COVID-19: With fewer tests, Nigeria ties with Ghana, Algeria in death burden
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•As WHO warns of possible significant increase in cases
By Sola Ogundipe, Health Editor & Chioma Obinna
With a total of 221 COVID-19 deaths, Nigeria, with estimated population of 205.5 million recorded a total of 7,526 confirmed cases which is equivalent to one death per million population according to data from the Johns Hopkins University of Medicine, JHU, released on May 23rd, 2020.
From the data, Nigeria has lower death burden per million population when compared to the 7 deaths per million population recorded by South Africa (59.2 million) with 21, 343 cases and total of 407 deaths and Egypt (102.1 million) with 16,513 cases and total of 808 deaths.
In terms of the death burden per million population, Africa’s most populous country, ties with less populous countries like Ghana (31 million) 6,617 cases and total of 198 deaths; Algeria (population 43.7 million) with 8,113 confirmed COVID-19 cases and total of 31 deaths; Ivory Coast (26.3 million) with 2,366 cases and total of 30 deaths and Togo (8.2 million) with 373 cases and total of 12 deaths.
Despite Nigeria’s ranking among other African countries, the country is gradually recording high number of positives and deaths from the pandemic. In March Nigeria recorded 2 percent case fatality rate, which rose to 3 percent in April, and three weeks into May, it remains stable at 3 percent.
Statistics from the Nigeria Centre for Disease, NCDC, daily situation report show that Nigeria’s first death from COVID-19 was recorded on the 23rd of March and two more deaths were recorded in March , bringing the total number of deaths to 3. In April, Nigeria recorded a total of 56 deaths, as the NCDC, also revealed that from the 1st to 23rd of May, 2020, a total of 162 deaths were been recorded from the pandemic.
This development is coming to light as Nigeria joins the list of countries easing lockdown measures, and the World Health Organisation, WHO, warning of possibility of significant increase in cases, with a call on African governments to remain vigilant and be ready to adjust measures in line with epidemiological data and proper risk assessment.
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From the data, Africa recorded a total of 107,747 confirmed cases and 3,257 deaths, and of the total 1.5 million COVID-19 tests so far conducted in the continent, Nigeria conducted a total of 43,328 tests, which is 2 percent of the total, compared to South Africa that has carried out 564,370 tests (37.6 percent); Ghana, 193,705 (12.9 percent); Cameroun, 161, 882 (10.7 percent); Egypt, 135,000 (9 percent); Morocco, 133,561 (8 percent); Kenya, 76,692 (5 percent), and Ethiopia, 57,650 (3 percent).
The data also shows that Cameroun (26.4 million) with 159 deaths, has 6 deaths per million population from 4,400 cases, is followed by Morocco (36.8 million) with 7,406 cases and total of 198 deaths, Gabon (2.2 million) with 1,934 cases and total of 12 deaths and Sierra Leone (7.9 million) with 621 cases and total of 39 deaths, each of which has recorded 5 deaths per million population.
With a total of 648 cases and total of 60 deaths equivalent to 4 deaths per million population, Chad (16.3 million) is followed by Guinea Bissau (1.9 million) with 1,114 cases and total of 6 deaths which ties at 3 deaths per million population with Niger (24.1 million), 943 cases and total of 61 deaths and Sudan (43.7 million) with 3,628 cases and total of 146 deaths.
Guinea (13.0 million) with 3,176 cases and total of 20 deaths has recorded 2 deaths per million populations, a position it shares with Senegal (16.7 million) with 2,976 cases, and total of 34 deaths.
Possibility of significant increase in cases – Moeti
In a statement regarding the development, the WHO Regional Director for Africa, Dr Matshidiso Moeti said against all odds, Africa has so far been spared the worst of the COVID-19 pandemic, but warned against complacency.
“For now COVID-19 has made a soft landfall in Africa, and the continent has been spared the high numbers of deaths which have devastated other regions of the world. It is possible our youth dividend is paying off and leading to fewer deaths. But we must not be lulled into complacency as our health systems are fragile and are less able to cope with a sudden increase in cases.
“The continent has made significant progress in testing with around 1.5 million COVID-19 tests conducted so far. However, testing rates remain low and many countries continue to require support to scale-up testing. There is a need to expand the testing capacity in urban, semi-urban and rural areas, and provide additional test kits.
According to Moeti, “Cases continue to rise in Africa and while overall it took 52 days to reach the first 10,000 cases, it took only 11 days to move from 30,000 to 50,000 cases. About half of the countries in Africa are experiencing community transmission. More than 3,400 health care workers have been infected by COVID-19. It is important that health authorities prioritise the protection of healthcare workers from COVID-19 infection at medical facilities and communities. There is also a need to provide enough personal protective equipment to health care workers and raise their awareness as well as increase infection prevention and control in health facilities.
Low death rate fueling doubt among citizenry – Saliu
In the views of the Chairman of the Nigeria Medical Association, NMA, Lagos State chapter, Dr. Oseni Saliu, the death rate in Nigeria could have been worse but for providence.
“There is really no lock-down as people are still moving around and activities are happening. Generally, in the night, people are still moving. The lock-down has been eased for a period of time now but we have already exposed ourselves to the worst situation that we can have.
‘’People are getting more conscious of using their face masks and hand-washing. However, the social distancing has remained a very bad one.
“We can only rely on God to help us. We are lucky the death rate has not been that bad, but I can assure you that the number of infections within the community is much higher than what we have. It is obvious that we are not seeing more deaths as it is happening in most other countries.
‘’Whether people are self-medicating or spontaneously responding to viral illness is something we need to establish. Already, we have a number of people that have been infected and recovered with or without drugs and the evidences are there clinically.
‘’The fact that we are not doing enough testing is making it difficult to predict the situation. The only reality on ground is that we are not having much deaths from the pandemic and that has also created a lot of doubt among the citizenry believing that the disease is not as fatal as it has been said. We should begin to reaffirm in their minds.’ he stated.
Higher number of cases’ll lead to more deaths – Tomori
In his contribution, a renowned virologist, Professor Oyewale Tomori, said with a higher number of confirmed cases, it was expected that the number of deaths will rise. Although the case fertility rate for Nigeria is currently about 3 percent, Tomori, in a chat with Vanguard, said there was need to also compare the number of confirmed cases each month to be able to state clearly if the number of deaths are rising or not.
“You do not look at the number of cases in absolute numbers and deaths alone. If we are having over 7,000 cases now, the question is that, how many died last month and now that we have over 7,000, how many are dying? The higher the number of confirmed cases, the more you will have more number of people dying.”
Speaking in terms of the human cost when the lockdown is finally eased by June 1, Tomori said: “We are likely to have more people even infected and more people dying. There are two sides to the lockdown.
“Government has its role and the people have their roles. If you can remember in the President Buhari’s speech, he said people should protect lives and they will preserve livelihood. The protection of lives is in your hand and not in the hand of government. Who dies from COVID-19? It is not government but the people.
“So the roles of the people are more important than government preserving lives. But we always talk about lockdown as if it is government’s problem. It is not, it is our problem and that of government but it is more of the people.
“So it means that you and I should do what we need to do to ensure we are protected, by not going to where people are gathering, wearing of face masks and washing our hands with soap and water regularly.”
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