The troubling data point behind Nigeria’s low number of coronavirus cases

Nigeria’s international airport stayed operational for incoming flights without quarantine until March 24.
Nigeria’s international airport stayed operational for incoming flights without quarantine until March 24.
Image: Reuters/Temilade Adelaja
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Nigeria, Africa’s most populous country, has a case count of fewer than 50 coronavirus cases. But what’s become increasingly clear is that low number is not because the country has been lucky or particularly effective with preventing the spread of the disease—it’s more likely because local authorities are simply not testing enough people.

The latest available report by Nigeria’s Centre for Disease Control (NCDC) shows the country had tested only 152 people as of Mar. 22. That’s compared with South Africa which has conducted over 15,500 tests so far despite recording its index case a week later than Nigeria.

For its part, the NCDC has adopted a strategy of limiting tests to only people already showing symptoms of the disease or have come in contact with confirmed cases. It’s similar to approaches adopted in the United States and the United Kingdom but in comparison to those countries, Nigeria’s test numbers are far lower. The UK had tested over 78,000 people as of Mar. 22.

The slow pace of Nigeria’s tests is largely down to a lack of capacity. While it can conduct tests locally, Nigeria lacks the manpower or capacity to do so on a very large scale. Indeed, very few countries do: despite ramping up testing in recent days, the UK remains short of its 10,000 tests per day target. The danger however is that, unlike the UK, Nigeria’s public health infrastructure is starkly short on critical medical equipment and facilities to deal with a full-blown outbreak: there are reportedly fewer than 500 ventilators across the entire country.

Beyond low testing figures, there are also questions over Nigeria’s handling of the outbreak since confirming its index case at the end of February. Despite evidence that early confirmed cases comprised mainly of foreign travelers and Nigerians returning from high-risk countries, the Nigerian government did not move to limit incoming international flights until Mar. 23 following widespread calls from civic society groups. Several other African countries had adopted stiffer measures on international flights a week earlier to mitigate the risk of importing the virus.

While quarantine is mandatory in countries like Kenya, Ghana and Uganda for nationals and residents coming from high-risk countries, it has largely remained an advisory measure in Nigeria. As a result, health officials are scrambling for contact tracing after travelers on flights that arrived the country, in some cases as far back as ten days ago, test positive. It’s a task made more difficult by the reality that, without functioning databases for contact details, the government will largely rely on public service announcements to find possible contacts. Nigeria’s minister of health has already suggested it’s likely that infected persons are currently in hiding.

The seeming laxity of Nigeria’s quarantine measures have also been felt at the heart of Nigeria’s seat of power: Abba Kyari, president Muhammadu Buhari’s powerful chief of staff, has tested positive for coronavirus. His infection now raises questions about the status of top government officials as Kyari has attended several high-level government meetings since returning from Germany on Mar. 14 without self-isolating as advised.

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