COVID-19: Dissecting the numbers

Imagine you are standing in front of a large barrel full of mangoes. You can’t see the mangoes, but you can reach in and pick them out. Most are delicious, but a very small number of them are rotten. About one in 20,000, you are told. You reach in blindly and miraculously pick out a rotten mango. You reach in again and withdraw a whole heaping mass of mangoes, maybe 50 in all. Most are good, but when you look closely you see them: one, two, three, four, five more rotten mangoes. One rotten mango is an amazing coincidence. Five means the barrel has lots of rotting mangoes in it and you were being lied to.

A friend of mine had an interesting story to tell me. Her younger sister, an undergraduate international student, was returning to school in Turkey and needed a COVID-19 certificate. The Airlines had referred her to the NCDC website where a list of hospitals was given where she could be tested. The young girl was afraid of taking the test after viewing horrifying videos online and so when she got to the hospital, she chose the ‘Nigerian’ way. She was informed that for a certain amount of money, she could get the certificate showing she was negative and therefore fit to fly, without doing the test. Nigeria, I hail thee!

Another colleague of mine narrated to me how the figures were being gathered. At the end of the day, each hospital is expected to send the number of positive cases to the state ministry of health who will collate the figures of the entire state and then send them to the NCDC. He remembered how, on a particular day, he called the commissioner for health and told him that 16 people tested positive for COVID-19 in his centre and his response was ‘But you know I can’t report that nah… let us leave the figure at three. Three is a good number’.

As of yesterday, according to Johns Hopkins University’s Coronavirus Resource Center, Nigeria has reported 69,645 COVID-19 cases so far. This number is most definitely an undercount given the high numbers of people who have been presenting to hospitals with no capacity for testing, with fever, cough and difficulty in breathing. When you add those figures to the ones who were missed, because someone decided to make a quick buck or because “they” do not want their state to look bad, well, I dare say the actual number may be twice what we currently have.

Falsifying data or ‘Juking the stats’ is not restricted to Nigeria alone. China, Indonesia and Iran have all come under scrutiny for their statistics. If you believe the Chinese authorities, the country’s battle against the novel coronavirus is all but won. But that claim is clouded by a fog of skewed data, political imperatives, unreported cases and possibly deaths. Even in the US, some centres are being investigated for manipulating the data.

In Nigeria, some states have vehemently and consistently refused to accept the COVID-19 figures. Testing has drastically reduced and the numbers are being understated. Here is where the rotten mangoes come in. If COVID-19 is so rare—fewer than 300 cases are being  reported in Nigeria daily- then what are the chances that most households have a patient that has suffered a very bad cold or even died from illness this year? What is the explanation for the increasing number of health workers being diagnosed with COVID-19?

There are, therefore, a lot of rotten mangoes, statistically speaking.

So why is COVID-19 grossly under-reported? What is the big deal you may ask? Why are the actual figures not portrayed? Why the dishonesty?

Again, I will refer to China- when the first trace of dishonesty resurfaced and the WHO warned Chinese government officials of suffering an even worse pandemic if they continued to hide their actual figures, China rightfully responded, without denying their claims, that they were doing what was best for their country; code language for: Mind your business.

My guess is that the need to diminish the figures comes from a basic human trait- Likeability. The need to be liked and not stigmatised. The need to pretend that everything is all right and all should remain as it is. The need for everyone to remain calm and not to panic. The need to show Nigeria in a positive light and make it seem like we are doing better than other countries. We all remember the stigmatisation China suffered during the earlier months of COVID-19, with Trump repeatedly referring to it as ‘The Chinese Virus’. Just imagine if this virus had originated from Africa- Hian!

There is actually nothing wrong with this line of thinking. Only God knows the extent of the economic setback the country suffered during the months of lockdown. Some individuals may never recover. However, that the motive is not wrong does not make the action right. Diminishing or downgrading the disease will bring more harm than good in the long run. It is imperative for government officials to relay accurate information, especially among states so that its indigenes can take proper precaution. Knowing the actual numbers in each state will help the government to assess the public health facilities and decide on how to strengthen them. Budgetary allocations, policies and socio-cultural habits that are peculiar to the different states of this country will be reviewed and solutions offered.

I remember when the popular ‘Okada’ or ‘Achaba’ was banned in some states following a rise in crime perpetrated by people riding motorcycles. Prior to that, one of the wards in Murtala Mohammed Specialist Hospital, Kano had been nicknamed ‘Achaba ward’ due to the sheer number of accident victims brought in daily. It took a bad thing- a rise in insecurity- to bring about a good policy- the ban on commercial motorcycles. Today, most of us are happy that the menace called Okada are absent from our roads.

I believe that if we are honest, something positive can come out of this pandemic- a better public health care system. And if we can’t have that, then it would be a crying shame.

Correction: In last week’s article titled ‘#Zabarmari: A war with no name’, I wrongly referred to the light skinned individuals who were seen begging on the streets of Lagos as Yemeni. My attention was drawn and I was made to understand that they are Toureg from the Niger Republic. The Yemenis were brought to Nigeria in the 1920s by the British Colonial government to work as hide and skin collectors being skilled in the business.