Early Lessons COVID-19 has Taught Us

Seven months ago, the world seemed a steady place. Christmas holidays upon us. President Trump was ramping up for his re-election bid. Boris Johnson had just won a thumping majority. Brazil’s agro-industry was receiving massive government support. The Federal Government of Nigeria was gearing up to borrow US$30 billion for massive infrastructure projects: mainly railways, a smattering of main roads, a huge dam, (but no hospitals) blithely turning a blind eye to the already fast-falling oil price and the ever-contracting market for black gold. Suddenly, news started to seep out of Wuhan, and China, that premier destination of Nigerian wholesale traders of consumer electronics who then fly home with Emirates, Ethiopian, Qatar, or Turkish, seemed less alluring. Four months later flights from the US, UK and mainland Europe started to seem like a way of importing possible death rather than goods.

At the same time as it has reaped death on a large scale, COVID-19 has also ravaged economies. Just as it sent US unemployment figures through the roof, so it sent the price of oil – so key to Nigerian government revenues – from fast fall into free fall, and then straight through the floor. Gone are the days of borrowing US$ 30 billion – as the Senate approved – Abuja has now scaled back its loan requests by a factor of 10 and is being granted a loan in order to survive – promising the IMF to behave, much as it had to back in IBB’s day. The IMF insisted “The focus should remain on medium-term macroeconomic stability, with revenue-based fiscal consolidation essential to keep Nigeria’s debt sustainable and create fiscal space for priority spending. Implementation of the reform priorities under the Economic Recovery and Growth Plan, particularly on power and governance.”

Fast forward to now. The Coronavirus has shown populist leaders to be ineptly disposed to handling a highly complex crisis. Or rather in some cases, the leaders showed themselves to be staggeringly foolhardy. Be it the maverick praise by Trump for self-injecting disinfectant, or an ignorant attitude toward testing and locking down London, or even Bolsonaro commenting “So what?” when being asked what he thought of the pandemic’s death toll in Brazil. Indeed, Trump ignored early warnings and thus by the time the White House swung into action, the virus was fast spreading. Johnson felt initially that it sufficed to simply recommend that the ‘vulnerable’ stay at home and No. 10 placed its faith in ‘herd immunity’. When it became clear that the death toll of such would be extremely high, he switched strategy in mid-stream. In Brazil, when confronted by the facts of a spreading virus, Bolsonaro simply sacked his health minister as the harbinger of bad news.

Indeed, it is fair to say that the virus has savaged single-slogan political solutions – be it “Make America Great Again and Drain the Swamp”, “Get Brexit Done” or “Let’s Make Brazil Great”. Such populist appeals to the people (along with the claim that they are being hoodwinked by an ‘elite’), do not deter virus spread. Nor, for that matter, does our own homegrown, broom-waving “Sweep out Corruption”. After all, populism is all about pandering to the people’s purported will, rather than imposing constraints on them, which is what the pandemic calls on governments to do. Pakistan’s PM Imran Khan openly said the matter of lockdowns was so very complex as it entailed a dilemma of striking an intricate balance between locking down and stopping the poor among the people from starving to death.

Let’s look at the planning behind those simple solutions to the crisis a little more closely as this may cast some light on what went wrong in the crisis response centres of Washington, Westminster, and Brasilia, as opposed to Berlin, Madrid or Paris. The United States, the United Kingdom, and sadly Nigeria share key policy weaknesses: They are all guilty of testing too little and too late. And then failing to introduce widespread tracing and quarantining in time. To be fair, the US and the UK have an advantage and thus even less excuse: They have far greater health infrastructure in place. The Nigerian healthcare system has been neglected for years, so retrospective action is to upgrade hospitals is at best to gloss things over (again, the SDG recommendation is 15%, the reality in Nigeria 4.5%). In this regard, for Nigeria, with its dwindling resources, the rush to buy ventilators/ICU beds was a race to the bottom, in that the baseline was max. 0.6 beds per million inhabitants as compared to a figure of 1 per 10,000 in the main EU Member States. To be equally fair: Nigeria had an advantage it wasted: If it had closed its airports at an early date, or at the very least introduced testing (and not thermometer guns) at the entry points, it would have been in a better position to control the spread.

Regardless in such a situation you must mass test, isolate; mass test, isolate, and ensure people maintain personal hygiene methods. On the testing front: In Germany as many as 400,000 people are being tested a day (the actual capacity is 800,000 a day), in Nigeria the total number tested is 17,500, with 2,500 of that number testing positive (1 in 7). In the US, 7.1m have been tested with 1.15m positive (roughly 1 in 7), in the UK 1.2m with 187k positive (1 in 6.4). What of Europe’s “front-line” states. Italy has tested 2.1million 210k were positive or a 1-in-10 ratio), Spain 1.93million (217k were positive meaning 1-in-9)  – and in Germany 2.5million have been tested with 165k positive (1 in 15).

