Looking closely at the global data across countries as tracked by the Johns Hopkins University Coronavirus Resources Centre (https://coronavirus.jhu.edu/map.html), the obvious conclusion would be that Nigeria is not doing badly after all. Using five most affected countries for such comparison with Nigeria, statistics on cases of infection and deaths (as at December 9, 2020 ) reveal a stunning difference. The United States of America for example has over 15.4m cases, with 290,992 deaths; India has over 9.7m cases, with 141,772 deaths; Brazil has over 6.7m cases, with 178,995 deaths; Russia has over 2.5m cases, with 44,769 deaths; and France has over 2.3m cases, with 57,043 deaths.
In this order of ranking (i.e. the first five countries), the criterion used was the number of cases of infection rather than the number of deaths. If the number of deaths were to be used, the order would slightly change with the first five countries as USA (290,992 deaths); Brazil (178,995 deaths), India (141,772 deaths) (note the swapping of positions by these two countries), Mexico (111,655 deaths (note this new entrant into the first five with respect to the number of deaths), and then United Kingdom with 63,179 deaths. Then if these are compared with Nigeria’s figures of 70,669 cases, with 1,189 deaths (as at December 9), then Nigeria appears to be doing well. But is it doing really well?
Perhaps, the logical question should focus on whether Nigeria’s coronavirus (COVID-19) data are robust and reliable enough to warrant the conclusion that it is doing well. It is the considered opinion of this column that Nigeria’s COVID-19 data on infections and deaths are not necessarily a true reflection of reality. The fact is that Nigeria is not testing enough. With an estimated population of slightly over 200 million people (December 2020 figure released by the National Population Commission was about 206 million), Nigeria has not yet tested up to 1% of her population. As of 9 December 2020, Nigeria has been able to test only a total number of 817,913 people. This number is very far from the expectations of many and concerned citizens.
The truth is that COVID-19 testing has been a huge problem for many African countries and not just Nigeria. But what are the reasons for this? This column will focus only on two issues to show that Nigeria’s COVID-19 data on infections and deaths do not actually reflect the numbers of infections and deaths in the society.
First, as Dr. Matshidiso Moeti of the World Health Organisation (WHO) told Bukola Adebayo of CNN in August 2020, although the cases in Africa are a small fraction of the global count but low testing in many African countries means infections have been under-reported. According to Dr. Moeti, while testing facilities have increased in some countries compared to when the outbreak began earlier in the year, Africa still fell behind the global benchmark.
Dr. Moeti’s point is very important as it challenges the robustness and reality of Nigeria’s COVID-19 data. Although Nigeria’s national policy response has been commended many times in this column, the issue of testing has been a very bad dent on the surface of this commendation. Regrettably this dent arises from the fact that testing for the virus is done at the sub-national level with many of the state governments not testing enough in spite of appeals by federal authorities.
This column had in the past made the point that only two sub-national governments namely Lagos State and the Federal Capital Territory (FCT) have been able to meet the expectation of testing up to 1% of their population according to the Nigeria Centre for Disease Control (NCDC). Some states for instance, have not made testing or even the fight against COVID-19 a priority and have not therefore been cooperating with the federal government in this regard. One particular state governor dismissed COVID-19 as a hoax and refused to cooperate with NCDC officials.
In fact, the Director-General of NCDC, Dr. Chikwe Ihekweazu expressed regrets that seven states are not testing enough and these are Cross River, Jigawa, Kogi, Osun, Ebonyi, Adamawa and Zanfara. He made this remark yesterday (December 10, 2020) at the national briefing of the Presidential Task Force on COVID-19. Yet, the Federal Government had built molecular laboratories in states of the federation and had on number of times given financial assistance to state governments to enable them manage the COVID-19 pandemic effectively. In addition, the private sector-led Coalition Against COVID-19 (CACOVID) has rendered tremendous assistance to the states to help them manage COVID-19. It has built isolation centres, procured private protective equipment (PPE) and bought and supplied large quantity of food items and other materials worth billions of naira.
Again, apart from lack of cooperation from some state governments, testing (though free in government-owned laboratories) has been a big issue in Nigeria as it is hard to come by particularly when people voluntarily want to be tested to know their status. Furthermore, it takes a very long time for the result to be out after undergoing the test. Many people have experienced different levels of anxiety or frustration regarding testing and results of tests. To be candid, testing for the coronavirus is one area where Nigeria’s response to COVID-19 pandemic has been less than satisfactory.
Given this fact therefore, the overall NCDC announced figures of infections and deaths cannot accurately reflect the reality out there in the society. The conclusion here is that Nigeria’s COVID-19 data on infections and deaths are not robust enough for the comparison made earlier as it is like comparing apples and oranges. But it is a fact that Nigeria’s national policy response to COVID-19 pandemic is commendable since the setting up of the Presidential Task Force on COVID-19. This fact has been acknowledged many times previously in this column.
The second reason that supports the thesis that COVID-19 infections and related deaths in Nigeria are not true reflections of reality is that actual causes of many deaths were unknown. Some deaths that appeared obvious to be COVID-19-related in some states were called mysterious deaths, and in one particular state the number of COVID-19-related deaths appeared to be grossly under-estimated and under-reported. There were a good number of deaths that appeared to be COVID-19-related but yet were not regarded as such publicly.
Above all, many of us have heard of deaths that were not announced (or treated) as COVID-19-related, but which might likely be. Many people have in these strange times lost many other people they know either as relations, friends, colleagues, acquaintances or even (street) neighbours.
One indicator that deaths are ‘under-reported’ (not deliberately though) is that the mortuaries are unusually filled to capacity in many parts of this country that keep the dead for a length of time before burial. For quite of a long time now since after the lockdown restrictions were lifted, burial ceremonies have been going on in some parts of the country every single day except on Sundays. This month of December and even the coming January (in 2021), have all been booked for burial ceremonies. The officiating priests have no rest days any more in these places. The truth is that people have to queue up to bury their loved ones.
Given all these and the fact that COVID-19 tests constitute the weak link in the chain of effective national policy response, Nigeria’s reported low cases of infections and deaths in comparison to other countries do not represent actual reality. The numbers are more likely to be much higher than reported. Going by evidence on the ground therefore, the obvious conclusion is that the national data on infections and deaths are not robust enough to say that Nigeria is doing well in relation to other countries where the numbers are much higher.
Prof. Isaac N. Obasi of the University of Abuja, is a Visiting (Adjunct) Research Professor at the Anti-Corruption Academy of Nigeria, (ACAN), ICPC, Email: email@example.com.