Theophilus Abbah and Daniel Adaji
Testing for COVID-19 has dropped drastically, according to weekly reports by the Nigerian Centre for Disease Control (NCDC) that show continued drops fewer and fewer records of testing in most of the 36 states and the Federal Capital Territory (FCT). For instance, for the week that ended on April 17, 2022, 18 states recorded single digit testing for seven days, an indication that many laboratories licensed to test Nigerians for COVID-19 were idle in those states. From March 6 to April 17, 2022, the number of Nigerians tested for the virus across the country dwindled, as shown in the charts below:
Since February 2020 when COVID-19 broke out in Nigeria, a total of nearly 256,000 cases and 3,143 deaths have been recorded, according to NCDC data. The highest cases of 22,562 and 220 deaths were recorded in Lagos State, followed by 10,291 cases and 202 deaths in neighbouring Oyo State. Other states with high incidences include Edo (7,694 cases and 321 deaths), FCT (6,385 cases and 82 deaths), and Delta (5,369 cases and 111 deaths).
However, these figures are believed to be a tip of the iceberg because of the low rate of testing for COVID-19 across the country.In terms of the testing trends, it has dropped from the height of 1.4 million persons tested in January 2021 to as little as 241,174 in the month of April 2022. The fall in the rate of testing affects the credibility of the number of COVID-19 cases reported in Nigeria. Our World in Data, which produces countries’ 7-day rolling average data on COVID-19, states about Nigeria that “due to limited testing, the number of confirmed cases is lower than the true number of infections.”
It’s interactive chart on COVID-19 in Nigeria should inexplicable rise and fall in COVID-19 cases, which may be attributed to haphazard testing for the virus. This downward trend demonstrates the complacency by government and institutions vested with the responsibility of carrying out the tests. With a population of about 211 million, the test rate of 5,152,011 million is barely above two per cent of the people who should be targeted for preventive testing.
Compared to Nigeria, South Africa has tested as many as 24,885,511, about 40 per cent of its population of 60,756,135. Another African country, Egypt, with a population of 106 million has effectively tested 1,318 per million. Both countries have left Nigeria behind in aggregate testing of citizens for COVID-19.
However, in Nigeria’s strategy document for combating COVID-19, government identifies testing as an important element, and the NCDC acknowledges it thus: “Diagnostic testing is an essential response strategy to interrupt the transmission for the COVID-19 pandemic by informing patient management and identifying positive cases, which can then be isolated. The Federal Ministry of Health has prioritised testing as one of the key interventions to the COVID-19 response in Nigeria. In order to rapidly contain the outbreak, the Government of Nigeria plans to rapidly scale diagnostic testing to cover all 36 States plus the FCT.” The low testing rate belies the content of government’s strategy document.
It has been proven scientifically that testing is critical to contain and mitigate the COVID-19 pandemic, as diagnostic tests help to prevent further person-to-person transmission. With low rate of testing, the NCDC data of the number of infected Nigerians cannot be reliable, as it is possible that thousands of persons are living with COVID-19 but are unaware of it. The World Health Organization estimates that only one in seven COVID-19 infections is being detected in Africa. The number of undetected cases not only increases the risks of infection between individuals but means the virus is likely to be spreading unnoticed and under-reported.
Why Testing is low in Nigeria
Dr Ifeanyi Casmir, a specialist in Laboratory Science, attributes the low rate of testing for COVID-19 in Nigeria to the framework put in place, which prioritizes testing at laboratories owned by the private sector rather than in government-owned laboratories. He argued that owners of laboratories for COVID-19 tests raked in billions of Naira from incoming and outgoing international travelers who are compelled by the Nigerian authorities to present negative test results for the virus.
He said, “I proposed that COVID-19 testing should be an integral part of our health screening, and should be routine, such that if anyone reported possible cases of cold or malaria in Nigeria, he or she should be tested for COVID-19 for free. The way it is at the moment, testing for the virus is not affordable. It costs between N40,000 and N50,000 to do the molecular testing, which is suspect. To cover more grounds, testing should be free. This is what is done in Cameroon. The reality is that COVID-19 has come to stay with us, so the test for it should be routine. All this is happening because the Medical Laboratory Science Council of Nigeria is asleep.” The council is vested with the responsibility of assessing and evaluation of laboratory testing test centres in Nigeria.
