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Brief Report

COVID‑19 in Nigeria: Matters Arising

Greater Kayode Oyejobi1,2, Sunday Olabode Olaniyan2, Mobolaji Johnson Awopetu2
1
International College, University of Chinese Academy of Sciences, Beijing, University of Chinese Academy of Sciences, Beijing, China,
2
Department of Microbiology, Osun State University, Osogbo, Nigeria

Address for correspondence: Mr. Greater Kayode Oyejobi, Department of Microbiology, Osun State University, Oke‑Baale, Osogbo 230212, Nigeria.
E‑Mail: greater.oyejobi@uniosun.edu.ng

Overview
In a short time, COVID‑19 has grown to become a household name. An infectious disease caused by a severe acute respiratory
syndrome coronavirus 2, COVID‑19 has been reported in 210 countries and territories around the world with a total of about
1,856,798 confirmed cases and 114,312 deaths as at the last update: April 13, 2020.[1,2] The viral disease which was first reported
as an outbreak in December 2019 in Wuhan city, Hubei province of China, has found its way across the globe and was declared
a pandemic by the World Health Organization (WHO) on March 11, 2020.[3] The USA replaced China as the country with the
highest coronavirus cases on March 26, 2020, while more than 92% of the global coronavirus cases are currently outside China.
The ten most affected countries as on April 13, 2020, include the USA (560,566 cases, 22,125 deaths), Spain (166,831 cases,
17,209 deaths), Italy (156,363 cases, 19,899 deaths), France (132,591 cases, 14,393 deaths), Germany (127,854 cases, 3022 deaths),
the United Kingdom (84,279 cases, 10,612 deaths), China (82,268 cases, 3343 deaths), Iran (71,686 cases, 4474 deaths),
Turkey (56,956 cases, 1198 deaths), and Belgium (29,647 cases, 3600 deaths).[2] Scientists and public health officials around
the globe have risen to the task of containing the rapid spread of the virus as much as possible.
Africa has also welcomed this “visitor” in a number of her countries, including Nigeria. Sub‑Saharan Africa reported its first
case in Nigeria on February 27, 2020, in an Italian man who had traveled to Nigeria from Milan. According to the Africa Centres
for Disease Prevention and Control (Africa CDC), 14,524 COVID‑19 cases have been reported in 52 of the 54 countries in
Africa, with 788 deaths and 2570 recoveries, as on April 13, 2020.[4] The ten countries in Africa with the largest number of
COVID‑19 infections are South Africa (2173 cases, 25 deaths), Egypt (2065 cases, 159 deaths), Algeria (1914 cases, 293 deaths),
Morocco (1661, 113 deaths), Cameroon (820 cases, 12 deaths), Tunisia (707 cases, 31 deaths), Ivory Coast (574 cases, 5 deaths),
Ghana (566 cases, 8 deaths), Niger (529 cases, 12 deaths), and Burkina Faso (497 cases, 27 deaths).[2,5]
Coronavirus crisis calls for concerns especially in Sub‑Saharan Africa. According to the latest Africa’s Pulse, the World Bank’s
twice yearly economic update for the region, growth in Sub‑Saharan Africa has been significantly impacted by the ongoing
coronavirus pandemic, and it is predicted to fall sharply from 2.4% in 2019 to between “-2.1% to -5.1%” in 2020, which may
suggest the first recession in the region over the past 25 years. Hafez Ghanem, World Bank Vice President for Africa said “The
COVID‑19 pandemic is testing the limits of societies and economies across the world, and African countries are likely to be
hit particularly hard.”[6]
Although there are no scientific evidence yet to confirm the role of the tropical conditions in Africa in the spread of COVID‑19,
among the several environmental factors that influence the survival and spread of respiratory viral infections, air temperature is
important, which is a reason for more respiratory infections during cold (harmattan)/winter seasons.[7] Despite the uncertainties
surrounding its spread, the COVID‑19 may be following this pattern. A look at the temperature data of the most affected countries

Date of Submission: 08‑Apr‑2020 Date of Review: 12-Apr-2020

Date of Acceptance: 29-Apr-2020 Date of Web Publication: 22-May-2020

Access this article online This is an open access journal, and articles are distributed under the terms of the Creative
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For reprints contact: reprints@medknow.com

DOI:
10.4103/cmi.cmi_51_20 How to cite this article: Oyejobi GK, Olaniyan SO, Awopetu MJ.
COVID-19 in Nigeria: Matters arising. Curr Med Issues 0;0:0.

