‘You may be disappointed if you fail, but you are doomed if you don’t try.’
– Beverly Sills
If we must continue to assume that the pandemic going on around the world started or originated from Wuhan in China, then we must re-examine the containment approach that was adopted by China in relation to what has been happening elsewhere, country by country. The Chinese showed us how to implement a total lockdown, the wearing of face masks and PPE, the hand washing, the social distancing, the research into curative treatment, the search for any functional vaccine, and the building of a ten thousand bed hospital in ten days that very few countries in the world can match. The isolation of the town Wuhan from the rest of China was near total for more than three months. The people of Wuhan did not exit the limits of the province and nobody went in either, except for the extremely essential services that were needed to care for the sick and sustain the healthy.
Wuhan Province went through this grind because its public infrastructure was robust enough to function for that period without much help from the rest of China. Consequently, contact tracing was comparatively simplified and absolute because they had the data of those that were locked in and those that left during the period; they also had enough land to bury their dead which was shockingly at a much lower rate. The beauty of this was that the epidemic curve was flattened fairly quickly and even then, when they felt ready, Wuhan was opened for business in phases. There was no rush to beat any deadlines, or stem the slide of the stock market, or politicize the issues.
The next big story therefore was that the most densely populated and related region in business to Wuhan outside the shores of China is the Lombardy region in Italy. Business and social interactions amongst the peoples of these two regions ensured that the virus hitched rides to Europe. Predictably, the Italians adopted the Wuhan Endemic Containment Playbook. With the severity of the infections in the Lombardy Region, Italy went a step further and locked down the entire country. Today, Italy has managed to flatten the curves.
The next most densely populated, planned, and organized city in the world happens to be New York. Mostly because of the cultural, business, and familial relationships between New York and Italy, on the one hand, and New York and Europe on the other hand, New York was hit hard by the pandemic, becoming the epicentre of Covid-19 infection in the entire US. The poor and the infirm in the population died in their thousands as the days rolled by. The city of New York that never sleeps went to sleep for 3 months except the Governor of the state and his executives, the essentials workers and the law enforcement agencies, who were hard at work during such periods; they communicated with the people, worked hard to save lives, empathised with those who grieved, and kept every New Yorker fully informed through the airwaves.
The reason I have gone to this length is because of the pitiful situation our country Nigeria is in. The uncoordinated way we live our lives, the unplanned cities particularly the densely populated ones, and the broken infrastructure constitute a huge nightmare for the management of this pandemic. And so, I worry about the much we can copy from those countries and cities that have experienced this pandemic. How much research have we done, and how do we begin to model our responses, in relation to our way of life, our culture, our religion and the lack of basic infrastructure? How do we execute contact tracing if an outbreak of infection occurs at Balogun Market in Idumota, Lagos Island, or Mile 12 Market at Ketu, in Lagos?
In life, the three most important sustaining components are the air we breathe, the water that we drink, and the sun for warmth and energy. The air that we breathe in most densely populated cities like Lagos, Ibadan and Kano is poisonous and infectious from pollution of all kinds. In most of these cities, we neither have data of those entering and exiting, nor the correct data for even the actual population. So, it is impossible to conduct contact tracing.
Similarly, we cannot conduct total lockdown because ineffective enforcement arising from the toll collecting antics of the enforcement agencies charged to implement the lockdowns sabotaged same. These security agents are now millionaires in their own bellicose rights. At some point during the period of the so-called lockdown, some travellers counted 93 check points between Lagos and Port-Harcourt. The Police, the Army, the Customs, and the Road Safety Corps Marshals were all represented.
