Kano COVID-19: If We Don’t Test Enough, We Wouldn’t Know Enough

Bala Ibrahim

By Bala Ibrahim

The public and the media in my native Kano have gone breathless since yesterday, because of the news that the state has recorded its’ “first” case of the Coronavirus. First? Readers should please pardon my distrustful positioning of the casualty figures, but I am completely skeptical about the layout. I don’t believe it is the first case, even if we want to hide under the cover of the word, reported. If we don’t test enough, we can’t be knowledgeable enough.

The bad news was confirmed by the state’s Commissioner for Health, Dr Aminu Ibrahim Tsanyawa, who said the patient was reported to be a diplomat, who developed symptoms similar to those of the COVID-19, on his arrival from Abuja, nearly two weeks ago.

Governor Ganduje explained further later, “Indeed, it is a sad moment for us. This is an occasion that we are not happy with. I am unhappy to inform the people of Kano state that today, we got a patient who tested positive to COVID-19, a 75-year-old retiree and a former ambassador who travelled to Kaduna, Abuja and Lagos and came back to Kano on 25th March. He was not feeling fine for the last few days and voluntarily invited our medical team, who took 10 samples. After the sample was returned, it was found out that he is positive, while the other nine samples were negative. It is confirmed today that we have a positive case of COVID-19 in Kano. He has no history of travelling abroad in the last six weeks. Also, his medical report shows that he has a heart problem, which aggravated his case.”

The Governor said contact tracing had commenced, with a view to establishing all those who interacted with the index case, and additional measures would be put in place if necessary. “We are liaising with religious and market leaders on the stringent measures to curtail large gatherings of people in places of worships and markets.”

And that is precisely the cornerstone of my concern because I am worried about the level of testing, which should determine the level of infection. The state has not shown much concern about contacts and the mobility of the disease through interactions. Only proper testing can tell the magnitude of infection.

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Kano is Nigeria’s oldest commercial city and the country’s centre of commerce. Historically, leather and cotton goods were widely transported from Kano northward, by caravan across the Sahara to Tripoli, Tunis, and Fez, in Morocco, for onwards shipment to Europe. Although in lesser proportions and arrangements, that trade relationship still persists.

Knowing fully the population pre-eminence of Kano, its strategic position in trade and the people’s propensity for free and easy movement, which could combine to accelerate the spread of the disease, should the state wait until a high profile personality is infected, or liaise further with others, before it imposes restrictions on movements? Had the state been testing, it probably would have discovered more infections.

Looking at what is happening all over the world, particularly the speed with which the disease spreads, do we need any additional consultations before doing the needful? Even in states where the lockdown was imposed, the President had announced the near timelessness of the curfew.

With a population of close to 20 million people and a high level of illiteracy in western education, it is the duty of the leadership to be proactive in thinking, action, and the execution of measures that would protect and prevent infection. We shouldn’t be deceived by the low level of reported casualties, its’ because we are not testing, that’s why we don’t know the level of infection.

Long before some states commenced the lockdown policy, I thought Kano was going to set the pace, by exploiting its’ limitless advantages. It did not do that, nor pay attention to the imperative of testing potential patients.

Beyond the poor level of testing, is the painful and ignorant opinion by some, that there is nothing like the COVID-19 in the state. Some Nigerians believe the coronavirus does not exist, thinking the government only wants to get money from international bodies and some influential personalities.

One of the messages I keep receiving from the National Centre For Disease Control reads: “Take responsibility, prevent the spread of coronavirus, by cleaning all surfaces frequently. High contact surfaces include door handles, stair rails and tables. As the situation is evolving, this advisory will be updated as more information becomes available”.

For the people of Kano, Nigeria’s most populated and predominantly Muslim state, the kettle used for ablution is not just among the high contact surfaces, but the highest contact surface. On the average, the Muslims pray five times a day, and the religion enjoins us to perform ablution each time, with the encouragement to re-perform the ablution before other prayers, even where the previous one is not obliterated. One contamination on the kettle can result in a catastrophe. We are not in the know of the level of infection, because we don’t care to test.

Another issue is the reluctance of the leadership to make adequate arrangements for the personal protective equipment of the health workers, which is as scary as the refusal to enforce the social distancing policy in the state.

Healthcare workers are always advised to observe standard infection prevention and control measures when attending to patients. But in a state of confluence like Kano, where travellers interact from all over, the medics are the most neglected. Refusing to motivate those that are in the frontline, is as bad as aiding the spread of the disease.

I became unsettled, when a medic confided in me, the magnitude of their predicament in one of Kano’s hospitals. He said, with over 100 doctors in our department, we were given just 50 pieces of N95 face masks. Certainly, some would not get, so they have to make personal arrangements. Yet, if one becomes infected in the cause of duty, the minister announced the mocking and ridiculous N50, 000 as hazard allowance for the victim. So apart from the anger of insufficient protection kits, there is the anguish of derision in risk allowance.

According to PMB, “The defeat of the virus in our country will be in our hands, alone. We cannot wait for others. We can only depend on ourselves now”.

This means to defeat the disease, we must first defeat the doubt. This is possible by increasing the level of testing. Because if we don’t test enough, we wouldn’t know enough.

The alternative would turn us into the tragic traffic of moving as potential patients.

Bala Ibrahim, a Media Advisor writes from Kano.

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