232 confirmed cases, 33 recoveries and 5 deaths following the outbreak of COVID-19

NEWS SITUATION TRACKING – NIGERIA

CORONAVIRUS PANDEMIC IN NIGERIA

Vol. 8

Location: NIGERIA

Issue: 232 confirmed cases, 33 recoveries and 5 deaths following the outbreak of COVID-19.

Date: March 31-April 5, 2020.

COMMUNITY PROFILING CRITICAL STAKEHOLDERS INCIDENT PROFILING

Population: Nigeria has a population of over 200,963,5992.

Basic Demography and Geography of Hotspots: Nigeria shares land borders with the Republic of Benin, Chad, Cameroun, Niger and the Gulf of Guninea of the Atlantic Ocean. The country has 36 States and the Federal Capital Territory (FCT). There are 774 Local Government Areas (LGA’s) divided across six (6) geo-political zones.

Ethnicity: Nigeria has over 250 ethnic groups with HausaFulani, Igbo, Yoruba 3 in the majority.

Nigeria Health Facilities: There are over 20,807 health facilities including Primary

Direct Actors: Community residents.

Affected Persons: Residents of Abuja-FCT, Benue (North-Central); Bauchi (North-East); Kaduna (NorthWest),Lagos, Ogun, Ekiti, Osun, Ondo and Oyo (South-West); Ed, Akwa-Ibom and Rivers (South-South); Enugu (SouthEast);

Interested Actors: Federal and State Governments, Federal/State Ministry of Health, National Center for Disease Control (NCDC), United Nations, National Primary Health Care Development Authority, World Health Organisation, Nigeria Medical Association, National Association of Resident Doctors, Nigerian Private Sector Coalition, E-Health Africa, National/State Emergency Management.

INCIDENT PROFILING

Nigeria is currently recording cases of the global pandemic-coronavirus disease (COVID-19) since its first detection in Wuhan, China, on December 8, 2019 9 . Since then, the virus has spread across the globe with more than 1,252,265 confirmed cases reported in over 190 countries and territories. In addition, there are an estimated fatality of 68,413 deaths and over 258,588recoveries, as of April 5, 202010 at 8.41 p.m.

In Nigeria, since the first confirmed case of COVID-19 on February 27, 202011, the country continue to record an increase in the number of infected cases and recoveries. Between March 31 to April 5, 2020, an additional ninety- seven (97) confirmed COVID-19 cases have been recorded from 135 to 232 cases12.

According to the Nigeria Centre for Disease Control (NCDC), a total of 224confirmed COVID-19 cases were reported as of April 5, 2020 at 9.30 p.m across 14 States. Also, of the confirmed cases, 33 infected persons recovered and have been discharged with 5 fatalities13.

FIG 1: Statistics of confirmed COVID-19 cases in Nigeria as of April 5, 202014 As shown in the graphical analysis above, out of the 232 confirmed cases, Lagos, Abuja-FCT accounted for the highest cases of 120 and 47 respectively, while Osun, Oyo, Edo and Bauchi States recorded 20, 9, 9 and Health Centres (2019 est) 4 . The healthcare infrastructures are inadequate compared to the population base. The 2020 budget allocation of 427.30 billion accounts for an estimated 4.14% of the proposed budget for the health sector. The year recorded a marginal increase in the overall budget from 424.03 billion naira in 2019. 5 This is abysmally low compared to the 15% World Health Organisation (WHO) benchmark. According to the Nigeria Medical Association, the country has about 40,000 doctors to provide care for over 200,000 million population. The WHO recommended physician to patient ratio is one doctor per 1,000 patients (1:1000), however, this is not obtainable in Nigeria. 6

Epidemics: Nigeria has recorded Lassa Fever, Ebola Virus Disease (EVD), Small Pox, Measles, Polio, Malaria, Tuberculosis, Cholera, Guinea worm, CerebroSpinal Meningitis epidemics, amongst others. Recently, the Lassa Fever outbreak in Nigeria has resulted in the fatality 161 people with 906 confirmed cases and 3735 suspected cases 7 across twenty-seven (27) States from January 1-March 15, 2020.

