The latest data from Nigeria’s infectious disease agency, NCDC, has further exposed the inadequate testing for COVID-19 in Kogi and many other states, a situation health experts believe is causing an underestimation of the true extent of the spread of the disease in the country.
On February 27, it will be exactly one year since Nigeria reported its first COVID-19 infection in an Italian businessman who flew into the country in a Turkish airline that landed at the Murtala Mohammed Airport in Lagos.
Nigeria has since recorded over 150,000 COVID-19 cases and over 1,800 deaths.
Since Nigeria announced the second wave of the pandemic last December, infections and deaths have increased. Nearly half of Nigeria’s infections were recorded this year alone with about 65,000 infections reported since January 1, 2021.
COVID-19 testing report
Meanwhile, health experts say the numbers do not give a “full picture” of the outbreak in the country. They say low testing in many states across the country means infections have been under-reported, a fact considered the biggest challenge in the nation’s management of the outbreak.
Kogi in focus
Kogi, a state of about 3.5 million people, tested only five people for COVID-19 between February 7 and 14, according to the latest weekly general fact sheet published Wednesday by the NCDC.
The report has further disproved the false claims by the state governor, Yahaya Bello, that a massive testing campaign was going on in the state.
With the five test samples submitted during that period, Kogi has tested only 3,370 samples since the beginning of the outbreak.
The figure is less than 0.1 per cent of Kogi’s 3.5 million population. Experts say this further explains why the state is yet to report a single case and death in about 230 days even with the recent spike in infections across the country.
“Our target in every state in Nigeria is to test at least 1 per cent of the state’s population. This is the only way we can accurately state if the outbreak has been controlled or not”, Chikwe Ihekweazu, the NCDC director said when Kogi crossed 120 days of no new cases and deaths in late last October.
The state is the least impacted across the country with a total of just five infections. Two patients have died and the remaining three have since recovered. The last fatality was recorded in early June.
Management of COVID-19 in Kogi has been enmeshed in several controversies. The Presidential Task Force (PTF) on COVID-19 earlier this month declared Kogi a high-risk state for refusing to acknowledge the existence of the disease.
The PTF also said that the Kogi government had failed to report testing, lacked isolation centres, and therefore warned Nigerians to be wary of visiting the state.
Health experts believe the situation in Kogi does not just raise serious concerns but has also made it more difficult to have a synchronized national strategy.
It also sets a bad precedent for other states who may decide to choose irresponsibility at the expense of their people’s lives, according to Confidence MacHarry, a security and health data analyst with SBM intelligence.
Testing: How states performed
While states are solely in charge of their coronavirus management and response, the NCDC supports and receives daily infection information from them which is then published by the agency.
The general fact-sheet, published weekly, contains information on states with reported laboratory-confirmed COVID-19 cases, recoveries, deaths, samples tested, and active cases.
According to the COVID-19 testing fact sheet for February 7 to 14, the five states that conducted the least tests during the period were Kogi (5), Sokoto (30), Zamfara (47), Cross River (50) and Abia (52).
Just like in Kogi, almost all the states at the bottom of the testing table had been accused of not turning in enough test samples.
Cross River, one of the states that fell out with federal authorities in the early days of the pandemic because of its controversial stance on COVID-19, is the state with the second-lowest number of tests.
With 50 tested samples during the period, Cross River with a population of 3.7 million people, has tested about 5,381 samples in total.
Between April and July 2020, Zamfara had gone 50 days without a single case and death from COVID-19.
The milestone would have been held up as evidence of the state government’s success in limiting the spread of the disease but for allegations that local officials were not testing enough samples.
Zamfara tested only 47 samples during the period to raise its total tests to 5,798 out of a population of 9.2 million people.
Even though Kebbi tested 123 samples last week between February 7 and 14, it is still the fourth lowest in overall testing.
Kebbi, a state of 3.1 million people, had tested a total of 6,238 samples as of last week.
