential Task Force he set up has been up to the task in the face of global competition for the same medical supplies and with limited funds.

    To be sure, federal and state governments continue to be criticised for not doing enough as are governments and their leaders all over the world. Neither American Donald Trump nor British Prime Minister, Boris Johnson, who got infected and nearly lost his life in the process, are exempted from sharp criticisms. No government was prepared for COVID-19, and no government has a perfect answer to the attendant problems.

    Nevertheless, there is no doubt that COVID-19 has exposed the Nigerian government’s inadequate investment in healthcare more than many other countries. This was clearly demonstrated by the admission by the Director General of the NCDC, Dr. Chikwe Ihekweazu, that there are only “about 3,500 bed spaces available across the country” to serve a population of over 200 million! “This is insufficient”, he added, “and it leaves the infectious disease control agency to struggle.”

    This admission is indicative of the shortfalls in all areas of healthcare across the country. There are shortfalls in healthcare providers. There are shortfalls in testing laboratories. There are shortfalls in medical supplies, including personal protective equipment for medical personnel.

    The inadequacies of the country’s health facilities should have guided the government in its initial reaction to the pandemic. International borders should have been closed by February 28, when it was clear that the index case came from Italy and that the virus was already spreading in Europe and the United States. Furthermore, arrangements should have been made much earlier, rather than wait until recently to scamper for hotels to use as isolation centres for quarantining and testing returnees from the Diaspora.

    These shortcomings should have warned the general public to be prepared to take responsibility for their own safety. Unfortunately, there are far too many poor people in the country, who could not withstand prolonged lockdown without dyeing of hunger. According to the National Bureau of Statistics, about 83 million Nigerians live on less than N137,430 a year, that is, less than N400 a day! Their disdain of the government was accentuated by the celebrated palliatives, which never reached them. Besides, the high level of incredulity about the virus among poor and illiterate populations makes compliance with prevention guidelines difficult, if not impossible.

    Of course, the elite have taken the guidelines seriously. However, they seem to forget that the masses that threw caution to the wind, especially after the government relaxed the lockdown on May 4, 2020, could become vectors of the disease. The artisans, drivers, and other daily paid workers, who work for the elite, could re-infect the elite, who are now cocooned in their homes. They, therefore, have a dual responsibility of self protection and of educating the masses to protect everyone by protecting themselves first.

    The elite have to do this if they don’t want to host the coronavirus soon.

  • Reactions to COVID-19 and mitigation measures

    Reactions to COVID-19 and mitigation measures

    Niyi Akinnaso

     

    AFTER the coronavirus, otherwise known as COVID-19, had landed in Nigeria through airplane travellers from Europe and the United States, the government began contact tracing, testing, and treating infected persons. The general public was advised to wear face masks; wash hands with soap under flowing water or  rub hands with alcohol-based sanitiser; maintain physical distance from other persons; and avoid crowds.

    Nigerians have reacted differently to the COVID-19 pandemic, which has infected over 3.6 million and killed over 253,000 people across the globe. The reactions vary from  ignorance, indifference, and denial to anxiety, worry, and confusion. At the same time, there are also those who understand the lethality of the coronavirus, and are, therefore, very cautious. Unfortunately, the latter group is in the minority in Nigeria. Yet, this is the group that the government typically speaks to on television and in print.

    The reactions to the coronavirus pandemic in the country reflect two extremes, indicating variations in levels of education, exposure, and historical knowledge. At one extreme are those Nigerians who simply have no idea whatsoever what coronavirus is or means or simply deny its existence. They include illiterates, artisans, and various categories of daily paid wage earners.

    I got to know their views through telephone conversations with contacts in Ondo state, especially Idanre, my hometown, and Akure, the state capital, where I have been in self isolation since mid-March. Most of the informants were people I grew up with and others who had worked for me or my wife on one project or the other in the last eight years.

    I found the level of incredulity among many of them intolerable. Nothing like coronavirus, many of them claimed with unfounded certainty. Some of them argued that the Federal Government manufactured the disease to get loans and donations from big businesses and that states were only providing figures of infected persons to obtain their own share of the money. There are some among them who thought it was only a disease associated with rich and powerful people since no one contracted it in their neighbourhood and the deaths they heard about were those of well-to-do people. Clearly, some of their views were molded by their knowledge of rampant corruption in the country.

    The people’s incredulity was further intensified by fake news, conspiracy theories, and the government’s policy shifts, occasioned by new knowledge of the pandemic and its steady spread across the country.

    A large chunk of the incredulous group consists of people officially designated as poor. Recent figures released by the Federal Bureau of Statistics indicate that 82.9 million Nigerians belong to this group. They live on about N138,000 a year, which translates to about N11,500 a month, that is, less than 400 Naira a day. Unfortunately, the longer the lockdown went on, the more hungry and uncomfortable this group became. This is also true of daily paid workers whose resistance to the government’s containment measures got intensified by hunger.

    The policies developed by various countries to curb and contain the pandemic have had debilitating effects on every kind of economic activity imaginable with the rare exception of those involved in the production of medical supplies.

    True, an economic meltdown of global proportions is in the making, the prospect for Nigeria is particularly dire. A country that has been struggling to survive largely on loans long before COVID-19 has had to borrow more in order to meet the costs of containment and treatment of the disease.

    Yet, the price of oil, Nigeria’s major source of income, has been slashed in half! The various emergency measures, including curfews and lockdowns, established by various governments, have led to drastically reduced demand for oil and its products, leaving oil producing countries with over-supply.

    Unfortunately, millions of Nigerians have no idea about the global economic situation and how it affects them. They are consumed in their own world of daily living, of waking up, finding something to do or someone to beg to provide food for the day. Just picture the almajiris in the North with begging bowls in hand. Unfortunately, they are now among the major carriers of the coronavirus as they move or are moved across Northern states.

    It is against the above backgrounds that we must assess the government’s COVID-19 policies. Although the government did well in initially restricting incoming flights to Lagos and Abuja, international borders should have been closed even at that time.

    The initial restriction of the lockdown to Lagos, Ogun and the Federal Capital Territory, where infections were initially detected, was also a grave error. The President should have secured the cooperation of all state governors to apply the lockdown nation-wide and close inter-state borders. All incoming arrivals from overseas should have been quarantined and their movement restricted within Lagos and Abuja for at least 14 days. Those initial errors reflect the government’s poor understanding of the patterns of spread in Asia and Europe, where lockdowns were applied nationwide.

    Today, the nation is suffering from the pains of those initial oversights as the virus spreads across the nation. This is particularly true of the North, where Northern governors were initially resistant to taking necessary mitigation measures. The warning editorial by The Punch newspapers on April 23, 2020, has turned out to be prophetic: “Severe danger lies ahead, … particularly with the stance of the Northern Governors’ Forum … (which) … decided that it would not prescribe a lockdown of the region … That decision is wrong and shows that these governors are not handling the pandemic scientifically”.

    A much greater danger lies ahead for the entire nation as the Federal Government lifted the lockdown on Lagos, Ogun, and the FCT on Monday, May 4, 2020. As the Presidential Task Force on COVID-19 noted on Monday, the level of compliance with safety measures to ward off infection has been extremely low.

    It may appear too early to assess the government’s action. But one thing is clear: In countries, such as Germany, Ghana, and Hong Kong, where lockdowns were lifted, the second spike has been devastating. We must expect an even greater spike, because we lifted the lockdown in the highly infected areas, even as the infection rates were going up.