ECOWAS Health Infrastructure (West Africa Health Organisation-WAHO): A regional agency with the responsibility of safeguarding the health of the sub-region’s populace, enabling highimpact and cost- effective health interventions and Agencies, International Coordinating group on Vaccine Provision (ICG), Nigeria Field Epidemiology and Laboratory Training Programme, Doctors Without Borders, Security Agencies including the Nigerian Air Force, Nigerian Ports Authority, Nigerian Civil Aviation Authority, etc. 6 cases with 5 cases in Akwa Ibom and Kaduna States and 4 cases in Ogun State. Also, Enugu and Ekiti States accounted for 2 cases each with Rivers, Ondo and Benue States accounting for one (1) confirmed case each. Out of the 33 recoveries, Lagos State accounted for 27, while Ogun State recorded 3 with one (1) each in Oyo, Ekiti and Osun States. Also, four (4) of the fatalities were recorded in Lagos (2), Abuja (1) and Edo (1) States, while the State the fifth case occurred has not been released by the NCDC15. The graph below further highlights the statistics of confirmed cases, recoveries and deaths in Nigeria.

FIG 2: Number of confirmed, recovered and fatality from Covid-19 cases in Nigeria16.

As the number of infected cases increase, members of the National Association of Nigerian Nurses and Midwives (NANNM) at the Enugu State University Teaching Hospital (ESUTH) embarked on a peaceful protest over lack personal protective equipment (PPE) on April 1, 2020 in the State17. Attempts by security operatives to ensure strict compliance with the stay-at-home order has led to the arrest of 273 residents including two Islamic clerics in Katsina, Kaduna18, Lagos19 and Ebonyi States20 with cases of human right violations emanating from alleged assaults commited by security operatives. Moreover, violent clashes between youths and security operatives enforcing the Government’s directive resulted in the death of two (2) people in Katsina and Delta21 States respectively with ten (10) motorcycles, seven (7) vehicles and a Police Station burnt down in Katsina State22. Five (5) people were reported injured including two police officers in the Lagos State incident.

Coronavirus spread in the country is further compounded by the outbreak of Lassa Fever, which has resulted in the death of 185 people between January 1-March 29, 202023. Aside this major health concerns, criminal attacks by armed bandits, amongst others, continue to ravage communities with an estimated fatality of of 24 people in Sokoto and Zamfara States, as recorded in the WANEP’s National Early Warning System (NEWS)24 on April 1, 2020.

programs including combating health problems, capacity building for health personnel and epidemiological surveillance in the sub- region. WAHO supports quality improvement of health systems, support for development of sustainable financing of health, amongst others8.

RESPONSES

• In addition to the measures aimed at curbing the spread of COVID-19, the Nigeria Centre for Disease Country (NCDC) revealed that about 6,700 contacts are being traced with about 4,000 persons tested as at April 3, 202025.
• Since March 31, 2020, several State Governments issued a ban on inter-state travels for 14 days, exempting essential services including vehicles converying agricultural produce, medical equipments and officials on essential duties.
• The Governor of Osun State, Gboyega Oyetola, on April 2, 2020, signed the Osun Infectious Diseases (Emergency Prevention) Regulations 2020 into law, as part of efforts to combat the COVID-19 pandemic26.
• The Federal Government has distributed 99, 642 face masks, 9, 999 face shields and 110 overall gowns donated by Jack Ma Foundation in China across the 36 states and the Federal Capital Territory, Abuja in the country27.
• Currently, there are eight testing laboratories for COVID including; NCDC National Reference Laboratory in Abuja FCT; Nigeria Institute of Medical Research in Lagos State; Lagos State University Teaching Hospital; Irrua Specialist Teaching Hospital in Edo State,;African Centre of Excellence for Genomics of Infectious Diseases (ACEGID) in Osun State; University College Hospital, Ibadan, Oyo State; Virology Laboratory of Alex Ekwueme Federal Teaching Hospital Abakaliki , Ebonyi State and the Bio-Security Centre in Lagos State28 .

RISK ANALYSIS

• The stay-at-home directives by the Federal and State Government to curb the spread of the COVID-19 pandemic has created a disruption in academic and business activities, with fears of a national economic downturn. The directive further spurred panic buying by consumers and traders in the country, which also led to a spike in the price of food items. This could affect household food consumption.
• As highlighted in the incident profiling, cases of alleged assaults by security operatives have been recorded in the course of enforcing the stay-at-home directives.
• The depreciation occasioned by the global pandemic had prompted the review of the 2020 national budget due to the decline in the prices of international oil market. However, the upswing in crude oil prices from as low as $20 in March 2020 to $34.42 per barrel in April 2, 2020 continue to have a direct impact on Nigeria’s economy.
• Given the overcrowded and poor hygienic conditions in internally displaced persons (IDPs) and refugees camps in the country, the risk of the spread of the coronavirus pandemic in such camps is likely.

