Anap Foundation COVID-19 think tank: Coronavirus alert
By Sam Agha Egwu
It is IMPOSSIBLE that only a few cases are in Nigeria. From the evidence in other countries, we can boldly project, statistically, that we should have hundreds now, and with so much free movement still, it would soon be thousands.
Nigeria is still trying the old method of tracing contacts that worked with Ebola. In Nigeria, with all its difficulties of contacts (phones and addresses? By the time you finish tracing the contacts from one aircraft for just one victim, it takes weeks, and to trace contacts of any secondary contacts infected takes much longer.
Coronavirus infects even when the symptoms are not serious, so it’s more deadly than Ebola. It can infect more people faster. Ebola is sudden, with rapid onset and infects by touch, blood or spittle and by direct one-to-one contact, when the person is ill, so it’s easier to track. People can see an ill person and back off. Coronavirus infects by the touch of mouth, nose and eyes, as well as by aerosol, droplets from the mouth when the victim sneezes or coughs. The secondary infections are therefore IMPOSSIBLE to trace as they can be completely anonymous, such as passengers in a shared bus.
The more modern position, developed by the Chinese, is to stop all movement in and out of an area until all the virus is defeated. That is lockdown. No travel. No gatherings. Just only essential movement. I am on lockdown right now in London.
HOW MANY PEOPLE HAVE IT?
This virus has an Iceberg effect. You are seeing an iceberg but the only 1/10th is showing above water. The other 9/10th remains hidden. With all the flights into Nigeria from all the affected countries, some victims not showing symptoms will by-pass airport security. Given trading, business and construction networks across Nigeria, it does not take a statistician to realize that the virus has penetrated the whole country. By the time you identify one person, they have already infected 5 to 10 random persons, unknowingly and the symptoms for those will start showing in 14 days. The ones infected, can be anonymous and infect another 5-10 random persons. Within two weeks one person can cause the infection of 50-100 persons.
If this assumption is wrong, it is better to be wrong than to find out that it is true, with all its deadly consequences. Coronavirus is far more insidious than Ebola. It starts infecting before the signs show. Hundreds should already have the infection in Nigeria, but with limited means of testing. The first victim got to the hospital too late, whilst waiting for his result.
In the UK, we were laughing at Italy and China, thinking it was their life style that was causing the virus explosion there. The UK Prime Minister was treating it with kid’s gloves, then we had 1 then 2 then 5 then 10 after a week, then suddenly, boom, it took off exponentially with a sharp upward curve.
Now we are getting a jump of 400 a day within a week. The death toll jumped from 71 to 127 in one day. They calculate that statistically, based on China, Iran and Italy, that 50,000 already have it. In less than 3 weeks, the numbers as of today is 6,180 active, 355 dead and 135 recovered.
In Italy, in three days, it went from over 500, then over 600, then over 700 deaths a day. Totals as of today are: 50,418 active, 6,077 dead, 7,432 recovered. They have passed the number of deaths in China because they delayed in locking down the country. America is still messing about, delaying the inevitable lockdown. In just 2 weeks they have 45,271 active, 582 deaths and 295 recovered.
Black people are not immune as some people claim. Blacks and whites are being hit in the UK and now in Nigeria. It is also not true that our temperature is too high, although that slows it down. It dies quicker outside the body in higher temperatures. As at the time of writing this, Nigeria has 37 active cases, 1 dead and 2 recovered making it a total of 40 cases.
Last Friday we had 8. At the beginning of the week before we had 1. Having 40 cases means we probably have well over a hundred incubating now. Nigeria may have it in hundreds now, but if we do not act it will soon become thousands, then millions. It will not stop until we stop it.
The three reasons why we may not be getting more figures may include:
1. The Government is being careful not to alarm people.
2. Access to real-time data is hampered by the reporting capacity of our health institutions.
3. Most importantly, testing is not happening as we have limited supplies of testing kits.
TAKING ACTION NOW
I cannot see how Nigeria and Nigerians can cope if this virus takes hold because we do not have health facilities and personnel. A sophisticated country like Italy is finding it hard to cope and doctors are being sent in from China, Cuba and other countries to help them. It is best to enforce social distancing and lockdown now that the numbers seem small than to wait to find out if we will have it, or be timid about taken drastic and draconian action to prevent it from spreading. We have to act NOW.
