COVID lessons from India

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Kayode Komolafe

With effect from yesterday, the federal government has banned from Nigeria passengers who have been to India, Brazil and Turkey in the previous 14 days. Stiff penalties would be placed on the airlines that break the rules. The regulations are subject to periodic reviews.

This is a wise step to take in the light of the surge of coronavirus infections in those countries. The disease caused by the virus, COVID-19, is ravaging those countries more than other parts of the world.

The government is rightly following science on this matter. The Academy of Medicine Specialities in Nigeria advised the government to take proactive steps to prevent transmission of variants of the virus from the epicentre of the pandemic. The Presidential Steering Committee on COVID-19 also recommended the travel bans.

Remarkably, Lagos State government is also on alert against the third wave of COVID-19 being triggered by the importation of mutants of the virus by inbound passengers. It is important that the state government is determined to enforce the federal government’s regulations in this respect. Lagos has a long list of countries which are being monitored for the transmission across borders.

From the particular case of India, where a humanitarian disaster looms, Nigeria should learn some urgent lessons.

The unfortunate situation of India has again shown that a country that had displayed remarkable bravery and capacity in the fight against COVID-19 could easily be overwhelmed by the pandemic.

India is the largest producer of vaccines; but now it does not have enough for its population as unprecedented figures of infections are recorded daily in the country. About 70% vaccines globally are produced in India. The Serum Institute of India (SII) has been producing AstraZeneca vaccine for 64 low-income countries including Nigeria within the framework of the COVAX programme of the World Health Organisation (WHO).

One of the grim implications of the situation in India is that the exports of vaccines to poor countries would be disrupted. The management of the pandemic in those countries would, of course, be negatively affected.

India’s overall medical capacity is relatively higher than many third-world countries. Yet medical oxygen has become a luxury in that country. The oxygen cylinders available to patients in critical conditions are not enough. Patients are taken out of the hospitals to join the queue for improvised oxygen cylinders at some production centres.

India has been a destination for medical referrals from Nigeria. In the pre-COVID time, Nigerians who could afford the exorbitant costs sought medical attention in private hospitals and other facilities in India.

In fact, few months ago India was rated as one of the countries managing the COVID crisis fairly well. For instance, only in March Indian participants spoke proudly about the management of the COVID crisis in their country at a webinar organised by the Kaduna-based think tank, the Gusau Institute, and the Monohar Parrikar Institute for Defence Studies and Analyses (MP-IDSA) of India. Such an upbeat mood about tackling coronavirus has since vanished given the reality on ground in India.

The situation was not helped by a political leadership that prioritised politics over public health based on false assurance.

In terms of the risk factors, a few parallels could be drawn between Nigeria and India. Although Nigeria’s estimated population of 210 million is hardly comparable to India’s 1.4 billion, yet the fact remains that Nigeria has the largest population on the African continent.

The recent surge in India was partly fuelled by mass gatherings which have tragically turned out to be super-spreaders. In most cases these events had the imprimatur of government.

More infectious mutants are also found in India. The uptake of vaccines has also been relatively slow despite the fact the country exports vaccines to other countries.

Lockdowns are difficult to enforce in a country in which about 90% of the workforce is self-employed. A majority of those working earn daily incomes. There is hardly any social safety net for the poor majority in India. Until the surge last month, India avoided national lockdowns. Complacency set in and the consequence is the wider spread of the virus. The infections of the variants have proportionally caused more deaths than the first and second waves.

The poor members of the Indian society relying wholly on the underfunded public healthcare system are more vulnerable. India spends a meagre 3.9% of its Gross Domestic Product (GDP) on health.

The private hospitals are better developed, offering quality services. But those who lack health insurance cannot afford the huge costs of private hospitals. When public health is underfunded at normal times, the society becomes more vulnerable during epidemics. Little surprise that the India public healthcare has failed to be resilient because it has not been socially equipped for the purpose.

Experts have also explained that age, air pollution and obesity could also be some of the risk factors in India.

So the moral of the Indian COVID story for Nigeria is that the hope on the medical and pharmaceutical options could be dashed because of some insurmountable factors. What is needed in emergency may be unavailable in practical terms.

The country should, therefore, upscale the efforts at prevention.