With 68 tested samples between February 7 and 14, Jigawa, a state of about 3.6 million people, has tested about 7,852 samples.
Sokoto tested only 30 samples during the period to become the state with the second-lowest number of tests last week. But overall, the state of 5.4 million has tested 17,687 samples in total.
Similarly, Abia with 52 tested samples, has conducted a total of 17,520 tests.
Meanwhile, Lagos, Nigeria’s coronavirus epicentre with the highest number of testing laboratories, came tops in the weekly ranking. The commercial city with over 20 million population tested 17,162 samples between February 7 and 14; raising the state’s total tests to 353,457, by far the highest of any state.
Missing out on two million target
On April 28, 2020, the Nigerian government announced its target of testing at least two million people within the next three months.
It has been seven months since Nigeria missed out on the ambitious 90 days’ target; yet, Africa’s most populous country is yet to reach two million tests.
As of February 19, Nigeria had tested over 1.4 million samples out of a population of over 200 million people. Over 150,000 persons have tested positive. Out of these, 126,417 have been treated and discharged and 1,803 fatalities recorded.
With about 1.4 million tests, Nigeria has conducted only 6, 884 tests for every one million of its population, according to data from worldometer.info.
This pales in comparison to South Africa, which has tested 146,751 samples of every one million citizens — or Morocco at nearly 150, 000 per one million, the highest of any African country, according to worldometer.info data.
Ghana has tested 849,891 samples; about 26,998 per one million of its over 31 million people.
Challenge of testing
Nigeria, the most populous African country, has tested less than one per cent of its 200 million inhabitants as of Friday.
There are over 80 testing labs in the country, according to the NCDC director, Chikwe Ihekweazu, but many citizens say getting a coronavirus test has been a challenge.
ALSO READ: COVID-19: PTF declares Kogi high risk state, warns Nigerians not to visit
While testing is free in state-owned laboratories, there are few of these facilities and they are in major cities and those seeking to be tested would wait in long queues for days, a PREMIUM TIMES check revealed.
Our reporter visited the testing centre at ThisDay Dome in Abuja on three different occasions within the past one month and could not get tested.
On those three occasions, there were long queues reaching about 100 people.
Nigeria is still experiencing shortages in test kits as health officials have had to transfer samples to other states to confirm results.
There have been discrepancies in daily COVID-19 results in some states due to testing gaps prompting the NCDC to suspend updating testing rates on a daily basis.
According to Mr Ihekweazu, the NCDC director, the test data is now shared weekly to reduce the pressure on the workforce at laboratories.
On four occasions this year, no daily data was included for Lagos, the epicentre of the disease in Nigeria, with the NCDC saying Lagos State health authorities did not turn in samples.
“On some days, there are delays with harmonizing and analyzing data at the state-level. Lagos has a high number of laboratories in any single state. Given our commitment to ensuring accurate reporting to Nigerians, we are prioritizing quality over speed”, Mr Ihekweazu said.
Apart from the shortages of test kits and discrepancies in figures, there is also the challenge of many Nigerians unwilling to get tested for the disease.
There are concerns that people are self-medicating and self-managing their symptoms at home.
A lack of adequate testing capacity means losing track of the spread of the virus thereby putting already stretched public health systems under even more burden.
Health experts have raised concerns that the official figures grossly underestimate Nigeria’s COVID-19 situation, raising the possibility that the country may not be seen as a priority for scarce global vaccine supplies despite the urgent need.
This adds to a mix of challenges Nigeria and other African countries are facing in competing with wealthier countries to secure vaccine supplies.
The stigma attached to the disease, a lack of information and victims’ inability to either reach or pay for health facilities may also reduce reporting, health experts say.
The World Health Organization (WHO) is concerned that testing is not available at the grassroots level in Nigeria.
“The challenge is how to decentralize these tests available in states and in countries like Nigeria where we need to get to people in the local governments,” the agency’s programme manager for emergency response for Africa, Michel Yao, told CNN.
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