Ghana, Uganda, Rwanda and Zimbabwe are all African countries that are taking seriously early, proactive action to stop the virus before it takes hold. Uganda has not yet gotten a confirmed case but has shut down flights and all social spaces – churches, mosques, schools, etc – to prevent the virus from coming. Zimbabwe even sent in the police to stop churches and mosques. Ghana and Rwanda are taking very intelligent actions. For Ghana, all passengers arriving are quarantined. In Rwanda, they also have public hand sanitizers.
NIGERIA, WORST HIT
People have said that India and Nigeria are going to be the worst hit. In Nigeria, there are a number of factors that will compound the situation. According to Atedo Peterside, founder of Stanbic/IBTC, on Channels TV, (https://youtu.be/ljDXCa637oQ) there are 4 reasons why our Coronavirus crisis could be the worst in the world:
1. POPULATION DENSITY: Nigeria has a high population density, especially in poor urban areas. With buses jam-packed, an infected driver going to work, who drives a Chinese or Italian victim, only has to sneeze and the whole bus has it. This is different from Ebola that requires physical contact. That driver and bus passengers take it back home to family and children, who take it to school and church or mosque. How is the tracing method going to work with these? Impossible. Tracing can only work with Ebola which was one to one contagion.
2. OIL: As the world shuts down, with less land and air travel, the need for oil has reduced drastically. The immediate impact is on Nigeria’s dependence on oil for revenue. The price has collapsed and may go below our production cost, but nobody is buying. This means that at a time when other countries are putting together stimulus packages to fight the virus, we have no money to fight it as a nation. The drugs and equipment needed are not in this country right now. We have no money for projects or to even pay salaries, so that individuals cannot fight it either. Nobody will lend Nigeria money now with the collapse of oil prices.
3. DOCTOR TO PATIENT RATIO: Even developed countries like Italy, China, South Korea were overwhelmed despite high doctor-patient ratio. In England, they threw other patients out of the hospital and cancelled operations, to make way for expected Coronavirus patients. In Iran with a lower density, people are dying on the streets with no hospitals to admit them. Nigeria has probably one of the lowest doctor/patient ratios, and despite the heroic efforts of our health practitioners, this virus will overwhelm them just like Italy, if it is not stopped now.
4. GLOBAL SUPPLY CHAIN: Unlike China, Italy and the UK, Nigeria does not manufacture the equipment or the drugs. China built 2 new hospitals dedicated to the virus in 2 weeks. They produce drugs. In the UK, they have run out of basic drugs like paracetamol and other over the counter drugs that can fight symptoms of the virus. Has our government in Nigeria ordered the testing kits and drugs yet? If it orders now they will take weeks to come. Each country that produces drugs will make their own Coronavirus outbreak its priority. If we get the drugs, then there is a severe problem of clearing through our choked ports. China can clear goods at their ports in 24 hours, but we take weeks at our ports.
PECULIAR NIGERIAN HABITS
Then there are peculiar individual characteristics that will come into play that will seriously make things worse, especially in the urban poor and rural areas:
1. ELITE LETHARGY: It is one of the reasons things don’t work in Nigeria. The Elite do not act for their people but for themselves. This is translated into Government. Until they start dying without access to European hospitals and drugs they may not act.
2. COMPLACENCY: Nigerians are like people who cannot see a train that is about to hit them. People are joking about it, calling it a conspiracy theory, discussing sex. This is the reason why some schools, churches and mosques, the biggest agents of distribution are not yet shut as I write. People are still going to clubs. They are unwilling to read long but informed articles like this one.
3. FOOLISHNESS: Nigerians hate to call a spade a spade and can often do what is against their best interest because of what they call wiseness. Somebody with Coronavirus would rather spread it or runaway than cooperate. People are still chasing girls; families are still hugging. They do not understand social distancing. Europeans work with rationality. It is explained, it is understood and everyone acts. Like, stay at home. They understand. They comply. Nigerians will think of their business, church, mosque, girlfriend, club or some silly conspiracy theory and make fake news.
4. FAKE NEWS AND CONSPIRACY THEORIES: The penchant for fake news is not helping matters. Lies, falsehoods and propaganda are spread about. Somebody advises: do not use masks because a criminal could lace them with something to make you unconscious and steal from you, or Bill Gates wants to inject you with a virus in the name of vaccination in order to reduce the population. In any case, do not accept a face mask from someone in case they pass the virus to you.
