SHEHU, a social media publicist who asked to be identified with his first name did not have headaches or fever when he walked in to know his status at Thisday Dome, a makeshift treatment and isolation centre for COVID-19 cases located in Central Area, Abuja on December 4, 2020.
But when a colleague in his office tested positive, every staff in the media firm where he worked were compelled to self-isolate and get themselves tested.
At the testing centre at Thisday Dome, Shehu had throat and nasal swabs taken from him by officials of the Nigeria Center for Disease Control, NCDC, before he was issued a verification number and told the outcome of the test would be sent to him via a text message on his mobile phone.
Shehu remained in self-imposed isolation for a two week period after the test but couldn’t stay locked up indoors for very long.
The idea of visiting his parents who were based in Lagos during the Christmas holiday looked very appealing to him but he also weighed the risks of exposing his family to the virus if his COVID-19 status was not confirmed.
After three weeks of waiting without a response from the NCDC either by text messages or calls, Shehu took his chances when he noticed he didn’t show the signs or symptoms of COVID-19.
He embarked on an 18-hour journey by road in a commercial bus with other passengers to and from Abuja to Lagos.
Speaking to The ICIR, Shehu is uncertain about his current status and still wonders if he is negative or asymptomatic to the effects of the coronavirus.
“I was to travel during the festive period in December but became hesitant because the result was not released. I could not make a decision since I would be interacting with family members in Lagos so I had to take necessary precautions by wearing masks while trying to maintain physical distance,” he said.
One month after his trip the result is still been expected despite the NCDC guideline that stipulates a maximum turnaround time of 20 hours to obtain the result after a COVID-19 test is conducted.
Shehu’s plight is not different from hundreds of Nigerians who have taken COVID-19 tests but are yet to be notified of their test results months after they got tested.
This exposes a clog on the accuracy of the current infection rate in the country posted daily on the website of the NCDC and also increases the risks of transmission from asymptomatic carriers to the general population.
A weak line of defence
Testing and tracing of people who exhibit symptoms of the coronavirus have been described by health experts as a “second line of defence” in controlling the spread of the viral pandemic.
Speaking at a news conference in Abuja, Osagie Ehanire, Minister of Health said the rise in cases was majorly driven by an increase in infections within communities and, to a lesser extent, by travellers entering the country.
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“We may just be on the verge of a second wave of this pandemic,” he said. At the press briefing, Ehanire ordered the reopening of all isolation and treatment centres that had been closed because of the declining number of patients in the fourth quarter of 2020.
Cases in Nigeria have been on an upward trend since early December 2020, as the country joined the league of African countries to record over 100,000 cases. The lack of access to the results of tests undertaken by Nigerians is likely to hide the transmission rate and make the true spread of the virus difficult to track.
In April 2020, the NCDC had set a target of analysing at least 2 million Covid-19 test samples within three months through state and federal laboratories but nine months later less than half of the target is yet to be achieved.
Nigeria registered 1,867 new cases of Covid-19 on January 15, which is its highest daily record of cases since the onset of the disease in the country reflecting a spike in the infection rate.
The number of tests conducted by the NCDC is estimated at 1.03 million tests as of January 14, when compared with its vast population of over 200 million people the testing rate is significantly small.
Countries in Africa with higher testing rates relative to their population include South Africa having tested 7.3 million people, Ethiopia with 1.8 million tests, Morocco testing 4.5 million samples, Egypt with 1 million tests conducted, Kenya carried out 1.04 million tests, Rwanda has tested 760,897 samples and Ghana with 697, 087 tests.
However, the NCDC is yet to articulate a coherent strategy to test and speedily provide results to stem silent carriers of COVID-19.
Uncertainty trail testing without results
Mercy Olayinka, a poultry farmer based in Abuja makes use of the space outside her home to raise chickens for sale.
Her business relies on physical interaction with her customers, even when payment for her birds is facilitated using a digital platform, the delivery chain of the business depends on meeting people directly.
In November 2020, Mercy decided to get tested for COVID-19 after she came in contact with a family member who was infected with the coronavirus.
Mercy had called the hospital where she got tested to inform them that she needed the result to facilitate a job opportunity, hoping the information will prompt them to release the results
“I have since moved on since the results failed to arrive on time especially since I didn’t notice the symptoms of the disease. It is not a good experience to take a test and not get a result,” she said.
One month later, she got a call from an official of Abuja’s Health Services who called to confirm her name. When she told him that wasn’t her name, that was the last time she heard from the official.
“What’s the essence of testing when you won’t get a result, “Mercy queried.
For, twenty-four-year-old Isah Abdullaziz who is on the low-risk category of contracting the virus, according to a global study he got tested on November 27, 2020, and was assured to be notified of the outcome of the result in a couple of days.
Two weeks later, Isah was contacted by a contact tracer who inquired about his health conditions and when Isah asked about his result the contact tracer told him to go back to the centre where he got tested to get his result.
“Initially I was on self-isolation after the test but after I exceeded the 14 days period without the signs I had to move on with my life. My concern is with the process that the NCDC uses to conduct testing because without a result it leaves you with uncertainty and you don’t know if you are infected or not,” he said.
The second month after Isah could not get his result, he used the verification number issued by the NCDC official on their website to check his result but his data did not exist on their portal.
“The testing is not co-ordinated, for instance, after I did the test I was given an epidemiological number which means that whenever I present the number on their portal or manually, my data is with the NCDC should reflect but that has not been the case,” he said.
According to a study published by the Nigeria Institute Medical Research (NIMR) examining the infection rates and deaths from Covid-19 in the country indicated that the number of people who had died from the virus could have been underestimated.
The Africa Center for Disease Control reveals that currently, 20 out of 55 African countries have Case Fatality Rates, CFR which is the percentage of people who die from the virus higher in Africa when compared with the global average of 2.2 which is likely to increase when compared with the first wave of the pandemic in 2020.
Ekaete Tobin, a consultant clinical epidemiologist at the Irrua Specialist Teaching Hospital, Edo State says people who got tested and have not seen their results would likely increase the transmission rates of the virus and complicate the pandemic.
“While people who have taken the tests are waiting for their results, they would have to be quarantined because the incubation period for the virus is 2 days but without getting their results they will have to go to the market or other public places and mingle with other people.
“The infected person if later confirmed positive will have passed the virus to hundreds of people even if their immune system has the capacity to beat the virus. What about the other people who got infected can we say their immunity was strong,” she said.
At a webinar hosted by the African Forum for Research and Education for Health, Nigeria’s presenter Rhoda Atteh, head of the Africa Field Epidemiology Network, Nigerian chapter at the Federal Ministry of Health said Nigerian contact tracers engaged in one-on-one communication to facilitate contact tracing process and prevent further transmission from asymptomatic carriers.
“We also focus on doing self-isolation at home and also monitoring contacts remotely when we have identified cases,” she said at the event.
The ICIR contacted the NCDC to ascertain the reasons for the delay in releasing Covid-19 test results to Nigerians who tested but are yet to be notified of their status after several months.
Emeka Oguanuo, spokesperson of the NCDC did not answer several phone call to him. He, however, acknowledged the email sent to him with a promise to reply. “Good evening, Amos, seen your mail. Will revert,” he said in a message on Wednesday, January 13.
A reminder was sent to him on Friday, January 15, but he has not responded as of the filling this report.