COVID-19: The Realities of a Pandemic in Nigeria - Living Environment


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Thursday, September 3, 2020

COVID-19: The Realities of a Pandemic in Nigeria

 By Dr. Natasha Aduloju-Ajijola

On February 27, 2020 the first case of COVID-19 was confirmed in Nigeria1. Since then Nigeria has had over 50,000 confirmed cases of COVID, the most in West Africa2. While at first glance these numbers seem promising, they also may be misleading. Currently, Nigeria had tested less than 1% of it’s population3.

In 2017, the World Health Organization gave countries a score ranging from 0 to 5 on it’s ability to prevent, detect, and respond to public health risks. Nigeria had an average score of 1.9, meaning that the country has a limited capacity to prevent biological, chemical, or radiation health risks4. Nigeria scored best in detection (with an average 2.5) and worst in response (average 1.5) suggesting that Nigeria had a limited capacity to respond to a sudden health risk4.
The COVID-19 pandemic has shown that these scores were accurate. At the beginning of the pandemic there were only two laboratories in Africa (in Senegal and South Africa) that had the ability to test for COVID-193. Due to this bottle neck, it took more than a week to confirm a positive case and it has been slow to resolve since international testing suppliers prioritize requests from Europe, the United States, and Latin America3. Now while, Nigeria has the capacity to test 2,500 COVID samples a day, about half that number are actually administered4. This is due to the shortage of human resources, testing kits, laboratories, and the definition of who can get tested4. In addition, stigma reduces the number of people willing to get tested and who report illness5. Pre-COVID, there were an estimated 350 ventilators and 350 ICU beds across the country4. In April 2020, an additional 100 ventilators were acquired4.
The impact of COVID-19 however, goes beyond testing and the people who need to be hospitalized. Similar to other countries, COVID has highlighted and in many cases exacerbated the stark inequalities that have plagued Nigeria for decades. Some of these underlying factors include lack of trust in the government, misinformation about COVID, and instability within the country.
The average Nigerian does not have a lot of trust in the government. One study showed that only 31% of Nigerians trusted the government and Nigeria ranks 130 out of 137 countries in terms of governmental trust6. Over the past decade during the continued Boko Haram crisis, the widespread misappropriation of funds for its victims has not engendered trust. While China was dealing with COVID-19, before the rest of the world had begun to battle it- the Minister of Health declared that an isolation center had already been provided in a public health institution in Abuja. However shortly after that declaration, it was discovered that not only did this center not exist, no money had been released to execute the project6. In addition, enforcement of the lock-down has amplified existing challenges around human rights abuses and bureaucratic corruption within state institutions7.

In March 2020, the legislature passed The Economic Stimulus Bill 2020 to support businesses and individual citizens during the pandemic. The bill aimed to provide a 50% tax rebate to businesses that are registered under the Companies and Allied Matters Act so they they can continue to employ their current workers4. However, there have been a number of issues with the implementation of the many of the relief programs over the past few months. In addition, while the majority of these initiatives are geared towards to the formal sector, 65% of Nigeria’s GDP comes from the informal sector which employs more than 90% of the workforce4. Since March, many people have lost their jobs8 and many small and medium sized businesses have closed. As a result the purchasing power of the population is dropping, while at the same time, the cost of necessary items is increasing. During the past few months the cost of bread, tomatoes, meat, and transportation has increased significantly and the cost of hand sanitizer has risen three-fold9. Economically, similar to what we are seeing in other countries, the stock market is falling and thus the Naira is continuing to devalue9,10.

