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COVID-19: Is Lagos winning the battle?

Ayodele Olalere

On February 27, 2020, Nigerians were shocked with the news of the discovery of first confirmed case of the dreaded coronavirus disease in Lagos.

The Ministry of Health had confirmed that the case, an Italian citizen who works in Nigeria but had just returned from Milan, Italy to Lagos, two days earlier had been confirmed by the Virology Laboratory of the Lagos University Teaching Hospital, LUTH, to have contracted the virus.

According to the ministry, though the patient was clinically stable, with no serious symptoms, and was being managed at the Infectious Disease Hospital in Yaba, Lagos, the discovery was the beginning of thousands of confirmed cases the country, especially Lagos, was going to discover in months ahead.

Several months after, Lagos, the commercial nerve centre of Nigeria became the epicentre of the virus as confirmed cases began to rise with no end in sight.

By March 3, Covid-19 confirmed cases in Lagos rose to seven with 21 contacts under follow-up. Two days later, it increased to eight with 81 contacts being traced. On March 6, confirmed cases rose to nine with no deaths yet recorded. As at March 31, Lagos had recorded 82 cases with 76 on admission and six discharged yet no death had been recorded.

While other states were yet to record any case, cases continue to rise in the Centre of Excellence. There were apprehensions among residents and government officials. Such apprehension was understandable going by reports coming from other parts of the world of thousands of people who have died of the virus.

Reports from National Centre for Disease Control, NCDC indicates Lagos accounts for 44% of Covid-19 cases in Nigeria.

To help the state fights the virus, President Muhammdu Buhari quickly approved the immediate release of a N10 billion grant to Lagos State. According to the President, the grant would enable the state to increase its capacity to control and contain the outbreak, while also supporting other states with capacity-building.

The money, it was believed would also help to curb the spread of the virus. Enlightenment and advocacy programs were embarked upon by the state government to educate the people on measures to be taken to avoid the contracting the virus. To motivate health workers, the state government increased their allowances by 400%, with the belief that the virus would be contained within two months while construction of isolation centres were embarked on.

However, if the state government had thought the virus would be defeated within a short period, it was proved wrong as subsequent events that followed proved the state was in for a serious battle to curtail the virus.

The rise in cases in Lagos triggered the pronouncement of total lockdown in the state by the federal and state governments for 14 days. While announcing the lockdown in Lagos, Abuja and Ogun States, President Muhammadu Buhari said: “All citizens in these areas are to stay in their homes. Travel to or from other states should be postponed. All businesses and offices within these locations should be fully closed during this period.”

By April 15, Lagos had recorded 232 cases with 85 discharged but this time, seven deaths recorded. Two weeks later, precisely April 30, it became clear the virus had come to stay in the state as 976 cases were discovered, 199 discharged and 21 deaths recorded. The rise in deaths threw Lagosians into more panic as many feared for their lives. As at May 15, cases in Lagos skyrocketed to 2,278 with 541 discharged and 36 deaths.

On May 31, reports from the National Centre for Disease Control, NCDC, indicated that confirmed cases in the state had risen to 4,943 with 825 discharged and 54 deaths. On June 15, it rose to 7,319 with 1,137 discharged and 82 deaths. By June 30, it became 10,510 with 1,603 discharged and 128 deaths.  As at July 15, it was no doubt Lagos had become the epicentre of the virus in the country as confirmed cases rose to 12,941 with 1,948 discharged and 175 deaths.

The chart released by the state’s Ministry of Health shows Lagos Mainland Local Government tops the chart followed by  Eti-Osa Local Government where the infection rose from 57 per cent to 85 per cent in nine days. Next is Ikeja Local Government followed by Alimosho.

Other affected local governments include Ikorodu, Ifako-Ijaiye, Ibeju Lekki, Badagry, Apapa, Amuwo- Odofin, Agege, Surulere, Somolu, Oshodi /Isolo, Mushin, Lagos Island, and Kosofe. The chart also reveals 70 per cent of victims are male while 30 per cent are female.

Though efforts to defeat the spread of the virus in Lagos State has been intense.  The Babajide Sanwo-Olu-led administration embarked on door-to-door checks on residents in order to carry out an electronic survey enquiring about cough, cold and fever. Also world class isolation centres in Yaba, LUTH, Gbagada, were constructed and equipped with state of the art medical facilities, yet with cases rising daily, there are apprehensions the state government might not be able to defeat the disease.

The recent pronouncement by the state’s Commissioner for Health, Prof. Akin Abayomi, that the state would experience spike in confirmed cases by August, has also heightened the concern.

“We believe that in the next week or two, we are going to see an increase in both the private sector testing and public laboratory testing. We are still seeing a gentle increase in the number of cases overtime cumulatively. Lagos will theoretically peak in the month of August, it will flatten out and over some time, we will see a decline,” Abayomi said.

The concern over the possibility of the state conquering the deadly disease became more pronounced when compared with the present situation in Kano, the second most populous state in the country.

In March, news spread that the first case had been confirmed in the ancient city. Prior to the discovery of the state’s index case, hundreds of death were recorded as a result of an ‘unknown disease.’ Though the state governor denied the deaths were connected to Covid-19, the NCDC, however, countered the claim, saying a large percentage of the victims died of the virus.

