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COVID-19 R-factor and weak links in Nigeria

A chain is as strong as its weakest link. That cliché underlines certain assumptions, oftentimes, dangerous and egregious. As a public figure and member of the Nigeria’s attentive public, I took some measures, personal and otherwise, to protect my family, staff and myself from COVID-19. I shut my office well before the federal government announced a nationwide lockdown in 2020. Thereafter, my office had zero tolerance for casual visitors; non-mask-wearing guests and guests not attuned to social distancing rules.

Personally, I wrote and commented publicly on the limitations of federal and state governments’ COVID-19 preventive measures and our lack of a national resiliency strategy. I tried to influence proactive and pre-emptive policies. All these were borne out of experience from a pandemic simulation exercise I was involved in many years back at the United Nations. On December 16, 2020, I closed my office after a rather rough business year, bypassing the usual Christmas party. Rather, my staff and I met for 30 minutes. I wished them well, shared pies, cookies, drinks and presents and sent them away for three weeks holidays with vehement cautions to stay safe and avoid large holiday’s gatherings and COVID-19. On December 22, I underwent a routine pre-travel COVID-19 test. The next day, December 23, 2020, my result indicated I had tested positive for COVID-19. It was a rude shock. By any measure, I was an unlikely COVID-19 candidate. Yet all my efforts had come to naught.

In reality, neither federal nor the 36 state governments can say categorically the number of Nigerians infected with COVID-19. As per Nigeria’s R-Factor (Infection Risk Factor), NCDCs extant national figures of 97,478 confirmed cases; 17,584 active cases; 78,552 discharged cases and 1,342 deaths are a gross and grotesque underestimation of reality. They represent an outlier. These prevalent estimates are way off base, buttressed by ambivalence, scepticism and flawed public policy responses and implementation. These numbers are also not in tandem with global COVID-19 demographics. Because Nigerians are not being broadly tested, it is assumed that the national rate of infection is low – a faux premise and narrative. Of those tested, contact tracing is at best abysmal. Meanwhile, Nigerians are being infected daily in hundreds of thousands, if not millions. Many continue to die, most deaths hardly ever documented. Indeed, for every prominent Nigerian who has succumbed fatally to COVID-19, there are thousands of unknown Nigerians befallen by such fate. Hence, the high COVID-19 infection rate in Nigeria is perhaps the best kept national secret. Meanwhile, COVID-19-related ameliorative efforts remain essentially transaction-driven.

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So here I was. I had joined the global league of 89.7 million COVID-19 afflicted. It was not a badge of honour. Yet as a matter of obligation, I took personal measures to make my infection public. My constituents and people close to me had the right to know. I personally did the contact tracing- reaching over 75 people to forewarn them of my status as I went into isolation and consulted my personal physicians in Nigeria and the U.S. And then, of course, my wife, an Emergency Room Attending Physician in the U.S. who had been in the COVID-19 frontline from March to November 2020 at Hackensack University Hospital in New Jersey, was on hand to do the needful. Interestingly, never for once, did I consider going into any federal or state hospital or isolation centre. My confidence in them was short, if not totally lacking.

Because I was asymptomatic, I naturally worried about my spouse. As per her possible exposure, we assumed the worst-case-scenario. After consulting our physicians, she went into isolation and commenced aggressive prophylactic measures. On her return to Nigeria in early December 2020, she had tested negative. When we did our pre-travel test three weeks later, she was also negative. Yet, she tested positive eventually and like me, remain in strict isolation, as I write.

COVID-19 is real and brutal. It is festering in Nigeria. As I struggled with acute and bruising challenges of COVID-19, and tried to manage anxieties amongst family, kith and kin, friends and well-wishers, the policy wonk in me analysed the possible weak link in the chain. Where was the chink in my protective amour; the index case, from whence I contracted the virus? It could have been any source; public, church, office and less so, family. My home was almost impregnable. But then, there were statistical realities. How many Nigerians, political associates, friends, acquaintances and relatives do I interface with daily, that were COVID-19 infected unbeknown to me?

As a nation, despite our best intention and efforts, Nigeria had done poorly in her per capita testing capacity and social orientation. In the South East and Anambra State where I reside, the pervasive cavalier mentality remains benumbing. Anambra governorship aspirants and their cohorts seemed to care less. Indeed, one governorship aspirant and I had met up close at an event two days before I tested positive. When I did, I contacted him personally by SMS to forewarn him to take precautionary measures; he ignored my communication and went about his public events, even though he knew full well he had possible exposure. And such a person wants to be the next state governor? Go figure!

Naturally, I did a mapping of my possible index case. I had narrowed it to a newly appointed staff, who tended to treat COVID-19 with benign levity and youthful exuberance; and possibly, a domestic staff. I ordered my entire staff tested, at my expense. My new staff and one other staff member tested positive. I immediately placed them in isolation and under a managed medical regime. But there was the weak link. For every unsuspecting principal, like me, it could be a domestic, a driver, security staff or office staff. So long as you don’t control their after-office-hours activities, they pose the weak link in your protective chain. Untested, they pose grave danger to you, your family and community. In an unguarded moment, an unwashed hand, a sneeze, cough or whisper in close proximity without masking up, could prove lethal.

But here is the upshot: Many Nigerians are unaware of their COVID-19 status. Testing is very limited and testing costs ranging from presumably free, to N15,000, N37,000 and N50,000 and millions of Naira for hospitalisation are prohibitive. If most Nigerians are not testing, it’s because they can’t afford to. On January 6, when the bulk of my staff went to UNTH, Utuku, Enugu, to be tested, 32 other Nigerians were tested. Twenty-two or so, I reliably gathered, tested positive on that single day. The positivity rate is well over 75 percentile. We can extrapolate those numbers into weeks, months and years. If someone were to suggest that 50 to 70 percent of Nigerians were COVID-19 positive without being aware, such analysis would be considered tendentious and alarmist. But that probability is plausible.

If the federal government plans to leapfrog a shaky COVID-19 response foundation to invest N400 billion to vaccinate 70 percent of Nigeria’s 200 million people, the result will be equally dismal as were the COVID-19 unused isolation centres, hoarded palliatives, and the lacklustre testing regime. The first time around, in 2020, Nigeria dodged the COVID-19 bullet. In 2021 and beyond, she might not be so lucky. There’s still time to turn back the hand of the clock, even if it means another lockdown. For now, two scenarios seem plausible; either that the federal government is in utter denial or has surreptitiously opted for the herd immunity approach.

Obaze is a public expert and the 2017 governorship candidate in Anambra State.

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