It is estimated that 94% of Nigerians are aware of COVID-1911, however as it is well established in the Public Health and Health Education literature that knowledge is not sufficient to change behavior. One of the primarily barriers to behavior change in this instance, is that many people do not believe that the virus is real. Due to the amount of misinformation about the virus11, religious rhetoric6, and a mistaken belief that Nigerians are immune, many people feel that this is yet another excuse for leaders to have access to international funds that they can then steal6,11. When COVID reached Nigeria, it was primarily affecting the political, upper, and middle classes, and was thus considered a “big man” disease6,11. In addition, many people have bigger issues to worry than COVID12, like the rising unemployment and continued instability13,14. Recent estimates suggest that 20% of Nigerians are unemployed13. Many of the measures that have been put in place including the lock-down, were taken from industrialized countries which have different systems of support and did not take into account the reality for many Nigerians11.
As many Public Health interventionists know, interventions must be tailored to be culturally competent. Considering that 43.5% of the population lives on less than $2 USD a day14, significant tailoring of imported solutions is vital in order for them to have the desired impact.
COVID has impacted many other realms of life including the environment. While some of the impact has been positive such as significant reductions in green house gas emissions and air pollution, others have not been so positive. There has been an increase in the volume of both non-recyclable and organic waste9; an increase in cyber and organized crime7; and there have been cases during the lock-down where individuals have had to protect their homes from bandits15. All of these combined effects, have the potential to fuel and continue to exacerbate instability present within the country14.
This pandemic and it’s ramifications are daubting, however, so was the Ebola outbreak at first. Even as we deal with this in conjunction with the rest of the world, our most effective approach will not be a copy and paste solution that ignores the realities of the Nigerian experience. Framed another way, this pandemic provides an opportuntity to lay the foundation for unique systems that work to benefit all Nigerians, regardless of religion, ethnicity, region, or social class. COVID-19 does not discriminate and neither should we, because we are only as healthy as the most vunerable amoung us.

Works Cited
1. Nigeria Centre for Disease Control. FIRST CASE OF CORONA VIRUS DISEASE CONFIRMED IN NIGERIA. 2020. Accessed August 20, 2020.
2. Africa CDC. Coronavirus Disease 2019 (COVID-19) – Africa CDC. 2020. Accessed August 20, 2020.
3. Adebayo B. Coronavirus in Africa: Nigeria has tested less than 1% of its population. Here’s why. - CNN. August 2020. Accessed August 20, 2020.
4. Dixit S, Ogundeji YK, Onwujekwe O. How well has Nigeria responded to COVID-19? July 2020. Accessed August 20, 2020.
5. Obiezu T. Fear & Stigma Keep Nigerians from Helping Contact Tracers | Voice of America - English. June 2020. Accessed August 20, 2020.
6. Onapajo H, Adebiyi J. ’COVID-19 is a Big Scam’ - Citizens’ Distrust in Nigeria| The Republic. March 2020. Accessed August 20, 2020.
7. Asimi S. In Nigeria, COVID-19 brings home the need for criminal justice compliant channels. June 2020.{\#}. Accessed August 20, 2020.
8. Ayoade O. Economic Impacts of the Coronavirus on Nigeria | Pulitzer Center. June 2020. Accessed August 20, 2020.
9. Hamwey R. Environmental impacts of coronavirus crisis, challenges ahead. April 2020. Accessed August 20, 2020.
10. Saadat S, Rawtani D, Hussain CM. Environmental perspective of COVID-19. 2020;728:138870. doi:10.1016/j.scitotenv.2020.138870
11. Nelson EA. Coronavirus in Nigeria: A Case for Community Engagement | Think Global Health. May 2020. Accessed August 20, 2020.
12. Vrieze J de. ‘It’s a tricky thing.’ COVID-19 cases haven’t soared in Nigeria, but that could change. Science. 2020. doi:10.1126/science.abd8208
13. Kabir A. Insecurity - Nigerians Pay Over N7 Billion Ransom to Kidnappers in Nine Years - Report. May 2020. Accessed August 20, 2020.
14. Reuters. Nigeria’s Covid-19 outbreak could impoverish 5m people, World Bank says. June 2020. Accessed August 20, 2020.
15. Mbah F. Nigeria: Lagos residents defend homes against curfew bandits. April 2020. Accessed August 20, 2020.

Natasha Aduloju-Ajijola
Doctorate in Health Education and Promotion, University of Alabama, USA.

CEO Vitalera Consults.

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