Ease of lockdown: Are COVID-19 infections declining?

Available data from the Nigeria Centre for Disease Control (NCDC) shows a decline in new coronavirus infections being recorded in Lagos State Medical experts, however, believe the irregular and inconsistent decline was a reflection of the number of samples tested. APPOLONIA ADEYEMI reports

For many residents of Lagos State, the recent Lagos State Government announcement, which relaxed the public gathering regulation, increasing the permissible capacity from 20 to 50 persons at any given period, must have been received with big relief. Obviously, not many are pleased with the negative impact of the coronavirus pandemic, particularly the restrictions on social and economic activities that see the majority of the population struggling to make ends meet.

The Lagos State Governor, Babajide Sanwo-Olu directive for the re-opening of social clubs with registered trustees and recreational centres with effect from August 14, has been widely viewed as light at the end of the tunnel. This has raised hope for millions in the educational sector, among others that have not been able to return to work due to the restrictions, that sooner the gates of education institutions and other sectors affected by the lockdown will be unlocked for the restart of normal activities, not only in Lagos State, but in other states of the federation.

Five weeks after the first lockdown, on May 4, the Federal Government eased the initial restrictions in Lagos and Abuja, opening some businesses, an indication that easing of the restrictions would be a gradual process. However, with the recent development in Lagos, concerned Nigerians are asking whether the current easing of restrictions in Lagos questions was an indication that new coronavirus infections in Lagos State was on the decline?

The current data on the number of infections being recorded currently could help in providing that answer. It will be recalled that President Muhammadu Buhari has ordered the lockdown of Lagos and Abuja, as part of the effort to contain the coronavirus in Nigeria, which recorded its first case of coronavirus on February 25. As at the time of filing this report on August 4, global: COVID-19 cases have reached almost 18.3 million with more than 693,000 deaths, according to data from Johns Hopkins University.

The spread of the novel COVID- 19 in Nigeria similarly continues to record significant increase going by the latest statistics provided by the Nigeria Centre for Disease Control (NCDC), which showed that Nigeria has 44,129 confirmed cases as at August 3.

On the same 3rd of August 2020, the NCDC stated that 288 new coronavirus confirmed cases and eight deaths were recorded in the country, out of a total daily test of 1,441 samples across the country. Coming down to the situation in Lagos State, available data from the NCDC, however showed a decline in the pattern of new infections being recorded in the ‘Centre of Excellence’. Statistics from the NCDC for Lagos in the last one week revealed a decline in the number of new infections: as at 1st of August, 2020, 65 new #COVID19 infections were confirmed in Lagos out of a total 285 #COVID19 tests conducted, bringing the total number of confirmed #COVID19 infections in Lagos to 15,215. As at 29th of July, 2020, 106 new infections were confirmed in Lagos. As at 26th of July, 2020, 156 new #COVID19 infections were confirmed in the state. By 23rd of July, 2020, 203 new #COVID19 infections were confirmed while the data was 180 new confirmed cases as at July 22, 2020.

The data was 100 new infections as at 20th of July and going by the COVID19Lagos Update as at 19th of July, 2020, 97 new infections were recorded in the state. While reacting to the development in Lagos, a Virologist and Chairman, Expert Review Committee on COVID-19, Prof. Oyewale Tomori disagreed that there has been a decline in the number of new COVID19 infections in Lagos. He said, “There has been an ir-regular and inconsistent decline in the number of cases, not only in Lagos State but also in all other states.

“The interpretation is complicated by the fact that we do not have the exact numbers of samples tested per state. Tomori, however noted that perhaps, the irregular decline being witnessed is a reflection of the number of samples being tested per say, while citing the example of Cross River state.

“All the days of zero COVID-19 case are over and the days of flattening the truth are over,” he added. According to Tomori, another state to watch is Kogi. “We understand that in a few more states, vigorous efforts are being made to flatten the COVID-19 curve on paper by limiting testing.