OPPORTUNITIES/RECOMMENDATIONS

• The Federal and State Ministry of Health should conduct surveillance across health agencies in the country to ensure adequate distribution of personal protective equipments (PPE), while also investing in community health programs to mitigate the spread of COVID-19 in States.
• The National Human Rights Commission in partnership with Civil Society Organisations (CSOs), media and security agencies should embark on awareness raising in the promotion of human rights in enforcing the Federal and State Government’s stay-at-home directives. Also, the State and Local Governments should improve its collaboration with traditional and religious institutions in sensitizing the public and enforcement of Government’s directives.
• It is also imperative for the Federal, State and Local Governments to enhance cooperation and collaboration to ensure decentralization of responses at the local or community level in order to mitigate the spread of the diseases at the communities.
• The Federal Government should strengthen engagement with external actors, especially World Health Organisation (WHO) in areas of responses and equipments as well as other support to healthcare institutions to effectively mitigate the threat.

https://thenationonlineng.net/covid-19-nigeria-gets-additional-labs-tests-4000/ 26 https://www.tv360nigeria.com/coronavirus-osun-signs-infectious-disease-regulation-2020/ 27 https://thewillnigeria.com/news/fg-distributes-99642-face-masks-from-jack-ma-to-states/ 28 https://thenationonlineng.net/covid-19-nigeria-gets-additional-labs-tests-4000/ 29 https://www.thisdaylive.com/index.php/2020/04/04/hope-rises-for-nigeria-as-crude-oil-prices-climb/

1 https://www.infoplease.com/atlas/africa/nigeria-map 2 http://worldpopulationreview.com/countries/nigeria-population/ 3 https://photos.state.gov/libraries/nigeria/487468/pdfs/Nigeria%203overview%20Fact%20Sheet.pdf 9 https://www.theguardian.com/world/2020/mar/13/first-covid-19-case-happened-in-november-china-government-records-show-report 10 Coronavirus Global Cases Update (https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6) Data retrieved on March 27, 2020. 11 https://ncdc.gov.ng/news/item/241/?t=frequently-asked-questions-on-coronavirus—15%2F03%2F2020 12 Coronavirus National Update: Data retrieved from the Nigeria Centre for Disease Control (NCDC) on April 2, 2020. http://covid19.ncdc.gov.ng/ 13 http://covid19.ncdc.gov.ng/ ; https://punchng.com/govt-finds-3550-contacts-concern-as-cases-reach-190/ 14 www.ncdc.gov.ng Situation Tracking is a periodic analytical report designed by WANEP through its National Early Warning System (NEWS) to monitor the changing trends of specific conflict threats as civil society support to peace and security in Nigeria 2

4 http://snisnet.net/MFLDSS/MFLDSS.php?source=4&snu=0&factype=&owner=0&country=NG 4. https://www.premiumtimesng.com/health/health-features/361373-n2igeria-budgets-n2000-for-the-healthcare-of-each-citizen-in-2020.html 5. https://www.hrw.org/news/2020/03/25/nigeria-covid-19-cases-rise 6 https://www.ncdc.gov.ng/themes/common/files/sitreps/bfd8f02878ff5ded5edc9c25308fdad.pdf 7. https://www.ecowas.int/institutions/west-african-health-organisation-waho/ 15 https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Nigeria 16 www.wanep.org/news 17 https://www.thecable.ng/video-nurses-protest-lack-of-protective-gear-against-covid-19-in-esuth 18 https://www.vanguardngr.com/2020/03/covid-19-kaduna-police-arrest-165-for-violation-of-sit-at-home-order/ 19 https://punchng.com/covid-19-police-crackdown-on-lagos-party-allegedly-injure-three/ 20 https://www.premiumtimesng.com/regional/ssouth-east/384495-covid-19-nine-persons-arrested-for-flouting-ebonyi-govt-ban-on-burial.html 21 https://www.premiumtimesng.com/news/headlines/385688-one-killed-as-soldiers-clash-with-residents-while-enforcing-coronavirus-lockdown.html 22 https://punchng.com/residents-flee-katsina-community-after-one-dies-in-pro-jumaat-riot/ 23 file:///Users/amasedobor/Downloads/An%20update%20of%20Lassa%20fever%20outbreak%20in%20Nigeria_280320_13.pdf (www.ncdc.gov.ng) 24 www.wanep.org/news: An estimated 24 people killed by armed bandits in Zamfara (Maru LGA) and Sokoto (Sabon Birni LGA States on April 1, 2020. 0 20 40 60 80 100 120 140 COVID-19 CASES IN NIGERIA BY STATE, APRIL 5, 2020 CONFIRMED COVID CASES RECOVERIES DEATHS Linear (RECOVERIES) Situation Tracking is a periodic analytical report designed by WANEP through its National Early Warning System (NEWS) to monitor the changing trends of specific conflict threats as civil society support to peace and security in Nigeria 3