COVID-19 Lockdown violation: Fear heightens over community transmission in states

• People still gathering in markets, worship places

• Inter-state transportation on the increase

• Only 0.1 % of Nigerians tested

• Experts warn of out-of-control scenario

Community transmission of the deadly coronavirus is being recorded in states across Nigeria because of increasing violation of lockdown order amidst policy inconsistency by relevant authorities, Daily Trust reports.

Health authorities at the national and state levels are yet to give actual figures or the magnitude of the community transmission as the COVID-19 disease spreads to 19 states and the Federal Capital Territory (FCT).

But experts spoken to attributed absence of actual statistics to the inability of relevant authorities to test more people in line with the recommendation of World Health Organisation (WHO).

Analysis by the Daily Trust showed that Nigeria has so far tested only 0.1 per cent of its more than 200 million, far below the global threshold and the successes recorded by other African countries. (See info graphic on this)

This is amid fears that many people who have the virus are moving freely on the streets.

Though the federal government had only directed total lockdown of FCT, Lagos and Ogun states, many states followed suit as part of efforts to stem the spread of the COVID-19 pandemic.

But findings revealed that lack of uniformity on how the lockdown should be implemented and policy summersault in some states, lapses on the side of law enforcement agencies and the “I don’t care attitude of the citizens” are aggravating the spread of the diseases.

Authorities in the FCT, Lagos, Kaduna and Kano have all admitted recording community transmission but did not give specific numbers. Experts say unless urgent measures are taken, the situation could go out of hand in the coming weeks.

The federal government had on Monday, April 13, renewed the two-week lockdown slammed on the FCT, Lagos and Ogun states in line with the advice of experts and international protocol.

Community transmission is a situation where a person infected with coronavirus has not travelled overseas recently and has not been in contact with a confirmed case of the disease. It means the source of the infection cannot be traced by authorities.

How authorities gave hint on community transmission

The chairman of Nigerian Medical Association (NMA), Lagos State chapter, Dr. Saliu Olugbenga Oseni, told Daily Trust in an exclusive interview yesterday, that community transmission of coronavirus remained a problem because of the attitude of the citizens.

He confirmed that there were some people who don’t want to be quarantined after being tested positive and decided to go home to seek other forms of care, thereby exposing people around them to the virus.

Oseni said COVID-19 is a pandemic and therefore not for private hospitals to treat. “It is a pandemic; the cost of treatment is beyond an individual. It is wrong for someone to have the problem and keep it to his or herself.

“Just like the hotelier that came to Lagos and refused to be tested and also refused to be quarantined, he went home and died in Abuja. These are the problems we are facing,” he said.

Dr. Musa Ibrahim, a community health expert said the only option for Nigeria is a national policy to be driven by the federal government. “Yes, we are operating a federal system but it is wrong for the federal government to do one thing and the state governments to do something else especially during times of emergency.

“If you are imposing lockdown, do it countrywide for a certain period,” he said.

The Minister of Health, Dr. Osagie Ehanire, had recently said that Nigeria was already seeing what may be indications of sustained community transmission, saying 30 per cent of the cases so far recorded have incomplete epidemiological information, 51 per cent imported and 19 per cent from contacts of known cases.

“We are using the small window of opportunity remaining to intensify investigations to identify cases and their sources,” he said.

The National Coordinator of the Presidential Taskforce Force (PTF) on COVID-19, Dr. Sani Aliyu said on Wednesday, April 8, that they had recorded more cases of community transmission compared to imported cases.

“More of our cases are now community-linked. We are having fewer cases that are linked to travel abroad or contact with people who have been abroad. Our health care services need to look out for this alert,” he said.

The Lagos State Commissioner of Health, Prof. Akin Abayomi, had said that they expected to see up to 39,000 cases of COVID-19 in the state if residents failed to comply with social distancing.

“But if everyone practises good social distancing, the figure will be limited to 13,000. If we add social distancing to active contact tracing, then we will be able to bend the curve further.

“Now that the borders have been closed, there are increasing numbers of local transmissions. There are more transmissions within the community,” he said.

Also, the Kaduna State Coronavirus Disease (COVID-19) Taskforce had expressed fear that the state could record up to 57,000 cases if the violation of the lockdown order persisted.

The Commissioner for Internal Security and Home Affairs, Samuel Aruwan, while addressing security men in a video clip, said the state did not have “the capacity to handle large number of infected persons.”

According to him, “Imagine the guy that came from Lagos; he is a gateman from Kawo. He entered a commercial vehicle from Lagos to Kaduna, and he must have infected so many people. Now we can’t trace about 300 persons from his own family and people in Mando.”

The State Commissioner for Health, Dr. Amina Mohammed- Baloni had said the case had no connection with the first five cases earlier detected and warned that there was risk of community transmission.

Also, the two persons that tested positive for coronavirus in Kano state on Monday were reportedly products of community transmission considering that they were not part of the contacts of the index case.

Violation free for all in states

Two weeks into total lockdown and a 24- hour curfew imposed by the Kaduna State government, residents have continued to violate the curfew through frequent community engagements and discreet inter-state travels.

