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Independent Reflections on Covid-19

As COVID 19, in many countries has started out as an urban disease and there is concern about how some of the megacities in the Global South will effectively address the issues, we are delighted to invite Dr. Jide Idris, previous Commissioner of Health in Lagos, who led the Ebola response in Lagos State to be a special guest writer to share his independent views.

Covid-19 appears to reflect the WHO’s prediction of Disease X since it attained a

pandemic status. Its impact has been enormous ranging from health systems

destruction, threats to national and international security, raising scientific

challenges, severe global economic damage to several industries etc. This

underscores the importance and reality of the cliché that “Health is Wealth” and

the need to look at Health as a Security issue.

Back in Nigeria, our response to this pandemic, especially between Lagos State

and the National Center for Disease Control (NCDC) teams has so far been

commendable. It shows that we learnt a few lessons from the Ebola outbreak of

2014, especially the importance of Preparedness. It would also appear that apart

from Lagos and very few other states, most states in the country are not ready

and prepared.

However, considering the mode of spread of this virus, our response needs to be

modified especially in view of the gaps we have as a country, as highlighted by

both the Joint External Evaluation (JEE) and the Global Health Security (GHS)

Index scores for Nigeria. Top amongst these is our fragile health system. A key

component of this is the severe shortage, quality and capabilities of our health

work force in some key specialty areas. A major concern is our seeming inability

to handle a surge (with complications) when it occurs. Therefore, there is a need

to increase our surge capacity by training our health workers (both public and

private) on emergency respiratory care (ventilator care), Intensive Care etc.

Also important is the large number of vulnerable groups like people with


Tuberculosis, Sickle Cell Disease, Malnutrition, Cancer, Cardiovascular diseases,

the increasing number of slum areas, our communal living style, especially as it

relates to the military and police barracks etc. These represent the vulnerable

segments of our population. All these require us to review our response

strategies, more so as It would appear we already have community spread of this

virus now. Perhaps, we should consider decentralizing our detection strategy by

creating specialized centers where more rapid screening, using test kits can be

carried out.

In the same context, there is also a need to review our concept and

implementation of “social distancing” if we consider the less privileged people

living in the slum areas (the face-me-I-face-you) type of housing, people living in

the barracks etc. Furthermore, there are many communities with little or no

access to safe water supply. This also, is a reflection of our mitigation and

preparedness status. If we want to encourage the culture of hand washing,

perhaps governments should consider the provision of bore holes in those

communities.

As a country, we have many factors (e.g. the environment, population explosion,

social migration and conflicts, food, agriculture and animal industry etc.) that

render us vulnerable to biological threats. Lassa fever is currently taking its toll in

the country, in addition to the current Covid-19 pandemic. So, we must

continuously review and update our level of preparedness and response

strategies nationwide. Health must be taken as a security issue.

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