To the shock of many, On Friday, May 8, the NCDC recorded its
highest daily figure since February 27 when Nigeria’s first coronavirus
case was confirmed, as the number of confirmed cases jumped from 3,526
to 3,912, an increase of 386.
To some, the increase was alarming and pointing at an aggravated
danger, but a critical look only shows that we are beginning to take the
disease very seriously and doing the necessary to curb the spread of
the virus with proactive measures.
Going by world trends, it was obvious that Nigeria was lagging
behind in COVID-19 surveillance, contact tracing and testing when
compared with its peers in other African countries. Ghana, for instance,
had conducted over 100,000 tests while South Africa had conducted close
to 200, 000 tests. At the time these countries were reaching these
commendable feats, Nigeria was grappling with a little over 12,000
tests.
This is not to diminish the effort the NCDC has committed to
tackling the virus, given the peculiarities of a country such as
Nigeria. The agency was established in response to challenges such as
this, hence, the high expectation. It just so happens that Nigeria is
one of the countries that were slow to react, and it’s perhaps one of
the reasons the country was slow in initiating proper guidelines which
may have limited the spread of the virus, hence, the explosion of an
outbreak and COVID-19-related deaths in Kano.
Effectiveness of President’s order to scale-up testing
During the President’s broadcast of Monday, April 13, 2020, he
assured Nigerians that the government has identified 92% of all
identified contacts while doubling the number of testing laboratories in
the country and raising the testing capacity to 1,500 tests per day.
Days later, the NCDC Director-General, Chikwe Ihekweazu, disclosed
during a joint national briefing of the Presidential Taskforce Force on
COVID-19 that the President had mandated the agency to increase national
testing to 4000 per day (Lagos -2,000; FCT - 1,000 and the rest of
Nigeria - 1,000). Ihekweazu added that the agency is targeting testing 2
million people in the next three months.
A very ambitious target, you may say.
The projected testing capacity ordered by the President may not be
truly achieved, but there has been no doubt an increase since the order.
The recent spike in the number of confirmed cases is a manifestation of
the increase in testing carried out by the NCDC. Before now, the NCDC
had concentrated in chasing after returnees, but we now see that the
agency has become more proactive and responsive in its attempt to
contain the spread of the virus by tracing other secondary contacts.
An increased testing capacity can only mean that more contacts are
being identified and contained before they can infect more people. When
the cases are identified, traced, isolated or quarantined, they are
prevented from further spread of the virus and also stand a chance of
getting treated.
As of May 8, Nigeria has tested only 23, 835. With no cure or
vaccine in sight, Nigeria’s best option to containing the virus remains
to test and isolate confirmed cases to avoid more transmission, a
situation which can take a heavy toll on the already suffering
healthcare system.
Challenges of rapid scaling up COVID-19 testing
The NCDC's test procedure for COVID-19 relies on a semi-automated
real-time PCR process that delivers results between 3-8 hours. This
usually involves the use of a sterile swab inserted to the back of a
person’s nasal passage and throat to absorb secretions, which are then
tested for the presence of SARS-CoV2 in a molecular laboratory.
Understandably, the process of testing is quite tasking. Nigeria is
struggling with a deficit of test kits. The NCDC DG, Ihekweazu last
week, lamented a desperate need for test kits, as they are grossly
inadequate in the country. Ihekweazu said Nigeria needed to stock more
of the RNA extraction kits to cater for the expansion of its COVID-19
testing capacity. Procurement of medical supplies has been difficult as a
result of the slowdown in manufacturing of these supplies coupled with a
high global demand.
In late February when the first case of the virus was reported,
there were only five laboratories able to test for COVID-19 in the
country. Today, there are now about 20 of them with plans of citing at
least one in each of the 36 states and encourage private sector labs to
also conduct tests.
Apart from the lack of adequate labs, isolation centres are already
over-burdened. Some states are already experiencing difficulties
accommodating patients in their over-burdened isolation facilities,
especially in Lagos and Kano states where the number of cases currently
outweighs the capacity of the centres, whether they are asymptotic,
mildly symptomatic or severe. This has however led to revolts and public
protests by patients in some of the centres.
There’s also the problem of how active our public workforce is in
identifying samples, collecting and sending them for testing. The
efficiency of collecting the right samples from the right patients and
bringing them the labs is key.
Emphasising the need for more and more testing
With the partial lifting of the lockdown in some states, the need
to conduct more testing cannot be over-emphasised. Experts strongly
believe that many Nigerians are going about with full-blown coronavirus
and such people remain asymptomatic. It is therefore in our collective
interest to sort out these people and to timely recommend them to NCDC.
As Nigeria struggles to ramp up the number of COVID-19 tests,
widespread testing sits at the heart of the battle. To drive mass
testing and increased COVID-19 surveillance, every Nigerian should be a
combatant in the ongoing war against the pandemic. We can continue to
play our parts by strictly observing social-distancing and every other
precautionary guideline prescribed by medical experts and the
government.
Victor Enengedi is a social and public commentator and he writes from Lagos.
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