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”.
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