The world was scared for Africa. In March 2020, news headlines warned African countries to prepare for the worst from the coronavirus pandemic. Experts anticipated that the crippled health care system of Africa’s most populous country will cause the pandemic to kill many of its residents.
More than a year later, the world’s most prepared countries for a pandemic, according to the Global Health Security Index, have been hit harder by the virus with millions of positive cases and deaths, while the giant of Africa appears to be in a better condition with about 165,000 cases and a little over 2,000 deaths recorded.
From WhatsApp group chats to Zoom conferences and socially distanced gatherings, possible explanations have been offered in attempt to understand why the country has not suffered from millions of positive coronavirus cases and deaths in the same way its developing counterpart, India, as well as countries in the global north have.
Experts predicted that poorer communities in Nigeria where social distancing is nearly impossible, access to running water is limited and health services are unreliable will be the epicenters of the pandemic with high infection rates and deaths. But it appears that this is not the case.
“Most of the very poor people who live in terrible conditions are not getting [COVID-19],” said Dr. Ene Esan, a public health official in Lagos state. “Or is it that they are getting [COVID-19] and they are dying, and people are not blaming [COVID-19]?”
Many members of rural communities have not had a personal encounter in which them or a close relative or friend contracted the virus and fell sick or died. For this reason, they have remained skeptical about the existence of the virus.
“There are still a lot of people in this country that still don’t believe that there is COVID-19 because a lot of them will tell you that they never saw one person that had it,” said Dr. Omo Obaseki, a medical doctor in Abuja.
One question that researchers, health officials and Nigerian citizens have been asking is “why does it appear that the coronavirus has not spread dramatically in our population?”
“For everybody, it is shocking that we’ve still not been overtaken by [COVID-19],” Esan said.
While this article takes a look at the speculations and potential answers to this question, it is important to note that research into these hypotheses is at preliminary stages and none of these suppositions can be confirmed yet.
“I am aware that there [is] some research going on with respect to the COVID-19,” said Maj. Gen. Dr. Shina Ogunbiyi, the medical director of the Lagos COVID-19 treatment center. “Some papers have been published in international journals that emanated from our experience in Lagos.”
“People are researching all kinds of things,” Esan said.
For a population that is constantly dealing with malaria and consuming medication to prevent and recover from it, experts believe that there could be some sort of basic immunity in our population because of our frequent battle with malaria.
“Many people feel very strongly that the symptoms of [COVID-19] are very similar to the symptoms of malaria,” said Professor Ibironke Akinsete, a hematologist and founding member of the Society for Women and AIDS in Africa, Nigeria.
“A lot of research is ongoing that our immunity to repeated bouts of malaria has conferred some sort of protection,” said Esan. “It will most probably take three to five years, or if not more, to find out.”
The country’s young population and low life expectancy of 54.3 years, according to the World Bank, is also a point that researchers are looking into to find an answer to why the country has a lower coronavirus death rate when compared to other nations.
“Maybe this could be the reason: a younger population [with a] good immune system,” Akinsete said.
Another possible reason for the country’s apparent containment of the virus so far, is the relatively speedy reaction from the government at the beginning of the pandemic.
In March 2020, the government shut the country’s international and local borders, prohibited mass gatherings and shutdown schools and religious gatherings.
Based on its previous experience with the Ebola epidemic in 2014, Lagos state reacted faster than other states by setting up emergency COVID-19 centers and prompting other states to do same, according to Esan.
“The government quickly set up a presidential task force on COVID-19 because they realized that this is a public health issue,” said Esan. “But they were not quick enough to shut our borders as quickly as they should have.”
“I think [the government] responded relatively quickly. I won’t say very quickly,” Akinsete said.
The uncertainty of the reason behind the country’s apparent containment of the virus is largely attributed to the lack of statistics and lack of resources to attain data that will provide answers to these questions.
Experts say that data is difficult to attain and the information currently available is inadequate to accurately assess the unique factors affecting Nigeria’s coronavirus spread.
“Nigerians are not following due diligence. They want to be anonymous and not give their names and numbers. We can’t compile data if we don’t have full amounts,” Esan said.
“Our statistics that we have given of the pandemic ... I don't think [they are] accurate because testing was [very] limited,” Akinsete said.
What appears to be a low number of positive coronavirus cases and successful containment of the virus may simply be a lack of testing. Afterall, if no test is carried out, then no positive cases will be recorded.
Since the first confirmed case of COVID-19 in Nigeria, the country has tested 1,939,165 samples, according to the Nigeria Center for Disease Control. This is less than one percent of the country’s 200 million plus inhabitants.
The virus may be spreading like wildfire across the country, but experts are unaware because there are not enough COVID-19 tests being conducted daily to affirmatively say that the virus is not spreading exponentially throughout the Nigerian population.
“We definitely have a lot more cases and deaths than are being reported,” said Esan. “But because it seems to be a mild disease in the population, … we can’t prove it because we don’t have the data to show for it.”
“If you don't have adequate numbers being tested, you can't say that your data is representative of the population,” Esan said.