The situation with COVID-19 is still rapidly unfolding globally, with constantly shifting patterns and trends. Some East Asian nations who have been praised for being able to slow the rate of infections are now seeing a second growth stage. Adam Kucharski explained that some outbreaks can behave this way, and the image below is from his new book "The Rules of Contagion" (which I am currently reading).
More pertinently, I have some questions about what we have been seeing in Nigeria. I am not an expert in this matter, the more reason why I think we need to see more explanation. The total number of cases in Nigeria is still low (maybe there is an African pattern here) and I do not know how to think about it.
The first thing that comes to my mind is testing. NCDC says in their latest weekly situation report that daily laboratory testing capacity has been increased to 1500 per day - but I can't find any new information on the total number of tests that have been done. Are we seeing such a small number of cases because we are not testing at a large enough scale? There is also the issue of tracing. There are 6,701 passengers of interest that are being monitored. How many of them have been found and tested? Controlling for security risks, and privacy concerns, I think we need more information.
I am also interested in mortality and recovery. There has been some coverage on how under-resourced the health sector is, and worries about overburdening the system if we see a huge jump in case numbers. ICU beds, ventilators are in short supply. But so far over 10 percent of reported cases have recovered, and less than 2 percent of cases have died. I feel like these numbers make no sense (and dangerously premature) until we know how many tests have been conducted and whether infection pattern has clusters (some 30 percent of reported cases still have incomplete epidemiological information). So far we do not know how many patients need critical medical attention. Most of the cases reportedly have mild to moderate symptoms. Is this due to efficient tracing (and early self-reporting) or it has to do with the age distribution of the infected, given that Nigeria has a young population and COVID-19 has been known to be fatal for older (60 and above) people? Or does this have to do with preexisting conditions or the country's overall disease burden?
The Punch newspaper reported yesterday about a 55-year-old patient with hypertension and diabetes, who reportedly died from COVID-19 complications. The patient allegedly did not disclose his travel history, and the “fingerprint antibody test was done on him”, which confirmed his positive status for COVID-19. The newspaper reported that this happened at the Lagos University Teaching Hospital(LUTH), Idi-Araba - and that both the Lagos State Commissioner for health and the Director of Public Affairs did not respond to phone calls. So far as I know, there has been no official confirmation of this story. The closest hint I could find was from a tweet by the state government’s senior special assistant on new media.
I understand the need for information to be coordinated around specific channels, but there should not be lags and gaps in dispensing timely information to the public. This can create vacuums filled with fake information, and imaginations that can spread panic. More importantly, we need expert knowledge to explain some of the underlying patterns to how the epidemic is unfolding in the country - this will inform official policy response, and inform the public's attitude to safety information and precautions. Dear Nigerian scientists and relevant experts, please step up we need you.
Update: The Lagos State Ministry of Health has confirmed the LUTH incident. You can read the entire thread on Twitter here.