COVID-19: Has Nigeria flattened the curve?

Since the first week of September, the country has continually recorded a low number of new COVID-19 cases daily.

On Thursday, Nigeria recorded 155 new COVID-19 cases, bringing the total confirmed cases to 59,738 out of 545,364 persons tested so far.

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51,403 cases have been discharged and 1,113 deaths have been recorded in 36 states and the Federal Capital Territory (FCT).

Nigeria’s epicentre of the virus, Lagos State recorded no case on Monday, October 5, 2020, according to data obtained from the Nigeria Centre for Disease Control (NCDC).

Since the index case of COVID-19 in Nigeria on February 27, the country witnessed a steady rise in the number of daily cases for about five months.

At the peak of the pandemic in May and June, the country recorded between 150 and 800 daily new cases.

The country in August began to record occasional decreases and occasional rise in new cases with Plateau State consistently topping the number of states with the highest number of new cases in the last week of August.

From September 1 to date, the cases have ranged from 50 to 250 cases.

In Lagos state, after no case was recorded on Monday, October 5, it recorded 41 cases the next day October 6, 2020.

The state also recorded 84 confirmed cases on October 7.

Lagos State has recorded  19,776 confirmed cases as of Thursday, October 8, with  4,322 on admission.

Out of the number, 15,250 have been discharged and 204 have died.

From 32 cases in March to 1,123 in May, the figures rose to 9,497 in June before it became over 19,000 by October.

Health experts and relevant government organisations such as the Presidential Task Force for the Control of Coronavirus (COVID-19), the Federal Ministry of Health, and the NCDC have however, warned that the low daily cases does not mean that the country has flattened the curve.

They warned the public not to be complacent but continue to adhere to the instituted safety measures and protocols.

Flattening the curve involves inhibiting new infections during an epidemic or pandemic.

It means slowing the spread of COVID-19 so that the peak number of people in need of care at a time is reduced and the healthcare system is not overwhelmed.

The same number of people may fall sick but the infections happen over a longer span of time when the curve is flattened.

Asked if Nigeria has flattened the curve, Dr  Chikwe Ihekweazu, Director General of the Nigeria Centre for Disease Control (NCDC) said,  “Generally, we are recording a decline in cases across the country.

However, the situation really varies across states.

“We still have a cumulative test positive rate of 11% meaning this percentage of people that have been tested, have come back as positive.

“WHO advises that to describe the epidemic as under control, we need to get to 5% positive rate or less.

“We have supported all 36 states and the FCT to establish testing laboratories.

“We have maintained an ongoing supply chain to ensure that laboratories can continue testing as required.”

A virologist at the Lagos University Teaching Hospital (LUTH), Prof Sunday Omilabu said that Lagos is having a decrease in the number of cases because many people are no longer coming for screening.

Explaining the pattern observed in the last few weeks, he noted that the number of tests carried out daily was reducing.

Among the few tests conducted, he said, those who tested positive are mostly asymptomatic who do not show signs and symptoms.

“We can speculate and say COVID-19 is going down because we don’t have severe cases anymore.

“It is not as if there are no more COVID cases in Lagos, but they were not as severe as it was three months ago.

“The virus is still in our midst.”

He added that nobody could say for sure when the virus will eventually become extinct.

Despite the reopening of schools, international flights, religious centres, Omilabu noted that the impact of the gradual reopening of the economy has not been seen yet.

“It’s too early to say the places reopened will eventually lead to a skyrocketing number of cases.

“Let us observe for some weeks before appraising the situation to know if the reopening will lead to more cases or not.

“Most schools are just reopening. The schools and religious centres that were just opened were observing the COVID-19 protocols.

“I don’t expect us to see any unusual increase.

“There would not be any cause for an alarm if they apply all necessary protocols.”

He said that the masses should not let loose their guard as COVID-19 was still active in the community, and cases are still being recorded daily.

“Since Lagos still records a few positive cases daily, it tells us that the disease is still very active amongst the population.

“We should keep to protocols such as hand washing, facemasks, distancing, and others.

“It is too early for people to avoid facemasks or sit in an overcrowded vehicle or environment.”

“There will be upsurge if care is not taken,” he warned.

He enjoined individuals with underlying medical conditions to keep to protocols as they would feel the impact of the disease the most if infected.

The severity of COVID in people with diabetes, high blood pressure, obesity, and other conditions are high as they will feel it the most, he stated.

The Lagos state Commissioner for Health, Prof Akin Abayomi urged citizens to keep adhering to safety precautions even as a low number of cases are recorded in Lagos state.

Chief Press Secretary to the Lagos State Governor, Gboyega Akosile said, “As Lagos continues to be the epic centre of the pandemic in Nigeria, it is important to emphasize that now is not the time for us to rest on our oars.

Rather, it is a time to remain conscious of the pandemic and to continue to intensify efforts at flattening the curve.”

Minister of Health, Dr. Osagie Ehanire, had during the national briefing by the Presidential Task Force (PTF) on COVID-19 on Thursday said the country was testing below capacity and does not have reason for complacency even with reduced cases and fatalities in Nigeria and the sub-region.

He said the second wave of COVID-19 outbreaks across several European countries and reopening of schools and economies and increase in international flights raises concern that there may be a surge in the number of positive cases, if the country does not step up its response strategies of trace, test, isolate, and treat.

He said, “Our testing and tracing capabilities have improved a lot, such that virtually every state has at least one laboratory that has increased our daily testing capacity to about 3,500.

“We are, however testing well below that capacity, because laboratories are receiving fewer samples than they could handle, leaving some partners to doubt our reports.

“I therefore appeal to state governments to improve on sample collection and capacity utilization.

“All persons with COVID-19 evocative symptoms, or who may have come in contact with a confirmed COVID-19 case should please submit themselves for testing.”

Speaking during an earlier briefing on Monday,  he said the number of active cases has continued to drop as the country revises its  discharge criteria in line with new knowledge of the disease even as it continues to strengthen case management pillar to provide effective and efficient quality care to all those who test positive whether they are in facilities or home care.

Secretary to the Government of the Federation, Boss Mustapha said the number of COVID-19 cases was dropping when compared on a month-to-month basis but that the country still needed to be vigilant.

He said the situation of COVID-19 in Nigeria continues to give the PTF serious concern especially as it relates to testing.

“In the week leading to Nigeria’s 60th Independence anniversary, we noticed a drop in the number of confirmed cases and a further reduction in the number of states reporting new confirmed cases, while the rest of the world continues to declare high numbers of cases and fatalities.

“Although Nigeria is no longer in the top five countries by cumulative deaths in Africa, the PTF continues to urge Nigerians to change their attitude of skepticism and nonchalance to the virus.

“For the avoidance of doubts, the virus is real, ferocious and deadly.

“The PTF is fully conscious, but not deceived, by the fact that our recovery rate is high and very encouraging.

“We still urge, however, that everyone should get tested because testing is the only way to detect, isolate, trace and treat,” Mustapha said.

He said health was a shared responsibility on the concurrent list adding, “and as partners in the fight against COVID, we urge sub-national entities to thread on the side of caution by increasing the rate of testing.

“We desire the support of institutions (religious, socio-cultural, traditional, etc) to insist on in-depth engagement at community levels, especially in observing the protocols.”