© 2020 Current Medical Issues | Published by Wolters Kluwer - Medknow 1

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Oyejobi, et al.: COVID‑19 in Nigeria: Matters arising
aside China – South Korea, Italy, Iran, and Spain – shows that
the mean monthly temperatures between January and March
of 2020 range between 6°C and 12°C. In Sub‑Saharan Africa,
most countries that have recorded cases of COVID‑19 – such
as South Africa, Nigeria, Senegal, Togo, Cameroon, and
Benin – had mean monthly temperatures of 20°C to 32°C
in this same period.[8] This suggests that there are marked
temperature differences between the most affected (colder) and
least affected countries (warmer) in the COVID‑19 pandemic.
However, this pattern alone cannot fully explain the current
low number of cases in affected African countries.
According to the Nigeria Centre for Disease Control (NCDC),
Nigeria has reported 323 cases with ten deaths as at the last
update, April 12, 2020, with a fear of more cases in the
coming days.[9] The WHO has outlined some basic protective
measures for the public against the new coronavirus.[10] The
Nigerian government has taken necessary steps to control
the spread of COVID‑19, which include campaigns through
mobile short message service, radio and television programs
to enlighten the public on best practices, social distancing,
discouraging large public gatherings including closure of
religious (worship) centers and schools, and a total lockdown
in all the states of the country.[11] Other African countries have
also adopted a number of strategies to contain the spread of the
virus. For example, Rwanda, in its capital, Kigali, has set up
portable sinks in public areas to encourage handwashing. The
Government of Ghana has also imposed a ban on all public
gatherings including conferences, funerals, festivals, political
rallies, Church services, and Islamic worship since March 16,
2020.[12] Several countries in Africa, including Egypt, Ghana,
Kenya, Morocco, Nigeria, Senegal, South Africa, Sudan, and
Tunisia, have also suspended all international travels from the
most‑affected countries.[13]
As with other continents of the world, Africa is also
experiencing high demand and global shortage of personal
protective equipment (PPE) such as gloves, masks, and hand
sanitizers. However, the WHO has been very active in the
distribution of PPEs to countries with confirmed cases. The
Chinese government has also been providing assistance,
especially in the supply of ventilators and PPEs to African
countries to help them contain the virus.
This review further outlines some public health concerns that
relate to the use of masks, especially among rural dwellers and
the reported number of COVID‑19 cases in Nigeria.
Reuse of Disposable Masks as a Protective
Measure against COVID‑19: a Hidden Threat of
Public Health Concern
Masks, being disposable, are to be worn for a short time and
then disposed. Although masks contain filters that prevent
germs from being spread, their use for a long time could
jeopardize the protective effects and even increase the risk of
other infections.
2 Current Medical Issues ¦ Volume XX ¦ Issue XX ¦ Month 2020
Although the WHO actually recommends the use of masks
for healthy individuals only when taking care of a person
with suspected COVID‑19 infection,[14] it is only logical
for everyone to use it when outside to reduce the risks of
exposure to the infection, especially exposure to asymptomatic
individuals.
Different nationals including Nigerians have been seen to
wear masks in an attempt to protect themselves against
COVID‑19. However, the authors are concerned about the
many Nigerians, especially rural dwellers who have little or
no access to adequate supplies of masks to protect themselves.
According to the National Population Commission of Nigeria,
approximately 64% of the population lives in rural areas.[15]
As it may also concern dwellers of urban areas, there is the
fear of limited supply of masks, especially with the fact that
there is no factory for the production of masks in Nigeria.
The available quantities would hardly cover a population of
about 200 million of Nigerians, coupled with the high cost of
the available masks owing to limited supplies. We, therefore,
hypothesize that people could be forced to use masks for a
longer time than required, and therefore, fear that they could
expose themselves to a number of other infections.
Breathing into masks provides a moist and conducive
environment for microorganisms to thrive; thus, long use
could result in other secondary infections, especially in
immunocompromised individuals (elderly; people with
underlying diseases, etc.). This is a public health concern.
We, therefore, suggest that awareness be raised about the proper
wearing and use of masks among Nigerians. Furthermore,
they should be made to understand that the use of masks is to
be complemented by regular washing of hands, use of hand
sanitizers, and other protective measures. This also calls for the
government and other relevant agencies to look into making
masks available in a quantity large enough to go round the
people, and if sold, at a reasonable cost. We also suggest that
some textile companies or related companies help to produce
masks, as done in some other countries including China.
There Could be More Cases than Reported: a
Concern of Limited Testing Facilities
Unlike developed countries where there are large number
of testing centers and facilities, Nigeria, as with some other
African countries, is short on adequate facilities which have
limited the number of people being tested. We, therefore,
hypothesize that if more people had been tested, there could be
more cases detected. In other words, no tests mean no positives,
small tests mean small positives, and small positives result in
small intervention plans.
According to the NCDC, there are just nine laboratories where
COVID‑19 can be tested,[9] to serve 36 states (and a federal
capital territory) of the country. We fear that there are
more cases, especially in areas where there are no testing
facilities nearby, and this calls for concerns. Many key
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Oyejobi, et al.: COVID‑19 in Nigeria: Matters arising
personalities (including elites and political class) in the country
have been reported to test positive; a situation which could also
suggest that such people have better access to the available
testing facilities and can have themselves tested.
The authors, therefore, call on the NCDC to hasten to make
more testing facilities available, at least one in each state of
the country and also start conducting more tests at random
for common citizens. We also suggest that the number of
individuals being tested should be made available to the public,
especially scientists/researchers, to keep us abreast of such
parameters as the rate of spread, case per population, case per
test ratio, and especially the rate at which preventive measures
have been helpful.
Conclusion
The authors call on the Nigerian government to focus on saving
the lives and livelihoods of its citizens by improving on the
current health systems and taking quick actions to minimize
disruptions in food supply chains. We also recommend
implementing social intervention programs, including cash
transfers, distribution of food, and other relief materials to
support citizens, especially those working in the informal
sector.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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