Why We Need To Know More
|Apr 6, 2020|
In dealing with a pandemic, information is important. We are dealing with a virus we do not know much about and we have a government whose modus operandi is secrecy. Secrecy has its time and place, but not now.
So far, our epidemiologists are nowhere to be found. There are no models informing us on possible policy action. We are simply flying blind. We do not know the share of the population that will eventually “catch” the virus, if we have case clusters, and what should be the best approach? Is it doing nothing and waiting for herd immunity, or mitigation a.k.a flattening the curve? Or do we adopt suppression - cutting exponential growth and fatality rate?
The government has instituted a lockdown, which is our best course of action in my opinion. What should follow is aggressive testing and tracing. We can’t afford a steep rise in the curve. First-world healthcare systems have groaned under the weight of the curve. Nigeria with 0.8 ICU bed per thousand simply does not have the capacity.
Of the 120 cases in Lagos, 30 has been discharged with 2 deaths. That is a discharge of 25% and death of 1.67%. Due to incomplete information, I could not get the gender ratio by state and epidemiological history - whether it is from foreign travel, contact with an infected person or community transmission. We need more data from the NCDC to be able to this. We need to be able to map the age range effectively too. And if possible location so we can map the clusters, if there are any.
Abuja with the second-highest number of case burden has seen no discharge at all and two deaths since its first 3 cases on the 21st of March. Abuja recorded its first death (first in the country) on the 23rd of March. A subsequent one on the 1st of April. Both cases were managed at the University of Abuja Teaching Hospital, Gwagwalada.
Ogun, where the index case was found had 1 earlier case of contact with the index. This was the first person to be released on the 13th of March. As at 16th March, apart from the index case, the NCDC has screened 53 persons with 47 negatives, 4 pending results, and 1 positive. All negatives were released to lead their normal lives. All these cases were connected to the index case. It is puzzling that the NCDC does not report the numbers with these details anymore. For instance, we do not know if the 2 currently active cases in Ogun are contacts from the index case, new incident cases from foreign travel, or community transmission.
Osun State has seen the highest jump in cases. In a span of 72 hours, the state recorded 15 cases averaging 5 per day. We have no information on the nature of transmission there too. So far, there have been no discharges and deaths.
Controlling for a lack of adequate information, the question still remains - are we doing enough testing? Measuring the number of screened against passengers of interest, our testing capacity has ranged between 3%-19%. This linear testing as occurred as we traced contacts, we haven’t even scratched the surface on random testing. What the data show is that the NCDC possibly have constraints around testing as the number of the exposed widens. We currently stand at 8,881 passengers of interest (see table above) and the NCDC has stopped reporting the number of screened people since March 26th. Although the confirmed cases remained a lowly 232, how are we to know this is all? Surely this can’t be all. But we need more data, so we can know what to expect.