Ounce of prevention is worth a pound of cure
Written at the beginning of the coronavirus pandemic in Nigeria, a push for business and government leaders to take heed urgently rather than later
Originally published in BusinessDay on 17 March 2020.
The global covid-19 pandemic and the resultant reduction in global demand for oil and falling oil prices are precisely why we need to diversify and transform Nigeria’s economy. We are especially at risk in Nigeria given our already depressed, low-growth economy — GDP growth was projected at 2.5% for 2020 — and the wider socioeconomic conditions — the high levels of inequality, widespread poverty, limited social safety nets, and high and rising unemployment rates. These long-term stresses weaken our ability to respond to and recover from the shocks of pandemics, fires, explosions, or global economic shifts.
Over the past few days, the global situation has arrived more visibly in Africa. The case counts and deaths are rising drastically — Africa’s covid-19 confirmed cases rose from 83 on 8 March to 401 by 16 March, and people are wondering how this happened. When Gabon originally introduced its strict travel limitations on travel from countries that had any covid-19 cases, I wondered why they were being so harsh. Countries such as Ghana, Kenya, Rwanda, and South Africa, have now followed in their footsteps, although for the latter, it is likely too late for a containment strategy.
In Nigeria, in-person meetings, religious events, sports activities, social events and school continue amid a global pandemic. We feel justified that our case numbers are so low, so we are free to socialize. However, a few million people could die in Nigeria if we are not able to put in place rigorous containment measures. The most extreme models project the potential to have 50–80% of people will be infected, globally, and suggest up to 5% mortality rates from coronavirus.
The NCDC and the state and Federal Ministries of Health are doing laudable work to contain the cases that are known. The Emergency Operations Centres set up to manage exactly this type of pandemic, are working — and the staff are working hard to trace contacts and to locate people potentially exposed to the virus. The abundance of hand sanitizer and temperature checks at businesses are a step in the right direction. However, the risk of the unknown cases remains — and we do not have enough testing kits.
We need to take bold steps in Nigeria to address coronavirus before the unsettling projections manifest.
First, the Government of Nigeria should take the step to close our borders to non-Nigerians arriving from countries with any covid-19 cases. All people arriving from countries with cases need to stay under strict self-quarantine for 14 days — with continued follow up from the state and federal health teams working together with NCDC. This must be a strict requirement, and all arrivals, including VIP arrivals and those arriving by land need to be screened and documented.
Second, we should promote social distancing, preemptively cancelling non-essential in-person meetings, close universities and schools, cancel religious and social events, including weddings and funerals, and stop shaking hands for at least 30 days. This may seem extreme. However, we have had extreme measures in the past — schools and universities have closed for longer time periods due to student or teacher strikes, and we restricted movements over the course of two weekends last year for the rescheduled elections. Further, we have not yet closed our borders, and social distancing can help to protect the most vulnerable in the society. While we do not yet have evidence of community transmission, experience globally suggests that this will happen soon.
If the government will not order this level of social distancing, business leaders should take heed — we can make a difference if we take bold actions before it’s the trend, before we look more like South Africa or the UK than our present case load suggests.
Third, we need to deploy the best of artificial intelligence that already exists to help detect potential high impact locations, predict where the coronavirus may spread next, inform decisions by state and local executives, and contact individuals.
Finally, we need to make urgent investments in increasing our capacity to respond to the most extreme cases — we need more ventilators on standby and medical supplies, particularly protective wear for our medical professionals.
The argument is that we will not see many cases in Nigeria. With a global pandemic, the aim is to be proactive, rather than reactive — one day of delay in strict measures, whether border closures or social distancing measures can have a significant impact on the outcomes. We need a clear plan in place to deal with the worst-case scenario, with continued hopes and prayers that it does not come into existence.
I think the “ounce of prevention is worth a pound of cure” motto attributed to Benjamin Franklin is still valid today. We need to continue work to transform the economy and to address preemptively the shock coronavirus could have directly and immediately on our people.
Reflecting on the article 13 months later, we have not yet gotten out of the pandemic in Nigeria. The entreaties here remain valid as we see new strains and new waves of disease across the world. We continued to have a disconnect between the requirements to address the pandemic and the lived experience of Nigerians during the pandemic.