I witnessed some part of this narrative personally. I was in my hometown in Delta state before and during the lockdown and I got lots of phone calls from concerned citizens about the state of the River Niger Bridge at Asaba, which had become a parking lot just like the Apapa flyovers. The grid- lock is the result of check points on either ends of the bridge where the security bodies were busy collecting tolls from hapless drivers. The ensuing and daily traffic gridlock inevitably exacerbates the air pollution on this highway and the adjoining cities. I later gathered from a journalist who went undercover there and witnessed the sordid transactions going on relentlessly that the agents were ‘killing it’ at the toll points. The officers were neither perturbed by the traffic disruption their actions have unleashed nor concerned about the effects of the static loads on the only bridge between Delta State and Anambra State. I wrote about this sometime ago but nothing has been done. I fear for the bridge and our economy if any structural damage to it should cause a collapse or render the bridge unsafe.
Then there is the next most important life sustaining component, water. Most households in Nigeria do not have running water. If it exists even in hospitals, it is most probably from a local borehole and is untreated. Worse still, when the borehole becomes unserviceable, the hospital is left with no running water. How then can one effectively disinfect instruments, the wards, and the beddings? How can doctors scrub properly before and after surgery? How do patients clean up while on admission?
I believe what we have experienced so far in Nigeria is the daughter of Covid-19, brought in by those that have travelled to the affected countries in Europe, America, and the Far East. The mother is yet to reach Nigeria. We must therefore prepare for her visit because if she finds a home in Nigeria, she may stay with us forever. The current relaxation on interstate travels is a big invitation for the mother lode of Covid-19 to come calling. This, in my opinion, is a huge mistake. We simply do not have the right infrastructure to fight this war. I do not want to have us in a situation where we will not find enough land to bury the dead, especially in major cities.
There is therefore the need for us to develop Nigeria-Sensitive lockdown blueprint. This will borrow some of those measures that have worked elsewhere for application here, as well as adapt other measures to be case specific to our way of life. Public service employees, managers, and all those in supervisory roles need to step up and implement recommended guidelines. We should not leave the populace to their own devices. Specifically, the good measures include;
Wearing face masks and/or face shields in public
Keeping at least 2 metres between you and another in public
Limiting the size of congregations at offices, religious venues, wedding receptions, parties of all sorts, funerals.
But I believe that we should modify and adapt these other measure thus;
Reinstate the ban on interstate travels. This will shorten the endemic period of the first wave, while preventing numerous spikes of infection rates in states.
Within the states there is need to compartmentalize the lockdowns community-wise. By this I mean, locking down individual Local Government Areas where infections are high.
Treating non-severe cases at home with regular visits from health personnel.
Isolating severely infected LGAs means that as much as it is practical, all essential services must be made accessible within the LGA. These include markets, supply of foodstuffs, provisions, and essentials so the people do not have any reason to cross LGA boundaries.
We also need to improve on our testing (diagnostic) processes for the detection of the Covid-19 disease. In this regard, we need to step up our capacity with increased volume and quality of tests we can provide on a daily basis. We must also shorten the waiting time for results to be communicated to patients/candidates so that treatments or discharge can be put into effect. Why these are important is that until we can catch the majority of sick citizens and treat them, we will not be in a position to slow down the transmission or flatten the curve. If we do not control the infection, we cannot fully return to rebuild our economy, nor integrate our people into the global economy in good time.
My spirits are lifted up with pride to learn that some of our scientists have successfully developed vaccines that have gone into trial phases. We have arrived at the time the Government needs to bring all of them together and fund their research to develop therapeutic drugs for this Covid-19 which will be a scientific cure to fight this virus that will be Nigerian and possibly African in content. This strategic thinking is not new, but it would be Nigerian owned. John F. Kennedy did the same to American scientists in the 60s and empowered them to figure out how to send a man to the moon.
For our own survival, we must begin now to look into our ways of containing this virus because a carte blanche copy of all that is successful elsewhere may not work very well in Nigeria for the obvious reasons. Besides, the nations involved in the various on-going researches will first deploy any successful vaccines and therapeutic drugs amongst their people before considering the export markets. During the quest for creativity, we may have full success, partial success, or none at all. But we will be doomed if we do not try.