It was observed that in densely populated places such as Kurmin Mashi, Unguwan Dosa, Hayin Dan Mani, and Tudun Wada, neighbourhood markets are thriving daily despite the stay at home directive.

An attempt to enforce the stay-at-home order at a market in Tirkania led to the killing of four youths by law enforcement agents last week.

Our correspondent gathered that discreet inter-state travels especially between Lagos and Kaduna were ongoing, mostly at night, and this explained how the latest case of COVID-19 patient, a guardsman sneaked into the state.

The Kaduna State government had also granted a two-day weekly grace period for residents to purchase food and other essential commodities which it threatened to revoke last week if the people continued to flout the “quarantine law.”

When the Kwara State Technical Committee on COVID- 19 issued the stay at home order two weeks ago, the movement restriction order was variously violated by residents particularly by commercial vehicles, motorcycles and tricycles operators.

Although the state government had announced the closure of its boundaries with neighbouring states, interstate movement was still ongoing as many buses heavily loaded with passengers entered Ilorin from Eyenkorin and Okolowo axis.

Two weeks ago, the deputy governor, Kayode Alabi who chairs the state technical committee on COVID- 19 expressed worry over the complicity of security operatives on noncompliance by motorists and travellers.

He blamed some of the security operatives who were stationed at the state entry points for compromise.

However, following the confirmation of two cases of coronavirus last week, the government imposed a two-week total lockdown in all the 16 local government areas of the state.

Ironically, people were allowed to go about their businesses from 10 am to 2 pm on Monday, Wednesday, and Friday of every week.

The lockdown imposed by Rivers State government is being breached by the residents of the state on one part and the law enforcement agents on other.

Some of the measures adopted by the state governor include the shutting down of all state boundaries, the restriction of movement from all the sea routes to the state, the closing of markets, and restriction of religious gathering to a maximum of 50 persons.

However, the shutting down of markets in the state is being violated in some of the local government as some of them still operate makeshift markets where traders converge to sell their wares.

There was also confusion when Governor Wike relaxed the restriction of a large gathering of worshippers to enable Christians attend Easter Sunday Service. The governor later made a U-turn on his decision and announced that the restriction order was still in force.

In Edo State, government had declared partial lockdown with a ban on gathering of more than 20 persons, social distancing among others but the people are violating the directives.

`Many shops that were not supposed to open to customers are still opening despite the government directives.

Also, intra-state transporters were to convey two passengers at the back seat and one in the front seat but they were not adhering to the directive.

The government also ordered residents to stay at home, wear face masks and banned gathering in churches but some of them still held services during the Easter period.

The attempt by Governor Ifeanyi Ugwuanyi in Enugu to give a “friendly face” to the lockdown in the state seemed to have been grossly undermined by some residents of the state.

At the commencement of the shutdown, traders at the popular Ogbette Main Market came out in droves to do their normal buying and selling. But the following day, the government ordered the men of the state fire service to use water to disperse the crowd of traders who turned up while the police deployed their men at the main gates of the market.

On Easter Sunday, some churches still held their services and drinking joints at Achara Layout within Enugu were still operating with people clustering the places.

In the Garki Area within Enugu South Local Government Area, a reasonable section still bubbled with human activities, thereby making it little difficult for one to differentiate activities in the normal market setting and activities during the lockdown. In Ogun, the lockdown announced by President Muhammadu Buhari alongside Lagos and FCT did not take effect until after four days following what Governor Dapo Abiodun termed as “lack of preparedness.”

And when the lockdown finally became effective on April 3, the state only experienced total lockdown for just three days because Abiodun had ordered a window of seven hours every forty-eight hours to allow for economic activities especially for markets and petty traders.

On Sunday, worshippers at the Christ Apostolic Church (Oke-Iyanu) on Hospital Road, Ogijo in Sagamu Local Government Area of the state scampered for safety when policemen arrested their pastor, Jonathan Olowonisile, and four others during service.

In Benue State, the lockdown policy is only being complied with by religious bodies since its commencement on April.

Our correspondent reports that the government’s directive has not been obeyed to the fullest as traders have moved their items to the roadsides leaving the market  under locks and causing chaos in narrow places as they contend for space to sell their wares.

Some inconsistencies with the violation policy that created confusion among religious bodies was the fact that the government and the state chapter of the Christian Association of Nigeria (CAN) had earlier created an opportunity for not more than 30 congregants at once during worship but later directed that there should be no congregation for worship, burial and weddings.

Though the Oyo State government did not order the total shutdown of the state, Governor Seyi Makinde had ordered a 7 pm to 6 am curfew in the state as part of efforts to reduce the spread of COVID-19.

However, some residents are not complying with the directive which informed the recent impounding of 36 trailers and other articulated vehicles for flouting the stay-at-home order in the state.

Despite having six confirmed positive cases of COVID-19 in Bauchi, the state government had suspended the 14- day lockdown few hours before its commencement and shutdown only borders with other states which is not being respected.

