There has been a lot of debate recently about the effectiveness of the lockdown in Lagos state, Ogun state and the FCT during the current Covid-19 Pandemic, and I believe our government needs to review this lockdown option.
There is of course no argument or debate that in absolute terms, and in theory at least, a total (100{ea8c11308c9c5919903708965b7b7a67d75ff567d88a1bebc318ff793fd0b309}) lockdown of any country, city, or community for an appropriate length of time (determined by the incubation period of a communicable viral epidemic disease) will eventually stop disease transmission and ultimately eradicate the disease.
This policy works because during the lockdown, those not already infected cannot be infected, and those already infected will either overcome the illness by getting rid of the virus, or become very ill, needing hospital care where they will be sequestered and treated until recovery, or maybe unfortunately eventually die of the disease. Either way, the infected patient cannot transmit the disease to uninfected persons. This scenario will of course only work in an organised, structured and socially and economically advanced society where palliatives to cushion the lockdown are already in place, or can be delivered to the vulnerable at short notice. It will unfortunately not work in most poor developing countries found in Africa and Asia.
Let us imagine for a moment the worst case scenario of allowing Covid-19 to actually spread unchallenged and unfettered in this country without a lockdown, a vaccine or effective treatment. It is projected and estimated that the disease may eventually kill about 1.4{ea8c11308c9c5919903708965b7b7a67d75ff567d88a1bebc318ff793fd0b309} of our population based on the current global (true) case fatality rate. That’s about 2.8 million people assuming our population is the hyped 200 million! Is that a large number of deaths? Yes it is, especially if it affects you or your loved one. Any life lost prematurely is always painful and regrettable. But in the greater scheme of things, it may actually be a small price to pay collectively for our continued survival as a species on this planet. Looked at another way, about 197.2 million Nigerians out of 200 million would actually still survive the plague of Covid-19! This surviving 197.2 million people (98.6{ea8c11308c9c5919903708965b7b7a67d75ff567d88a1bebc318ff793fd0b309}) would have acquired immunity to the virus and we will move on. The 1.4{ea8c11308c9c5919903708965b7b7a67d75ff567d88a1bebc318ff793fd0b309} that will be consumed by the pandemic while the rest of the population acquire herd immunity will be the martyrs of our generation, and they would have died so the rest of the population, who are mostly their children and young people (since the disease kills mostly old people over 65 years of age) can survive and live.
The narrative above is of course a “worst case scenario” which is unlikely to happen because the scientific community is now beginning to appreciate that local and peculiar mitigating factors may be at work in much of Africa which is likely to limit (and is currently limiting) our fatality rate to about 1{ea8c11308c9c5919903708965b7b7a67d75ff567d88a1bebc318ff793fd0b309} or less!
The option of not restricting or locking down people during this pandemic is actually currently being practiced in Sweden and Denmark. These two countries figure that the economic loss of a lockdown would be far worse on the populace in the long run than the possible death of 1.4{ea8c11308c9c5919903708965b7b7a67d75ff567d88a1bebc318ff793fd0b309} of the population that may be caused by Covid-19. They are rather expecting herd immunity to develop while their countries continue to flourish economically. Different strokes for different folks!
The lockdown approach is actually not the best option for our country and most of Africa. It was imported with a “copy and paste” mentality by the elites (us) who are also the elderly population, to protect ourselves (selfishly?) at the expense of the younger and poorer population (who are hardly affected or killed by Covid-19) and who actually drive the economies of these African nations.
We must also appreciate that the median age in most African countries is 18 years (17.9 years in Nigeria), compared to 42 years in Europe or 38.3 years in the USA, and that only 2{ea8c11308c9c5919903708965b7b7a67d75ff567d88a1bebc318ff793fd0b309} of our population is over 65 years of age (the most vulnerable persons to Covid-19) which means Covid-19 is unlikely to have the same devastating fatality outcome here as in Europe and the USA.
This lockdown unfortunately disproportionately punishes the poor in our communities, who have little or no savings beyond their daily earnings, and cannot afford the luxury of social or physical distancing. The lockdown may even end up killing more poor people than Covid-19 which the poor people are yet to see or feel!
And let’s be honest, most poor people will prefer the lottery of Covid-19 infection over the certainty of starvation!
When you live in a 6 bedroom detached mansion in Ikoyi, VI, Lekki, Banana Island, Ikeja or Magodo GRA, with a garden and maybe even a swimming pool, lockdown is easy to bear! However, when you live in Ajegunle or Mushin in a single room shared with 5 or more occupants, without running water, the slogans of “social distancing” “frequent hand washing” and “lockdown” become mere comical rhetoric!
There is also a general misconception that once we are through this lockdown, we will somehow be rid of the Coronavirus, and will then return to our normal lives. Nothing can be further from the truth! A lockdown only works if adhered to by everybody or at least the vast majority of the populace, like it happened in Wuhan, China.
The ‘fake’ lockdown we are observing right now just means the disease transmission is only partially suppressed, but will surely resume transmission (with a vengeance) when the lockdown is lifted and people are then lured into a false sense of security and safety. To make matters worse, since neighbouring states and the rest of the country are not locked down, influx of infected persons from the rest of the country will make nonsense of our four weeks of deprivation and sacrifice.
This recrudescence of infection unfortunately would then constitute double jeopardy because not only would we have failed to significantly curb the disease transmission, but we would also have lost 4 weeks of productivity and inflicted untold hardship, hunger, deprivation and possibly even death on our underserved urban poor.
One thing is certain however, the Covid-19 pandemic will eventually pass, and the vast majority of the world population will still be left standing. This is not armageddon! The world is definitely not coming to an end!
At the end of this pandemic, no matter which mitigating option we adopt, we would still have lost many frail, infirm, aged and even some young apparently healthy people. Maybe that’s nature’s ‘culling’ intention anyway in this overpopulated planet.
Ultimately, life on this planet is all about survival and preservation of the fittest of the species, and unfortunately, that’s “Hardball!”
I believe this lockdown should be lifted without any further delay, while we continue as much as possible to educate the public to observe the standard recommendations of physical or social distancing, frequent hand washing or sanitizer use, avoiding large crowds, wearing of face masks in public, and never neglecting to liaise with and carry along community leaders in all decisions of government.
A very important Public Health maxim goes thus: “Know your epidemic, know your response and act on its politics.” I hope our government will heed this maxim.
Our ultimate salvation in Africa from this pandemic however, is the hope and prayer that in the not too distant future, an effective vaccine or treatment for Covid-19 would be found.
Most poor people will prefer the lottery of Covid-19 infection over the certainty of starvation
Dr. SEYI ROBERTS , a consultant neurologist and a member of VOR, lives in Lagos.
April 20, 2020
