TELL Magazine

Warns authorities to prepare for rebound due to easing of lockdown.

As many concerned Nigerians express fear and apprehension over what they perceive as premature easing of the lockdown in some states as a result of the ravaging coronavirus disease, COVID-19 which has so far claimed no fewer than 85 lives in the country, the chief executive officer, CEO, of the Institute of Human Virology, Nigeria (IHVN), Dr. Patrick Dakum, has lent his voice, alerting that Nigeria stands the risk of having close to about five to 10 percent of the entire population having this disease. Dakum, who expressed grave reservation about the decision to ease the lockdown, was unequivocal that “easing of the lockdown is definitely going to result into another rebound”.

The renowned virologist who bared his mind on Monday on Channels Television breakfast programme, Sunrise Daily, posited that individual states and the country in general, are walking a very tight rope between the economic and public health realities in which we find ourselves. Concerned about easing of the lockdown especially at a time the curve was far from being flattened, Dakum said “What I foresee in Nigeria happening is no different from what we have seen in other countries. Look at Ghana or Taiwan. And if we go right back to the Spanish flu in 1918, 1920, the same thing happened when the lockdown was lifted. After a couple of weeks, we found a very huge rebound. And in the Spanish flu of 1918 where a quarter of the whole world passed on, it resulted again in another lockdown that lasted longer”.

Painting a rather scary picture of a worst case scenario of the Nigerian situation, Dakum said “I think to put it in a very direct way, we stand the risk of having, will I say, close to about five to 10 percent of the entire population having this disease. If you look at the data that the commissioner for health, Lagos State, shared one time about their community testing, he did say that if they go into the community, those that have got respiratory illnesses, that is, cough, catarrh, anything, those are the set of people that they test. Of those that they tested, 20 to 25 percent of those people have tested positive for the coronavirus. So, let’s extrapolate then. In the general population, how many people have respiratory illnesses? We probably could say that at any point in time, close to about five, 10 percent may have respiratory illness. So, if you take 10 percent of our population of 200 million; that is 20 million. So, assuming out of that, we now calculate to say between 20 to 25 percent of them will test positive for the coronavirus if we don’t do anything. Ten percent of 20 million is two million; 20 percent is four million. If we are not careful, we may have between two to four million people that may test positive.

“And assuming out of those who test positive, five percent of them are critical; 10 percent of about four million will be 400,000. Can you imagine us having about close to about 200,000 people needing to be on admission in hospitals in this country? That will be terrible. And remember that this thing is exponential; that is, you catch it, you are potentially infective to several other people. His Excellency, the governor of Kaduna State, Nasir El’Rufai did say that ‘I infected four people’. Well, the number of people that were exposed may be probably more than that. But the ones that have confirmed to test positive is four. So, for every case that we are talking about, we are talking about a minimum, from his own experience, if we are to use that individual data which of course statistically we cannot, but at least that is what we have to go by publicly that is stated; then, it’s going to be terrible.  Here in FCT, it means that by the time we have a tweak, we do nothing; we probably may end up with close to about five to 10,000 people needing admission”.

Cocksure that Nigeria would experience a rebound consequent upon easing of the lockdown, Dakum stated that how big the rebound would be would depend on a couple of things. “Number one is the level to which we can aggressively find out those who are positive in the community, isolate them, and place them on treatment, and then pursue their contacts. The more aggressive we can do that, the less the rebound is going to be. But as to whether a rebound will happen, it will definitely be”.

According to him, the ball is now in the court of both the officials that are responsible for carrying out community testing and the community itself. Dakum expressed concern that majority of Nigerians were not obeying the rules of wearing of face masks and restriction of movement. “For me here in Abuja, leaving my house and coming here is a pretty short drive; maybe just about 17 minutes. But what I have noticed is the fact that I can see close to 70 percent of the people I saw on the road were not wearing any face covering. Remember that face covering is your expression of love for another person. If you think that you care about me, then you wear a mask; if I think I care about you, then I wear a mask. So, I think that we are going to be seeing a very challenging time in terms of enforcement of the rules since people may not necessarily be arrested because they didn’t wear a mask. But at the same time again, on the public health side, we must be very, very prepared”.

He, however, suggested a carrot and stick approach in the enforcement of the rules and regulations guiding the lockdown. In his words, “I think it should be like what I heard the presidential task force chairman mentioned at one point in time. He said somebody has come out on the road, you are an enforcement officer, rather than clamp on this guy and begin to beat the guy up, why don’t you just talk to him in a gentle way and say hello, you are not supposed to be on the road, I’m not gonna let you pass, so, please go back. If he insists, then you can begin to enforce the law by arrest. I think for face mask issue, it should be a combination of an appeal and also some level of getting people know that there is a consequence. An appeal in the sense that if we appeal to people for them to see reason for why they are doing what they are doing, it probably will enable us succeed better”. According to him, a law that people identify with, and they think that yes, this is for my benefit, is a law that they may really obey.

On the alleged mysterious deaths in Kano, majority of which has however been confirmed by the presidential task force to be COVID-19 related, Dakum opined that it is sometimes difficult to determine “especially in situations where the tradition permits for immediate burial of loved ones” adding that “when you go again to take interviews of people that have lost loved ones, sometimes they are not in the mental framework to be able to provide you with information”.  He, however, argued that “in the era that we are, and seeing the fact that we have something that we know can be a causative agent, I will assume every mysterious death is COVID-19 until proven otherwise. People have suggested that we can take swabs immediately before the burial; where that is feasible, it is okay. But where you can just go on looking at the symptoms from what the relations tell you, then, you go ahead and make your presumptive diagnosis that way. But I think that majority of the mysterious deaths that we are currently seeing, especially where we know that coronavirus disease is on the rise, is most likely COVID”.