COVID-19 in Nigeria: A Failure to Test (a thread)
I was saddened as results of confirmed cases of COVID-19 were reported around the world. I was pleasantly surprised though at the low incident rate reported in Nigeria. That emotion has since given way first to skepticism and now
I was saddened as results of confirmed cases of COVID-19 were reported around the world. I was pleasantly surprised though at the low incident rate reported in Nigeria. That emotion has since given way first to skepticism and now
to extreme anxiety.
There is something unsettling about the COVID-19 test results from Nigeria: the numbers just don’t make sense.
First, the reported numbers are rather low for our country size and also for the amount of travel that takes place (in) directly between Nigeria &
There is something unsettling about the COVID-19 test results from Nigeria: the numbers just don’t make sense.
First, the reported numbers are rather low for our country size and also for the amount of travel that takes place (in) directly between Nigeria &
many of the countries worst-hit (anecdotal observation).
At the time of writing, Nigeria had recorded only 40 cases in total. That record becomes more stark when viewed per 1M population (per capita measure) around the world. Table 1: Confirmed case by country and territory
At the time of writing, Nigeria had recorded only 40 cases in total. That record becomes more stark when viewed per 1M population (per capita measure) around the world. Table 1: Confirmed case by country and territory
Extreme right column is cases per 1million people in each country
Secondly, the reported cases in Nigeria seem rather muted when compared to our West African ‘neighborhood’.
Secondly, the reported cases in Nigeria seem rather muted when compared to our West African ‘neighborhood’.
Table 2: West African Neighborhood (as of March 23) 
Only Togo and Benin are yet to record any fatalities while Nigeria’s reported number is lower than that of Burkina Faso & Ghana.
Pandemic Trendlines
Around the world the pandemic is being tracked by a logarithmic graph / trend line showing the change (increasing or decreasing)
Pandemic Trendlines
Around the world the pandemic is being tracked by a logarithmic graph / trend line showing the change (increasing or decreasing)
of confirmed new cases on a daily basis. The normal signature is for new cases to increase at the beginning, peak/flatten out and then fall off (See purple trend line in Figure 1).
Figure1: 2020 Coronavirus cases in China
Source: By Phoenix7777 - Own workData source: 疫情通报 Outbreak notification, CC BY-SA 4.0, commons.wikimedia.org/w/index.php?cu…
The chart above shows that china has peaked and incidents rates have dropped off almost to zero.
Source: By Phoenix7777 - Own workData source: 疫情通报 Outbreak notification, CC BY-SA 4.0, commons.wikimedia.org/w/index.php?cu…
The chart above shows that china has peaked and incidents rates have dropped off almost to zero.
Figure 2: Selected Coronavirus trend lines in Africa (Source: Wikipedia)
The chart of selected African nations above shows that only Egypt seems like it is about to level off prior to the expected flatlining and attenuation.
This brings me to the third point: timeline!
The chart of selected African nations above shows that only Egypt seems like it is about to level off prior to the expected flatlining and attenuation.
This brings me to the third point: timeline!
Timeline
The first case in Nigeria was recorded on 27th February: same day as Estonia, Denmark, Northern Ireland &Netherlands.
On Feb 28: Lithuania & Wales reported their first cases & on March 2 Saudi Arabia did.
The first case in Nigeria was recorded on 27th February: same day as Estonia, Denmark, Northern Ireland &Netherlands.
On Feb 28: Lithuania & Wales reported their first cases & on March 2 Saudi Arabia did.
Those numbered have mushroomed everywhere except…you guessed it: Nigeria!
Table 3: Coronavirus cases in countries that reported first cases circa Feb. 27
Table 3: Coronavirus cases in countries that reported first cases circa Feb. 27
The unique Nigerian Situation
Viewed by any metric, Nigeria is an outlier and the most plausible explanation for this is not good fortune but a failure to test.
As far as i have seen reported, except for one case carriers in Nigeria were already symptomatic when tested.
Viewed by any metric, Nigeria is an outlier and the most plausible explanation for this is not good fortune but a failure to test.
As far as i have seen reported, except for one case carriers in Nigeria were already symptomatic when tested.
Per the World Economic Forum as many as 60% of people with coronavirus show mild or no symptoms. (weforum.org/agenda/2020/03…)
This indicates that there may be twice as many carriers than reported already in Nigeria (conservatively)!
We should be scared!
We should be very scared!!
This indicates that there may be twice as many carriers than reported already in Nigeria (conservatively)!
We should be scared!
We should be very scared!!
Treatment for COVID-19 carriers involves hospitalization in ICUs & the use of respirators. There are a limited number of those equipment in Nigeria which strongly indicates that the only practical means of managing this scourge is prevention of the spread rather than treatment.
While I know several people that have come into Nigeria from Europe and North America over the last 3-weeks, I do not personally know of any that has been tested.
So far they are self-isolated and asymptomatic however this doesn’t mean that they are not carriers.
So far they are self-isolated and asymptomatic however this doesn’t mean that they are not carriers.
Most positive cases I have been made aware of in Nigeria where based on test administered on Individuals that were already manifesting symptoms.
Relying solely on symptoms has limited effectiveness because of the lost time as a result of the incubation period of 2 – 12 days
Relying solely on symptoms has limited effectiveness because of the lost time as a result of the incubation period of 2 – 12 days
(the time between contracting the virus and symptoms showing up) during which asymptomatic carriers may continue to spread the virus.
Age: Nigeria’s Mitigating Factor
The median age of the Nigerian populace is 18.4 years (Wikipedia / CIA World Factbook 2018 est.[3])
Age: Nigeria’s Mitigating Factor
The median age of the Nigerian populace is 18.4 years (Wikipedia / CIA World Factbook 2018 est.[3])
and most Nigerians are in the 15-54 year bracket.
As a mitigation to COVID-19, this is beneficial as youth positively correlates with chances of survival. This however doesn’t consider underlying medical conditions such as diabetes, cancer and asthma (think Port Harcourt Soot).
As a mitigation to COVID-19, this is beneficial as youth positively correlates with chances of survival. This however doesn’t consider underlying medical conditions such as diabetes, cancer and asthma (think Port Harcourt Soot).
Nigerian Population Age Structure per Wikipedia
Juxtaposing this demographic structure & huge population against the lack of healthcare infrastructure portends that Nigeria may end up with a mass of carriers that become hazardous to elderly parents, family members, neighbors and unsuspecting strangers: perennial parricide.
This is of heightened risk as the elderly tend to depend on family support systems for daily life.
Incidentally, the political elite currently pulling the levers of government and presiding over the national response to this pandemic are more elderly.
Incidentally, the political elite currently pulling the levers of government and presiding over the national response to this pandemic are more elderly.
They would collectively be guilty self-harm if they do not find the strategy and vim required to effectively combat this crisis. All success cases of containing the spread are underpinned by a strategy of aggressive testing and contact-tracing.
This is the biggest pandemic ever to grip Nigeria and so far, we are fighting in the dark. END.
Cameroon added to update @africatechie
