Lagos commissioner of police Hakeem Odumosu speaks to passengers to enforce physical distancing in a bus as part of measures to curb the spread of COVID-19 in Lagos, Nigeria, on March 26, 2020.PIUS UTOMI EKPEI/AFP/Getty Images
Doug Saunders, The Globe and Mail’s international affairs columnist, is currently a Richard von Weizsaecker Fellow of the Robert Bosch Academy in Berlin.
Lagos is the sort of place you’d imagine a pandemic spreading out of control. The sprawling Nigerian lagoon city is home to between 14 million and 21 million people – nobody seems to know for sure – many of whom live in tight-packed shack towns, where a trip to a teeming food market is a daily necessity and where toilets, if they exist, are shared by scores of households.
Yet Lagos has kept the COVID-19 pandemic under enough control that, on Wednesday, state governor Babajide Sanwo-Olu announced a gradual easing that will allow offices, workplaces, markets and stores to open for limited hours. The city will still have a strict curfew, schools will stay shuttered and religious gatherings remain prohibited – but the city has so far succeeded in keeping the novel coronavirus at bay.
This is not a matter of luck. Nigeria knows the virus: it killed the president’s chief of staff, and there have been bad outbreaks in some towns (including some alarming cases in the north this week). There is little evidence that COVID-19 is less virulent in warmer countries. African countries remain extremely vulnerable to an outbreak.
But when the virus escaped China in January, Nigeria and other sub-Saharan countries were able to respond faster and more decisively than, for example, the United States or Britain.
A child from Makoko Slum, along with his mother, carries a food parcel distributed by the Nigerian Red Cross in Lagos on April 25.Sunday Alamba/The Associated Press
The countries that have avoided big outbreaks are those that responded very quickly, in January or February, with coordinated systems. Some, like Taiwan and New Zealand, threw huge sums of money at the problem, buying up all the rooms in dozens of hotels to quarantine people or putting pandemic-tracing software on everyone’s phone.
Others, among them South Africa and Nigeria, responded not with money but experience. In 2014, Nigeria kept the Ebola pandemic at bay even after it devastated neighbouring countries, learning a set of techniques – quarantine, contact tracing, social isolation – that Western countries spent long weeks mastering this year.
I spoke with Ifeanyi M. Nsofor, a doctor who monitors and advises Nigeria’s health system at Nigeria Health Watch, and he noted that his country has already had to deal with a string of serious epidemics. In fact, COVID-19 is not Nigeria’s deadliest epidemic of 2020; lassa fever, a disease that strikes the very poor, has caused almost four times as many deaths.
“In the last three years, Nigeria has responded to a meningitis outbreak, a cholera outbreak, lassa fever outbreaks, monkey pox outbreaks – and the more you do it, the more aware you are about infectious diseases and the need to take action to control them.”
A health official takes a nasal swab from a patient at a government-run COVID-19 testing center in Lagos on April 23.Sunday Alamba/The Associated Press
So when the first COVID-19 victim arrived in Nigeria on Feb. 24 – a man who flew from Italy and spent two days near Lagos before testing positive – officials knew what to do, and who should do it. The Nigeria Centre for Disease Control quarantined him and sent officials to interview hundreds of people who may have been in contact with him, tracking all of their contacts.
Within 48 hours, they had set up a coronavirus command centre, which gathered data from hundreds of offices reporting to pre-existing public health emergency operations centres in 23 states. Those centres gathered and digitized data using contract-tracing software that had been financed and set up years earlier by the Centers for Disease Control. The information is made public almost immediately, so officials and citizens know how to change their activities. This has allowed Nigeria to tightly lock down entire cities where outbreaks are detected, but also to allow rules to be relaxed when infection rates slow.
“Compare that with what happened in the United States,” Dr. Nsofor said. “There, it was just about five weeks ago that the president asked the states to set up their own public health emergency centres – so when there’s an outbreak of any sort, people are not sure who is to take responsibility. Here, there’s already somebody in charge, everybody knows who the person is, the person triggers the response that is already known before it gets out of hand.”
A woman walks past mobile beds arranged outside a new isolation and treatment centre at the Mobolaji Johnson Arena in Lagos on March 27.TEMILADE ADELAJA/Reuters
If there were a full-scale outbreak, a country like Nigeria would be devastated. By one estimate, Lagos only has enough hospital resources for 2,000 cases at once. To date, the city has had fewer than 1,000 cases, and 21 deaths; the number of new cases per day is usually in the dozens, and carefully tracked and quarantined – though there is a constant fear that undetected cases will cause an uncontrollable explosion, or the lockdowns will cause mass starvation, or that skeptical religious leaders will set off an infection wave.
Nigeria may be a poor and badly governed country. But what it has in abundance today is disease-fighting knowledge. We would have less death and infection on our hands today if we’d learned from this African experience.
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