Deputy Governor Bala Tela who is the chairman of the COVID-19 taskforce response committee said that the suspension of the movement of the people followed consultation with opinion leaders, statesmen, Ulamas and clergy, the security forces, healthcare professionals and taking into cognisance the fact that majority of the people find sustenance by the day.

In Abuja, at least 269 vehicles have been reportedly impounded by the Federal Capital Territory Administration (FCTA) enforcement team for violating the restriction on movement.

Daily Trust observed that commercial motorcyclists have defied the restriction order especially in satellite towns like Kubwa, Karu, Jikwoyi, Zuba and others as they ply the roads looking for passengers.

In Katsina, a restriction order was earlier placed on large gatherings at mosques and churches excluding markets but was later suspended with authorities saying the decision was informed by reports of planned protests by people on the matter.

Governor Aminu Bello Masari said the government had also uncovered that despite the ban, residents have been trooping to either Jigawa or Kano State to conduct such prayers.

“It was in that regard and to overcome the problems that government relaxed and asked people to pray the Juma’at with some conditions attached,” he added.

Experts decry attitudinal decay

Asked to comment on community transmission, the President of the Nigerian Academy of Science, Prof. Kalu Mosto Onuoha, said it is already happening, “because many people testing positive in the country didn’t travel anywhere or come in contact with confirmed cases of the disease.”

He said Nigeria would be in real trouble if it transcends to actual community transmission because of the state of its health system.

Prof. Onuoha decried the relaxation of the ban on gatherings and violation of lockdown by some states saying it may affect efforts in curbing the spread of the coronavirus.

He said Nigeria was also not testing enough, making its COVID-19 statistics under-reported. He said the large number of cases being reported in some countries was because of the number of people they were testing unlike what happens here where only symptomatic people could call and still be subjected to interview.

“The lockdown will help stop community transmission; that is the main reason for it while we keep tracing. If anybody tests positive, we try to trace his contacts and test them; that is the principle behind it because we are not testing massively. We are supposed to test more people but we don’t have capability to do so,” he said.

Prof. Oyewale Tomori, a virologist and chair of National Laboratory Technical Working Group (NLTWG), said Nigeria must move on with aggressive COVID-19 testing that includes all symptomatic and asymptomatic contacts of positive cases. “Only then can we truly know the magnitude of the COVID-19 problem and better prepare to prevent the looming catastrophe. We are tied to the apron strings of foreign donors for reagents and kits.”

On getting more Nigerians tested, the Director General of the Nigeria Centre for Disease Control (NCDC), Dr. Chikwe Ihekweazu, said at the moment, the validated method for COVID-19 diagnosis could only be carried out in molecular laboratories.

He said a brand new molecular laboratory requires extensive financial resources, time and human resource. “With new methods such as the use of Gene-Xpert machines, we hope to continue to scale up this capacity. With increasing demand globally for limited reagents, this could take longer than we would like.

“We also continue to adapt the national case definition as the situation changes globally and in Nigeria. We are prioritising testing for people who have COVID-19 symptoms, with a travel history outside Nigeria in the last 14 days, contact with a confirmed case or unknown source in states with high prevalence,” he said.

He said in the absence of a vaccine for COVID-19, “we have to depend on non-pharmaceutical interventions such as closure of large gatherings and cessation of movements.

“There is a strong chance that if these interventions are properly implemented and adhered to, we can flatten the curve and control this outbreak. By limiting movements, we are reducing the possibility of spread of the virus causing COVID-19, which is highly transmissible,” he said.

A COVID-19 epidemiologist at the Africa Centres for Disease Control (CDC), Dr. Olayinka Ilesanmi, said that the government could prevent community spread through partial lockdown.

“We can prevent community infection of COVID-19 through social distancing, limiting contact with people, proper hand hygiene after touching any surface because whoever is infected in a community will transmit it and others can become infected when their hands touch the places where an infected person has touched. Through the hands, the person can touch the face, mouth or nose, thereby becoming infected,” he said.

On Monday, the Northern Governors’ Forum through a virtual meeting called for a coordinated response to tackle COVID-19 but said it would not be possible to lockdown the region.

Chairman of the forum and Plateau State Governor, Simon Lalong in a statement by his spokesman, Simon Macham, said the governors resolved to strengthen preventive measures against the pandemic.

He admitted that while the lockdown in some states in the region had succeeded, there were concerns that enforcing cross-border movements remained a challenge as some of the cases recorded in some states were imported from outside despite the closure of borders by their respective governments.

Contributions by Fidelis Mac-Leva, Ojoma Akor, Terkula Igidi, Abbas Jimoh, Simon Echewofun Sunday (Abuja), Risikat Ramoni, Christiana T. Alabi (Lagos), Lami Sadiq (Kaduna), Habibu Umar Aminu (Katsina), Ismail Adebayo (Ilorin), Victor Edozie (Port Harcourt), Usman A. Bello (Benin), Tony Adibe (Enugu), Raphael Ogbonnaiye (Ado-Ekiti), Peter Moses (Abeokuta), Hope Abah Emmanuel (Makurdi), Jeremiah Oke (Ibadan) & Hassan Ibrahim (Bauchi).