Kano had recorded 73 confirmed cases of COVID-19 few days after the Nigeria Center for Disease Control (NCDC) reported the index case in the state. With the low level of literacy among Kano residents, Nigerians were fearful a major catastrophe was about to occur with the belief that the virus could spread quickly from the state to other northern parts of the country.

There were calls for the Federal Government to pay serious attention to the situation in Kano to forestall a major breakdown of the pandemic in the northern region.

The state Governor, Abdullahi Ganduje, requested for a grant of N15 billion from the Federal Government to enable the state to fight the disease, a request that was not granted till date. According to the governor, the grant would have enabled the state government to pay voluntary healthcare workers engaged by the state to support full-time health personnel, procure Personal Protective Equipment (PPE) and open up testing and isolation centres.

“You can understand that Kano is the most populated state in the country hence the only testing centre at AKTH is not enough for us,” the governor had said. As of May 7, Kano State has had 490 cases and 13 deaths from Covid-19.

Three months after, the suddenly decline in the number of confirmed cases in Kano compared with rising cases in Lagos has however become a concern on whether Lagos would ever win the war against Covid-19, compared with other states.

In Kano, as at July 15, cases were 1,318 with 1,035 discharged and 52 deaths. While full commercial activities are yet to resume in Lagos five months since its first index case, just three months after its first index, full commercial activities have resumed in Kano.

In spite of its 20 million population, Kano only recorded 11 new cases from June 21-27 prompting the belief the state might have eventually conquered the disease.

The sentiment was echoed by Dr. Sabitu Shuaibu Shanono, the Deputy Coordinator of the State’s COVID-19 Response Team when he said “the number of cases has drastically reduced; the number of samples we are testing has increased while the number of positives has reduced. So, it means that we have flattened the curve.”

With the sudden drop in confirmed cases, the three months’ lockdown was lifted by the state governor, Abdullahi Umar Ganduje, basing the lifting of the curfew on the sharp drop in infections.

 “We can beat our chest and say we are winning the case and there is no longer any need for the lockdown. There will be free movement for all,” Ganduje said.

Like Lagos State, and other parts of the country, several measures were also put in place by the Kano State Government despite mounting infections which has culminated in the flattening of the curves of the disease.

Lagos Governor, Babajide Sanwo-Olu, while explaining the reason for the continuous increase in total number of confirmed COVID-19 cases in Lagos State, had said it was evidence of the success of the state’s government efforts at curbing the virus.

“As we implement these strategies, and take testing deeper into our neighborhoods and communities, we expect that we will see more positive cases. I must use this opportunity to commend all the teams who are carrying out this active community case search,” he said.

However, while speaking on the possibility behind the rising cases in Lagos and Nigeria in general, a legal practitioner, Mr Don Akaegbu said:

“It is a fight that lacks sincerity, transparency and probity. It’s not just Lagos State but the entrenched culture of corruption. I have said at different fora that states, NCDC and the Presidential Task Force have not and will never wholly deploy Covid-19 funds for what it is meant for. Substantial part of it must have been diverted like what is happening with the Niger Delta Development Commission, NDDC.”

“How or what do I mean? Nigeria, Lagos inclusive, despite the huge amounts of money donated by corporations and individual, could not distribute palliatives to Nigerians like other countries did. The result was unimaginable hunger and resultant robbery and alarming crime rate. How many people do we have in Lagos and how many are tested daily?” he asked rhetorically.

He added: “We will win the fight if stakeholders use the available funds judiciously. Procure and acquire the best technology for the fight, motivate medical personnel by paying them very well and providing them with adequate protective gears. Test more people on a daily basis.”

A medical practitioner, Mrs Toyin Eniola, however, attributed the rising cases in Lagos to its economic importance to the country, adding that the influx of people into the state from other parts of the country is one of the reasons behind continued increase of confirmed cases.

She reasoned that based on the strength of financial resources committed by the state government to the fight against the virus, the state would soon experience a decline in cases.

“One cannot compare Lagos with any other state in Nigeria. Lagos is the commercial centre so every Nigerian wants to come here. Many come with various diseases and they use facilities provided by the state government. So it’s expected cases would continue to rise. The population in Lagos is huge so you can imagine the number of people that are yet to be tested.”

“Don’t forget that the first case in Nigeria was discovered in Lagos. It is not peculiar to Lagos. Developed countries are also experiencing increase in cases in their major cities especially cities that are commercial centres. Cities with huge commercial activities like Lagos are prone to high cases of this type of pandemic. I am convinced Lagos will win the battle in due course. There are competent medical personnel and a governor that has been proactive in the fight against the virus,” she said.

A cleric, Pastor Isaac Adegoke, in his reaction said the possibility of the state winning the battle against the virus like every other states in the country would be determined by the continued efforts of the state government.

He warned Lagosians and Nigerians that the virus ‘has come to stay’ and should endeavour to follow guidelines by the government.

“The fact is this virus has come to stay with us. Whether we like it or not, it will continue to come and go. All government needs to is to ensure sustained advocacy and continued testing of people. The virus might not be defeated totally but I am convinced its spread can be reduced. Lagos State Government is trying its best but the increase is understandable. Lagos is one of Nigeria major cities and most populated so what do you expect? It will take a while before it can be successfully dealt with. The good thing is as much as the cases are increasing, many are also being discharged and recently, fewer deaths have been recorded. Its assurance the state can defeat the virus,” he said.