Nigeria is not a high-risk country for Covid-19, argues Olawale Opayinka
There were 58 million deaths around the world in 2019.This infers approximately 20 million people have already died worldwide from various causes in Quarter one 2020 alone (Jan – April 2020) increasing by 5 million deaths every month.
Nigeria’s population is assessed to be 200 million and in excess of 30 million households. Assuming Nigeria fits the average data, then 1.5 million Nigerians will die this year 2020 and 380,000 have already died in the first quarter of this year. We can add 125,000 for every additional month. We know that the mortality of Nigerians is above average and so the number of deaths will be higher.
Every life is invaluable and responsible governments and people must do everything to preserve every life. However, every policy decision and actions must be proportionate. The decision to lockdown the FCT, Lagos and Ogun States, which account for 80 per cent of our GDP was a price too high for the risk we carry of losing lives to COVID-19. There was a clear disproportionate cost to the benefit of attempting to save lives. The new evolving situation in Kano is evidence enough that when the disease wants to unfortunately ravage a community there is little or nothing you can do in Nigeria to stop it.
There are two options when a person tests positive for COVID-19: they either recover and test negative or unfortunately lose their lives. Some 90 per cent of those who contact the disease need no intervention to test negative according to DG of the Nigeria Centre for Disease Control (NCDC).
In fact, current world data suggests that you have a 95 per cent chance of not falling ill and eventually testing negative. For 95 percent of those who test positive they will not suffer any symptoms anywhere close to contacting Malaria.
Global data to date suggests that there is a less than one per cent mortality rate for COVID-19 cases. This is less than the probability of being a Nigerian and dying without the effect of COVID-19 when the number of COVID-19 cases is expressed as a proportion of our population. There are less than 3,000 cases today in Nigeria. If we assume that 40,000 have been infected today in Nigeria that is still less than the number who died in the month of April 2020 alone by being a Nigerian – estimated at 125,000 lives.
In real terms, Nigeria has the 5th highest death rate in the world. The above projects about 2.4 million per year and 200,000 deaths every month, higher than the assumed average detailed above of 125,000. Of course, this is a large number and a significant deviation from the mean (75,000 cases above average).
Analytically, there is 60 times the chance a person will catch COVID-19 as a Nigerian and 6,000 times chance a Nigerian will die from COVID-19. These requires we have 40,000 cases and 400 deaths. Today, there are less than 3,000 cases and 85 deaths.
In conclusion, if we want to save Nigerian lives, then we are deploying scarce resources at the wrong policy objective; we need people back to work. The cost of not having people at work for 30 days is costing the Nigerian economy in excess of N600 billion per month at the low end. The true cost is many times higher.
We must keep our borders closed – air and road for a long time to come. Quarantine of international visitors must not change until 2021. This was perfectly done at the right time.
The social cost of the sit at home or lockdown policy is incalculable and can itself result in a spike in physical abuse at home, adverse mental health and acute depression. The social cost and simmering social order breakdown are all costs that we cannot afford. The security agencies which was stretched by other dilapidating issues in the country like banditry, Boko Haram and kidnapping among others are close to breaking limit trying to enforce a lockdown.
Nigerians have already paid a huge price by staying at home over the last 37 days. They should not have to do more. As we go back to work and promote the use of face mask made at home or other produced ones by factories, we should use emergency powers to command the production of face mask which we can export and use to generate much needed foreign income.
We should use the opportunity to emphasise the value of human life and sensitise Nigerians to looking out for their neighbour. This in itself can help reduce the above average mortality rate in Nigeria. We should have a national objective to get to the global average of 7.6 deaths per thousand per year instead of the current 11.6
We should declare a state of emergency in the health sector and use all the monies we can raise from Nigerians to strengthen our primary and secondary public health centres.
We must continue to sanitise people in the improvement of hygiene and all that WHO has recommended as a regular habit of our daily lives. It must be part of the new World we live in.
Nigerian lives matter, Covid-19 helps us value human lives but the potential deaths from Covid-19 is not our priority. We are losing 75,000 lives more than what we should be losing to mortality each year. That should be our focus. The time to act in the face of this emergency is now.
The idea of these intervention is to trigger the right discuss and push our national effort and resources to the right policy objective.
This is indeed an important time in our society, one that shows Nigerians value their lives. We must seize the opportunity to raise our national psyche. We should not have people die because they are giving birth in substandard primary health centres. Our roads should not be death traps. We should push to make sure that every Nigerian has a roof over their head.
The irony is we have asked Nigerians to stay at home, we have a minimum of 30 million households. Existing data shows we have a 22 million housing deficit in Nigeria. Where Nigerians live in houses the vast majority do not live in single dwellings. A pre-dominant number live in classic “face-me I face-you”.
Finally, back to COVID-19 and its spread in Nigeria – We are not a high-risk country as God wills. If we have the prevalence of COVID-19 in Nigeria, our hospitals will be full by now. The truth about COVID-19 around the World is that you cannot hide it if you have it and you cannot hide if you are sick, you will seek help. The situation in Kano is a spike which needs immediate attention. It can consume the country if not properly managed. The way to manage is to keep the border of Kano closed for NOW.
We are afraid we are carrying asymptomatic cases, but this is not a problem if you are not getting sick people.
The truth is we cannot stop COVID-19 spreading in Nigeria if we have the same prevalence that subsists in other climes around the World. Our living conditions meant when we were asking people to stay at home then you were likely to have a huge spread. Predominance of Nigerians live in slums – or densely populated areas. Asking people to remain in those areas can itself be argued that they are a seating duck and at a higher risk.
No one can author at this early stage why the COVID-19 pandemic has not ravaged Nigeria or other sub-Saharan African countries. It is not necessary we do at this stage; science will have its tested theories in coming years. What is important to know is that if there is an outbreak in Nigeria, staying at home is not the solution. We need to promote improved personal hygiene. We do not have the streamlined living conditions you find in order parts of the world to make staying at home viable.
We must invest in our public health care systems to save Nigerian lives, we can still work to save one million lives per year over the next decade. COVID-19 is not going to kill Nigerians, the social and economic impact of the lockdown to shield ourselves from COVID-19 carries a greater national threat to our country and its citizens.
According to John Banville, “We carry the dead with us only until we die too, and then it is we who are borne along for a little while, and then our bearers in their turn drop, and so on into the unimaginable generations.”
Opayinka is the Founding Partner 3e Actuaries