Put bluntly, Europe has been very strong on testing and has, despite the awful number of deaths, kept the number of persons testing positive for Coronavirus down in percentage terms. That is the product of careful, methodical planning to ensure best use of resources under tough conditions. In Germany’s strongly federal system, coordination between the states has been an absolute priority to make sure everyone was on the same page, even if state policies differ. Remember, all three countries in mainland Europe imposed stark lockdowns as quickly as they could in line with existing plans for pandemics (for the record: Trump had disbanded the US agency responsible for drawing up such plans) and are only now starting to think of easing the regulations.

Not so Nigeria. Here the policy initially seemed to be ‘wait-and-see’. And when the response came it was not based on a prior plan, but a copycat of the lockdown Modi had ordained in India. (causing a massive migration from urban areas to the villages and thus potentially spreading the disease very thoroughly). What did not go well in India was perhaps doomed to fail in Nigeria. Indeed, busy wrestling with a fiscal meltdown the government seems to have wilfully overlooked the fact that over 30% of the population are day-wage earners in the informal sector – and, therefore, if you ‘lock them down’ you condemn them to starvation. In other words, here advance planning should have involved not raising donations for new ICU beds but organizing a widespread system of getting food to people – and making certain there was fresh water everywhere so people could ‘wash their hands’.

Abuja’s strategy is also surprising because it flies in the face of the experiences we can assume the administration has garnered from both the IDP camps and the extensive social investment programmes; after all, the one field most definitely entails emergency/crisis management, while the other has hinged on the distribution of palliatives. Alternatively, we could conjecture that lockdown coordination has been so poor precisely because it was based on those experiences, and that precisely those programmes must therefore be deemed to have largely failed.

Be that as it may, in one thing there has been policy consistency: The incoherence of the initial lockdown has been matched by the incoherence in lifting it again although numbers of persons testing positive is starting to increase fast. Once again, a simple “open on Monday” may be sweet to the ears of those left starving by the earlier “We are closing on Thursday”, but it doesn’t help you plan and implement marketplace layouts that ensure social distancing, educate the populace on the right temperature at which to wash masks, etc. Allowing two people on the backseat of a taxi and one person in the front passenger seat may lower possible contact numbers, but few are the VW Golfs or Toyota Corollas where you can maintain a minimum of 1.5 metres between the front and the back. Likewise, reopening buildings with shared a/c systems is tantamount to encouraging the virus to buzz around…

What could have been done or should be done, even if some of the horses have long since bolted? The virus has illuminated the power of individual will and autonomy and its effect on health security. People have been asked to self-check, report their symptoms, self-quarantine, self-isolate in their homes, and self-connect themselves to public health authorities. This they have tried to do – in Nigeria, too. If the authorities cannot test, then home-testing must become the new norm, and indeed home self-testing, enabled in an affordable manner rather than as something only a very slender proportion of the population can afford. At the same time, government must effectively educate, explaining what the protocols must be, starting with how to wash masks properly, which test kits should be used, and which rejected, etc. And government should be ramping up pharmaceutical production capacity to enable it to produce the 10-minute test kits the Senegalese and British are busy developing together.

Nigerians, let’s also us remember, are telco natives and tech-savvy. What do we all have smartphones for in a time of crisis? No, not for sending texts or instant messaging but likewise to report test results. Here, the mobile phone companies of this world can do far more than simply donate to hospitals. They can surely be involved in creating the special hotlines for free text-messaging. And then the phenomenon of citizens having to wait, in places for over a week, for government to ring them back, will become a thing of the past. Iceland has paved the way here, with Mrs Jakobsdóttir, the country’s Prime Minister, stating a few days ago: “We have introduced a tracing app, but use of it is voluntary. And the app we have provided is under the strict supervision of the Institution for Personal Privacy. In back-tracing infections, we have found out where the infected persons have been infected in 93 percent of the cases.”

It is time to allow data to deliver mass-testing, to allow and enable individuals to exercise their autonomy to self-test, in an technology-driven, inter-connected manner with the public health authorities elected and appointed to serve them. To put it bluntly, to implement a lockdown that is ineffective because of a lack of data and leaves more deaths through starvation than would have been caused by COVID-19 is to put a population through trials and tribulations to no avail.

Lessons to be learned: Plan before you act. Plan on the basis of data and analysis. The more data we have, the safer we can be. The more we test, the more we can trace and isolate. The virus has not gone away simply because the lockdown has been eased. Here, data is the soap that helps stop the spread of the virus. Remember, never before have citizens stayed in their homes, waiting for contact from the government, be it testing or education. Yet we all have bank verification numbers that could be used to trace, isolate… and save lives.

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TAPI

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