Epidemiological trends of coronavirus disease 2019 in Nigeria: From 1 to 10,000.

BACKGROUND: The coronavirus disease 2019 outbreak in Nigeria was first reported on the 27th February 2020 and 95 days after, it had spread to 35 states and the Federal Capital Territory (FCT) with 10,162 confirmed cases. We reviewed the trends of the epidemic from the 27th February to the 31st May 2020, when it reached the 10,000th mark vis-à-vis government policies to contain the spread of the disease. METHODS: We used publicly available data from the Nigeria Center for Disease Control from 27th February 2020, when Nigeria recorded her first coronavirus disease 2019 case to the 31st May 2020. We used line graphs to describe the trends of the daily course of cumulative cases, discharges and deaths in states and nationally. The doubling time, transmission rates were inferred from these trends and the epidemiological curve generated was reviewed vis-a-vis the instituted government policies over the specified period. RESULTS: The epidemic curve in Nigeria has been on an upward trajectory as the number of cases crossed the 10,000 marks, 3 months after the first case was recorded. The first spike in the number of new cases was observed on the 21st April 2020, with 117 cases. The number of daily deaths within the study period was highest on the 2nd May 2020 (17 new deaths). Geo-political zone variations were also observed. Of the 63,882 screening tests conducted during the study period, 15.9% tested positive; the doubling time and transmission rates were 23.5 days and 1.0%, respectively, as at 31st May 2020. Since the lockdown measures were lifted in Lagos and the FCT on the 4th May 2020, the number of cases has been on a steady increase each week. CONCLUSION AND RECOMMENDATIONS: In Nigeria, the epidemic curve has been on an upward direction since the first reported case and it took 3 months to reach 10,000 cases. We recommend a sustained drive in the enforcement of physical and social distancing and increase in testing capacity to flatten the epidemic curve.

Evolutionary trends of the COVID-19 epidemic and effectiveness of government interventions in Nigeria: A data-driven analysis.

Background: Nigeria became the first sub Saharan African country to record a case of COVID-19 after an imported case from Italy was confirmed on February 27, 2020. Moving averages and the Epidemic Evaluation Indices (EEI) are two important but complementary methods useful in monitoring epidemic trends, they can also serve as a useful guide for policy makers and inform the timing of decisions on preventive measures. The objectives of this paper are to graphically depict the trends of new COVID-19 cases nationally and in two key States (Lagos and Kano) and the Federal Capital Territory (FCT) using the moving averages and the EEI. In addition, we examined the effects of government's public health interventions on the spread of COVID-19 and appraise the progress made so far in addressing the challenges of COVID-19 in Nigeria. Methods: We used data on new cases of COVID-19 from public sources released by the Nigeria Center for Disease Control (NCDC) from the 27th February 2020, when the first case was recorded, to 11th May, 2020, one week after the lockdowns in Lagos and the FCT were lifted. We computed moving averages of various orders, the log transformations of the moving averages and then the EEIs of new COVID-19 cases for Nigeria as a whole, and then for two of the most affected states i.e. Lagos and Kano, as well as the Federal Capital Territory (FCT). Then, we plotted graphs to depict these indices and show the epidemic trends for COVID-19 in each scenario. Results: Nationally, the number of new cases of COVID-19 showed an initial gradual rise from the first reported case on the 27th February 2020. However, by the second week in April, these numbers began to show a relatively sharper increase and this trend has continued till date. Similar trends were observed in Lagos state and the FCT. The rate of growth of the logarithm-transformed moving average in the period leading to, and including the lockdowns reduced by a factor of 0.65. This suggests that the policies put in place by the government including the lockdown measures in Lagos and the FCT may have had a positive effect on the development of new cases of COVID-19 in Nigeria. Nationally and in Lagos, the EEIs of the COVID-19 cases started off on very high notes, however, the effects of the lockdown gradually became evident by the end of April and early May 2020, as the EEIs headed closer to 1.0. In all case scenarios, the EEIs are still above 1.0. Conclusions and recommendations: The number of new cases of COVID-19 has been on a steady rise since the first reported case. In Nigeria especially across the two states and the FCT, public health interventions including the lockdown measures appear to have played a role in reducing the rate of increase of new infections. The EEIs are still above 1.0, suggesting that despite the progress that appears to have been made, the epidemic is still evolving and Nigeria has not yet reached her peak for COVID-19 cases. We recommend that aggressive public health interventions and restrictions against mass gatherings should be sustained.