5. IGNORANCE: Poor education and illiteracy will make this very difficult. People cannot read or read with poor understanding. It needs to be broken down in the language they understand and that information taken to them.
6. SUPERSTITION: It is a virus. We know where it came from, but in Nigeria, many people will call it end times; others will rush to the pastor, Malam or Babalawo for weird interpretations of facts. This is dangerous and must be countered.
7. RELIGION: Churches and mosques should simply shut down. But it is pastors that will invite people to pray for ‘end times’ or that the Holy Spirit will keep you safe, and claim it is a test of faith. Then you stay together for hours singing and releasing vapors from your mouths spreading the virus in such close contacts. Muslims will kneel close together to pray. Imams have already warned against closing mosques. Can people not pray at home? Some recent Governments directives have said Church services should not be more than 50. This is an unnecessary halfway house. Just stop all church and mosque activities.
8. SOCIAL GATHERINGS: This is a time to stop all social gatherings: marriages, funerals, demonstrations, clubs, evening drinking, motor parks, etc. If you cannot postpone funeral or marriage, have it very low key, for not more than 20 persons or completely abolished.
9. EGO, HUBRIS AND DENIAL: This is part of a unique complexity in the Nigerian character. The idea of feeling insulted by others who know better, or denial that nothing can happen to them because death is not their portion, or being covered by the blood of Jesus. The Muslim ‘Insha Allah’ is just as difficult. Both suspend reason, rationality and science for a baseless hope. If the Pope can shut down St Peter and Saudi Arabia can shut down the Ka’aba, Nigerian Pastors and Imams MUST not be allowed to threaten lives the false beliefs they are spiritually immune or that daring death is proof of faith.
10. POVERTY, UNEMPLOYMENT: This is the mother of them all. Unless there are individual bailout funds for the poorest, they will go for self-treatment, or just stay at home and die. Without work and their companies or markets working, many people will lose their jobs. With the collapse in oil sales, government and project workers will not be paid. Very few Nigerians can last 2 weeks without going out. Yet this virus needs at least 2-3 months of universal quarantine to be beaten.
11. HUNGER: Poor people will not be able to stockpile food for a month or two, to sit out the virus. In the UK you can stay at home without going out, with your saved money or money provided by the UK Government, and all food can be ordered online. This will be impossible in Nigeria. In fact, hunger will drive many people from home to look for money. Many people will have to go to the farm, go to the market. In this process, they may get or spread the virus. The Nigerian Government must find a way of helping the most vulnerable, financially, to stay in quarantine or self-isolation. Somehow the Federal Government must use the army and States
must use some form of security such as Amotekun to help farmers collect food in the villages. The IDP camps, as the Borno Governor recognizes, will be disastrous population centres of distribution, if the virus gets a foothold in any of them.
12. CRIME: The crime threshold in our society is very low and youth who have lost jobs may consider all levels of crime to survive. The Government needs to prepare for heightened security.
STOPPING THE VIRUS
Simply put, prevention is better than cure. In China and Iran, people were dropping on the streets. Nigeria cannot handle this virus if it takes hold.
In a developed country like the UK, the Prime Minister projects it will take about 3 months to stop the virus. But even when you stop it, your country must remain in some level of lockdown, until every other country has been cleared, or some victims from another country may come and reinfect. Coronavirus is a bit like Malaria, in that it can re-infect somebody who has been cured.
This was recorded in China. A patient who was cured and was negative was re-infected and became positive again.
Nigeria and other African countries will have to fight this thing themselves. People from developed countries will not come down like with Ebola when it was only in Africa. Developed countries have to fight their own virus and will have no time for anyone else.
The clear way to stop this virus is by social distancing, self-isolation, quarantine and lockdown; going out for only the most essential items and services. The UK Prime Minister has followed Italy to implement total lockdown of the whole country. Only staff of the most essential services should be going to work, such as hospitals, pharmacies, supermarkets, transport, food markets, water vendors, petrol stations, energy services, garbage collectors, police, military and so on. In the UK, some schools in which social distancing is practised will be looking after the children of health workers.
The Chinese did the following for about two months, to slow down the virus. They are still continuing for at least another month to try and stop it.
