Post-Lockdown Strategy: Where We Got it All Wrong

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On May 4, after five weeks of staying indoors, Nigeria joined Ghana in lifting the Coronavirus lockdown. According to the federal government, this is the first phase of easing the lockdown and the outcome of this decision will be assessed in the next two weeks.

The president cited the “heavy economic cost” of the lockdown. No doubt, the lack of activity has affected every sector of the economy with the impact worse among workers in the informal sector who depend on their daily profit to survive.

Where we got it all wrong

On the same day the president made the decision to call off the lockdown, reported cases jumped to 245. The COVID-19 pandemic has over flogged these three evident problems in the dysfunctional Nigeria health sector: inefficiency due to manual processes, fragmentation, and lack of data.

When Ghana made the decision to call off their lockdown, it was supported by an aggressive rise in testing and enhanced capacity to conduct contact tracing of infected persons. Ghana has conducted up to 100,000 tests which is four times the total number of tests done in Nigeria. It is important to know that Ghana is using drones to fly COVID-19 samples from difficult-to-reach rural areas to health facilities where they can be tested; shortening the time between getting tested and receiving your test results.

The Nigerian government has failed to look inwards. We need to focus on ourselves and come up with solutions unique to us. It is okay to admire the efforts of more efficient countries, but we have to be realistic when setting our own plans. Nigeria is a country of 200 million persons and just about 26,000 have been tested, that is 0.13 persons per 1000.

It is easy to see why Nigerian health professionals continue to argue against the decision to ease the lockdown especially in the hard-hit cities of Lagos, Ogun and Abuja. The truth is, we are not ready for this.

What can we do?
First of all let’s consider what has been done: tertiary health centers have been strengthened, more laboratories have been built and old ones made even better, with the support of the private sector isolation centres have been successful set up across all the geo-political zones.

To find a solution, we have to take into consideration that we lack the skills, resources and functional systems to handle a pandemic of this situation, even the United States is struggling.

We need to be original and come up with interventions that are peculiar to us and our problems. This is time to look back and find out what we have missed. What has the government overlooked that is pinging back our progress?

One of them is that the Primary Health Centres have not been fully engaged in the fight against COVID-19. More focus has been placed on tertiary institutions and specialised laboratories, ignoring a fundamental part of the healthcare sector. Primary Healthcare Centres which function at community level are the first point of contact for the majority of Nigerians and simply cannot be overlooked, especially now that we have entered the community level spread of the coronavirus.

There’s a lot to gain if the PHCs are well-equipped including: early detection of cases, more compliance to NCDC safety guidelines as people trust their community healthcare providers. If workers in our primary facilities are actively engaged, this not only improves their competence, but make them willing champions to support the fight against the COVID-19 in their respective communities.

We have innovators in the private sector, disrupting the healthcare sector with efficient problem solving technologies. 54gene, a private organisation focused on African genomic studies has played a key role in boosting Nigeria’s daily COVID-19 testing. The private sector in Nigeria consistently displays enterprise, competence and accountability and all these qualities we require at this time. In fact, a majority of South Africa’s 200,000+ tests (highest in Africa) have been conducted in private laboratories. The government needs to engage more private organisations across different areas and levels.

Way forward
Five years ago, when Bill Gates warned that we were not ready for the next outbreak, this particular scenario is what he was talking about.
Getting ready for a pandemic is not a one-off issue. Epidemiologists continue to warn that we are in constant threat of emerging and re-emerging infectious disease outbreaks. What does this imply?

This implies that all the progress and innovations made in the health care sector during this period should not be abandoned as things begin to get better. All the successful collaborations, both private and non-private, should be made into widescale self-sustaining systems; the Bio-Safety-3 Labs established should not be allowed to go extinct due to poor maintenance.

We can’t keep making the same mistakes, the COVID-19 pandemic has exposed both our flaws and strengths simultaneously, let’s enforce the positives and turn around the negatives. There’s no better time than now to plan for the future.