Kogi has gone 120 days without recording a single COVID-19 infection or a death attributable to the virus, according to the daily update of the outbreak in Nigeria by the country’s infectious disease centre, NCDC.
The state is the least impacted across the country with a total of just five infections. Two patients have died and the remaining three have since recovered. The last fatality was recorded in early June.
This milestone would have been held up as a model for success in limiting the spread of the virus but for several controversies trailing the state government’s response to the pandemic including allegations that local officials are not conducting tests.
Kogi, a state of almost 3.5 million people, have tested just 268 samples, the national situational report published Monday by the Nigerian Centre for Disease Control (NCDC) showed.
While states are solely in charge of its coronavirus management and response, the NCDC supports and receives daily infection updates from each state.
This arrangement has not worked in especially Kogi and Cross Rivers, the last of Nigeria’s 36 states to report a COVID-19 infection. The governors of both states had in different instances described the deadly disease as a hoax even before their index cases were reported.
“Ninety per cent of the noise about COVID-19 is for political, economic, financial [or] material gain. The other 10 per cent [relates to] ordinary flu, like the common colds Nigerians generally suffer,” the governor of the state, Yahaya Bello, an accountant, had said in a video posted on his Facebook page on March 25, which went viral.
Cross River State Governor Ben Ayade, a professor who has a doctorate in environmental microbiology, on the other hand, questioned the need for social distancing, saying that masks are sufficient protection, in a video that went viral on social media on April 9.
Meanwhile, Cross River, which would later become the last state to report an infection, has continued to turn in daily positive cases, even after reporting its index in early July.
The number of infections in the South-South state is 87 so far, according to NCDC data. About 74 of them have recovered while nine patients died.
On the other hand, Kogi stopped reporting daily infections in late June after only five cases were discovered, the daily infection update by the NCDC showed on Monday.
“Our job is to support the states. They are the ones in charge of their COVID-19 management so we cannot tell them what to do. We only update whatever information we receive from states,” an NCDC official said.
Kogi, the controversial state
The COVID-19 situation in Kogi was enmeshed in controversies, especially before the index case was recorded. At the time, the state’s COVID-19 free status raised a lot of concern especially because the north-central state sits in-between states with rising numbers of infections.
Federal officials and health authorities believe the state officials are discouraging tests for people with symptoms of COVID-19.
On May 8, health minister Osagie Ehanire admitted that efforts to support Kogi have failed after a delegation including NCDC officials had to flee the state for fear of being quarantined by the Kogi State Government.
“We tried to send a team of the Ministry of Health and the NCDC into Kogi but there were some differences there to processes,” the minister had said.
Medical experts said the low number of test samples turned in from the state is making it difficult to ascertain if they are actually coronavirus-free but the state authorities believe there is a plot to compulsorily report COVID-19 cases in the state.
When the index case was eventually reported on May 27, state officials said it will not accept any test result “conducted outside the state,” a position described as ‘unfortunate and condemnable’ by the Nigerian Medical Association (NMA).
Chikwe Ihekweazu, the NCDC boss, had, at the time, clarified that the index cases were referred from a Federal Medical Centre in the state to the National Hospital, Abuja, which he described as a normal referral pathway.
“The individuals live in Kogi State. In public health, your public health response is based on where you live because that is where your contacts are.”
Mr Ihekweazu also provided more insight on how the five cases attributed to Kogi were found in an interview with PREMIUM TIMES on Wednesday.
The NCDC director explained why the cases were identified with Kogi even though they were discovered outside the state.
“There is regular movement of Nigerians across states for various reasons. This has led to the confirmation of COVID-19 cases in states that are different from the original location of the case. At the national level, we agreed on a policy with States that if a suspected case is identified in another state within two days of arrival, then the epidemiology number should come from the original LGA/State that the case came from.
“This is not a sign of failure for any state, but to ensure that we can quickly identify contacts of the case and reduce the risk of spread of the virus. We have done this with Kogi State and several other states that meet this requirement,” he said.
On whether there is any plausible reason why the state has not reported a single case in about 120 days, Mr Ihekweazu, like many health experts, attributed it to poor testing.
“Our target in every state in Nigeria is to test at least 1 per cent of the state’s population. This is the only way we can accurately state if the outbreak has been controlled or not.
“In the most recent national situation report published on the 26th of October, Kogi State has tested only 268 samples so far. We need to test more, to know the true situation in Kogi State and across the country,” he said.
On whether there are noticeable loopholes and challenges in the state’s response to the virus, the official said, “this question is best addressed to the state…”
More Questions, fewer answers
Efforts to get the state health commissioner, Saka Haruna Audu, to speak has been unyielding. When contacted, the commissioner promised to respond to questions regarding the management of the disease in the state via WhatsApp. He is yet to so, despite repeated reminders.
Meanwhile, health experts believe the situation in Kogi has raised more questions than answers.
“When we did an assessment of how ready Kogi was for full school reopening, we observed some issues in the management of COVID-19 in the state,” said Ikemesit Effiong, a forensic expert.
“However, it is only the state that can give a profound detail of how it has managed the disease thus far,” Mr Effiong, who is also the Head of Research at SBM Intelligence, noted.