Countries are isolated by cutting air travel; towns are isolated by stopping local travel; families are quarantined in their homes. This is not the time to shake hands, touch, hug, kiss, do boyfriend, girlfriend things or have sex. Even husband and wives should stay apart. Even within the home or family, keep a distance of one meter from each other. Wash your hands thoroughly with soap for at least 20 seconds before and after you touch anyone. Carry hand sanitizers. Teach yourself and your children to stop touching their faces. The virus enters through mouth, nose and eyes. Avoid going out. Work from home. If you must go out, wear medical masks over nose and mouth. Remember to wear it properly. Do not forget to cover eyes: spectacles will help, but goggles will be better. Clinical gloves will help too for touching surfaces such as ATMs, lift buttons, door handles, stair railing or those surfaces others can
Disinfect every surface in the home that comes in contact with outsiders. If any of you go out, on public transport wear a mask or invent one and avoid discussion so no one talks over you. Avoid sneezing or coughing persons. In your car, avoid taking any unnecessary passengers, whether friends or family. On return, thoroughly disinfect your car, yourself, your clothes and anything you are carrying. You could take a shower with soap before you touch anybody else – if you must touch. Remember, to disinfect door handles and surfaces, especially if you have an essential visitor.
If your school will not close, withdraw your child from school immediately. Avoid all social gatherings, including churches, mosques, parties, weddings, funerals, drinking parlours, lounges, clubs, motor parks, and so on. Avoid mass transit like buses, trains, flights, shared taxis and so on.
If you can order food, water and items for delivery to your door, please do so, as we do here in the UK. Getting money, food and water will surely drive you out. If you can, buy covered food items. Avoid eateries and their food, you do not know who is serving and who has been there. Transfer money from your phone wherever and whenever you can. Use gloves for POS and ATMs. Remember to sanitize both your hands and ATM cards after use. Disinfect all outer packaging, wash and heat food before consumption. If you buy bottled or ‘pure water’, sanitize the outside packaging or wash with soap and water.
The virus stays in the throat before it migrates to the windpipe and lungs. As the virus does not like heat, you can still destroy it in the throat and windpipe before it attaches to the lungs. Drink lots of warm water, so that if you get the virus, it will be flushed down your throat and your stomach acid will kill it. Gaggle with hot water and salt every morning and evening, and about 5 times each time you gaggle. Throw your head back to ensure the salt reaches deep in your throat, you can also put up a bowl of hot water, put your head over it, cover with a cloth and draw in deep hot breaths to destabilize the virus in the windpipe.
If food is brought to you in your home to help enforce the quarantine, by Government agencies or good NGOs (Charities), make sure you disinfect the packaging, then microwave or heat the food before eating.
SEPARATE VULNERABLE, SICK AND OLD FROM THE YOUNG
Most young people survive the illness from the Virus. It can be fatal for people aged 45 years and upwards and those with underlying lung, liver, kidney, cancer and other life-threatening illnesses. They need to be kept in a room by themselves and shielded from other members of the family, especially from young ones that are carriers of the virus or who can survive the
illness. However, it is a fallacy to say it is the disease of the elderly and young people should not care. There are three reasons why young people should care very much:
1. Younger people and even babies can still get very ill from the virus. If they do, the lungs can be permanently damaged, so that when they do recover, they would be on drugs all their life. It could shorten their lives.
2. If young people get it, they can infect and kill their parents, grandparents, uncles and aunts, as well as infect other young people that take it to their own families. This happened in large numbers in Italy.
3. It is simply humane to avoid infecting vulnerable, sick people by young people.
GOVERNMENT AND CHARITY
I recommend that the Government makes use of various agencies at their disposal to enforce quarantine, help distribute food and prevent crime.
Government is waking up to its responsibilities and some State Governments are shutting down schools; universities have been shut down, but a lot more has to be done.
The Federal Government should move into full national lockdown NOW. I also recommend Government partners with the private sector and NGOs.
This will require some distribution of food and other basic amenities to keep the most vulnerable at home. It is now that Companies, Churches, Mosques and wealthy individuals should use much of their money to distribute to poor areas to help them stay at home.
PASS PROPER INFORMATION
Above all stay safe. Share this essay widely. Use your PHONE and this essay to teach and persuade your friends, poor people, rural folks and others who are not listening, especially Business people, PASTORS and IMAMS. But encourage those offering essential services to keep doing so. Without essential workers, the country could grind to a halt and the virus will spread. Essential workers should all be properly protected by their employers.
Published by the Anap Foundation COVID-19 Think Tank on 23 March 2020, with the prior written consent of Sam Agha Egwu.
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