“Those states are only pretending they are not pregnant with the disease; we will soon begin to see the protruding COVID-19 pot belly. Therefore, either in Lagos or Yobe, Tomori affirmed: “This is not the time to relax the non-pharmaceutical interventions.

The professor of virology said, “If you must go to church, which I do not think you have to at this time, wash your hand thoroughly, let sanitiser be your holy water and use the real face mask, not the fanciful and ineffective plastic shield that is becoming the vogue, even among those who should know better.” The chairman, Expert Review Committee on COVID-19, said it was too early to talk of COVID-19 peaking in Nigeria. “I hear people talking of second wave. We have not even reached the peak of the first wave.

“Therefore, let us be more diligent in complying with the rules of reducing the spread and transmission of COVID-19. On its part, the President of the Guild of Medical Directors, Prof. Olufemi Dokun-Babalola while commending the Lagos State Government for its proactive approach to the control of the COVID 19 epidemic, said it was not a mean task to achieve in a crowded metropolis such as Lagos. However, Dokun-Babalola said the phased relaxation of restrictions as directed by Sanwo-Olu was in order, but stressed that it must be enforced.

“The impression must not be created that the crisis is over,” he added. However, “from the figures available, COVID-19 is still being transmitted. At the moment, most cases are unreported or undetected for the simple reason that many cases are mild or asymptomatic, said Dokun-Babalola who is a professor of ophthalmology. According to him, many cases were suspected in the domestic environment, but silently treated.

Similarly, he noted that the policy of home treatment instituted by the government may also give the impression that the numbers are falling. “Only a sero-prevalence survey can give us the true picture of the extent of the pandemic in Lagos,” said the president of the GMD.

The moral, according to him is that individuals should still be extremely cautious as they expose themselves to potential contagion in the public and especially in confined spaces such as places of worship. Hence, he reasoned that personal hygiene, hand washing, social distancing and face masks must be encouraged. The professor of ophthalmology stressed that fines must be put in place for the violation of face mask rules. “This is because it is not unusual for secondary spikes to occur after relaxation of restrictions as we have seen in many other countries in Europe and Latin America. He said, “COVID-19 transmission anywhere is COVID-19 transmission everywhere.” Dokun-Babalola lamented that unfortunately, not many states have been as proactive as Lagos.

“Some are under-testing and some are not even testing at all, playing the proverbial ostrich with their head buried in the sand. “Such governors are not doing their citizens any favours.” At the moment, the president of GMD said a lot of research was going on into therapeutics and possible vaccines. “There is a better understanding of what works and what doesn’t. “Studies suggest that some common drugs such as Ivermectin, doxycycline and dexamethazone have some effect, and some may be of use in prophylaxis.” However, he said to verify these observations, Proof of Concept Randomised Control Trials were necessary. “Some of these studies are already underway at the Lagos University Teaching Hospital (LUTH) and elsewhere in the world.” He disclosed that some vaccines such as the Moderna vaccine and Oxford vaccine were entering phase 3 trials.

However it is not unlikely that the effect of any of these candidate vaccines (some recombinant and others attenuated) may be short lived. That remains to be seen, he added. Also contributing to the discussion, the President of Medical and Dental Consultants’ Association of Nigeria (MDCAN), Prof. Kenneth Ozoilo said, “There does appear to be a slight decline in new diagnoses recently, but remember that we have had challenges with testing capacity. “This is the time to consolidate on the gains of the measures put in place to fight COVID-19 and not time to gamble with the risk of reversing all that has been achieved so far.”

Based on this background, Ozoilo stated: “The move by the Lagos State Government is hasty and ill advised; we risk another spike.” Similarly, reacting to the development, the Chairman, Association of Public Health Physicians of Nigeria (APHPN), Lagos chapter, Dr. Tolu Olufunlayo said it was too early to tell if the the announced directive from the Incident Commander in Lagos State, to relax the public gathering regulation in the state, actually translated to a decline in coronavirus cases. “I would advise that we stay on course with our interventions as we must not let down our guard at this stage. “I am cautiously optimistic that if we stay the course, we may begin to see a change in the COVID-19 trends for the better.”


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