For instance, if faced with a surge in hospitalisations, Nigeria does not have enough medical oxygen for the patients in critical conditions who may need it. Some efforts are being made in Lagos to produce medical oxygen. However, there is hardly any indication of national preparedness in case the need for this life-saving substance arises in the course of the pandemic.

Universally, a standard cure for the disease is still awaited. Vaccines are available, but the morality of its distribution is questionable. The rich countries seem to ignore the axiom of the pandemic that “no one is safe until everyone is safe.” Incidentally, about 20 world leaders echoed this scientifically loaded fact in a joint statement made on March 31, 2021. Yet the myopia of vaccine nationalism is still prevalent among some rich countries. The rich are, of course, reserving the vaccines for their populations. Hence while the United States has vaccinated over 100 million of its population, Nigeria is yet to vaccinate two million of its population. Given the slow rate of vaccination, the journey to the land of herd immunity may be longer than imagined at present.

The matter is made worse by the social viruses undermining the campaign for vaccination. These are the viruses of misinformation, conspiracy theories and vaccine hesitancy. The sociology of vaccination is such a complex one in which even some scientists join in spreading the misinformation to discourage unsuspecting members of the public.

Therefore to avert more deaths in the event of a third wave, Nigeria cannot rely on the capacity for treatment or vaccination. The country’s strength should be in prevention by emphasising stricter adherence to the protocols -avoiding crowds, wearing of masks, social distancing, hygiene etc. In the matter of COVI-19, prevention is not only better than cure, it is also cheaper and more readily available.

The presidential steering committee and state governments should intensify the campaign for all to embrace the culture of observing the precautions.

Complacency is noticeable on the part of the general public. Many people seem to have forgotten about the precautions. Members of the public simply ignore the warnings given by the health authorities about spread of the virus.

With the reported falling rate of infections, it is tempting to behave as if the pandemic is over. A few months ago, the figures of infections and deaths were also dropping in India. Today, India reports the highest figures of infections in the world. So the current statistics should not be an excuse to be careless about the virus.

This is no time to lower the guard in the fight against COVID-19.

For solutions, look more inward

Not a few people must have felt the pains of the parents of the 17 students of the Greenfield University in Kaduna. The bandits holding the students captive had threatened to kill them if their parents failed to pay ransom, after they had killed five of their colleagues. Some of the parents of the Greenfield students and those of the Forestry Institute, also in Kaduna, were at the National Assembly yesterday to cry for help.

While the anguish of those helpless parents continued, there were other reports about insecurity from various parts of the country.

It is urgent that the Nigerian state should demonstrate its presence. The public yearning for that presence is palpable. The people need to feel secure for them to believe that the state is present.

It was, therefore, expected that government should engage the people with greater empathy and a deeper sense of accountability. Steps should be taken to keep the public confidence.

Although President Muhammadu Buhari is yet to speak to the nation as many Nigerians expect, the meeting of the National Security Council which began last week continued yesterday and the senate has scheduled a meeting with the service chiefs tomorrow. The House of Representatives tried to calm down those whose children are in captivity.

The President should be more inward-looking in seeking solutions. He should give leadership by galvanizing the various moral and political forces within the nation to tackle insecurity. In any case, foreign help looks like a mirage in the circumstances.

For instance, the United States would act not to “help” Buhari, but to advance its strategic interests in Nigeria, if any. Those who, for whatever reasons, have refused to sell arms to Nigeria to prosecute the war against terrorism are not likely going to put boots on ground to save the country. This point was made eloquently by Dr. Chidi Amuta in his column on Sunday in this newspaper. Not a few are also displeased with the manner in which the request for external help is being made by the federal government.

However, more than any foreign help the unity of purpose of Nigerians could prove more useful in moral and political terms in the circumstance.

For instance, the President should look at the suggestions from the Peoples Democratic Party (PDP), ethnic organisations, professional bodies, mass organisations, retired military and security officers. The various views should be examined to see which ones could be useful. This should form the basis of engagement. The criminals don’t attack on their victims on the basis of political party.

The recent rhetoric from Abuja may not be helpful in the process of finding solutions. The government should avoid the temptation of resorting to authoritarianism. Doing so can only compound the crisis.

Instead, the President should lead the way by engaging all political and civic forces on one point: the resolution of the crisis.

This is necessary to prevent anarchy in the country.

It is the interest of the government and the people to prevent anarchy.

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