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Over 40m Nigerians infected with COVID-19, survey shows

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No fewer than 40 million Nigerians have been infected with COVID-19, with most of them not aware due to low testing capacity.

Findings of household sero-prevalence surveys conducted in Lagos, Enugu, Nasarawa and Gombe States, released Monday by the Nigeria Centre for Disease Control (NCDC) and Nigeria Institute for Medical Research (NIMR) and their partners, revealed that the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies – the virus that causes COVID-19 - was 23 per cent in Lagos and Enugu states, 19 per cent in Nasarawa State, and nine per cent in Gombe State.

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According to a press statement jointly signed by Director General, Nigeria Centre for Disease Control (NCDC), Dr. Chikwe Ihekweazu, and Director General, Nigerian Institute of Medical Research (NIMR), Prof. Babatunde Salako, this means that as many as one in five individuals in Lagos, Enugu and Nasarawa State would have ever been infected with SARS-CoV-2. In Gombe, the proportion is about one in 10.

The researchers said these rates of infection are higher than those reported through the national surveillance system and reveal that the spread of infection in the states surveyed is wider than is obvious from surveillance activities. They said this is not surprising for COVID-19, given that a majority of those infected do not have any symptoms.

A further breakdown shows that if one in five Nigerians of a population of 200 million have the virus; that means not less than 40 million Nigerians have been infected with COVID-19.

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Latest figures from the NCDC, on the February 22, 2021, showed 542 new confirmed cases and 23 deaths were recorded in Nigeria.

Till date, 152,616 cases have been confirmed, 129,300 cases have been discharged and 1,862 deaths have been recorded in 36 states and the Federal Capital Territory.

A further analysis shows that only 0.38 per cent that is only 152,616 of 40 million Nigerians that have COVID-19 have been tested and confirmed including the dead (1,862) and survivors (129,300).

Conducted between September and October 2020, the surveys were designed to improve the estimate of the burden of COVID-19 infection in the country and provide a more detailed estimate of the extent of infection with SARS-CoV-2.

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According to the survey, blood samples were collected from over 10,000 individuals residing in a representative sample of households in the four states. The blood samples were then tested for the presence of SARS- CoV-2 antibodies applying locally validated laboratory tests. Individuals who provided blood samples also answered a brief questionnaire that enabled the study team to characterise factors related to positivity and identify which population groups were most affected.

Results of the survey further showed higher rates of infection among: males than females (for example, 10 per cent vs. seven per cent in Gombe and 21 per cent vs. 17 per cent in Nasarawa); urban compared to rural and residents (for example, 28 per cent vs. 18 per cent in Enugu and 23 per cent vs. 19 per cent in Lagos); and persons aged 18- 64 years. There were also variations across the local government areas (LGA) within the four states. The survey team noted that these observations are in tandem with what had been reported by the NCDC based on the national surveillance system.

In interpreting the results, the survey team noted that “SARS-CoV-2 emerged only one year ago and antibody response according to severity of infection and the duration of antibody persistence are not yet completely understood.”

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The researchers said given the high proportion of asymptomatic cases in Nigeria, the true sero-prevalence of ever having infection may be underestimated in the survey if individuals infected early in the outbreak no longer had sufficient antibodies for detection when the survey was conducted.

The results from the survey shows that a significant proportion of people in Nigeria are still at risk of SARS-CoV-2 infection and therefore, COVID-19. “It is very important that Nigerians continue to adhere to public health and social measures including regular handwashing, proper use of face masks and physical distancing,” it noted.

The United States Centers for Disease Control and Prevention (US-CDC), the University College London (supported by Bill and Melinda Gates Foundation), the University of Maryland, Baltimore (UMB), and the respective State Ministries of Health supported implementation of the survey. The survey is being expanded to more states with a priority to capture information from States in the North West and South-South geopolitical zones, which were not included in the initial round of surveys.

Ihekweazu said the Federal Ministry of Health, its agencies NCDC and NIMR as well as the Presidential Task Force (PTF)-COVID-19 remain committed to strengthening Nigeria’s response to COVID-19 and controlling the outbreak.

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Also, as part of efforts to tackle vaccine hesitancy, the World Health Organisation (WHO) and Chubb Limited (NYSE: CB), through ESIS Inc., a Chubb company, signed an agreement on behalf of the COVAX Facility on February 17, 2021 for the administration of a no-fault compensation programme for the 92 low- and middle-income countries and economies eligible for support via the Gavi COVAX Advance Market Commitment (AMC) of the COVAX Facility.

According to a statement by the WHO, as the first and only vaccine injury compensation mechanism operating on an international scale, the programme will offer eligible individuals in AMC-eligible countries and economies a fast, fair, robust and transparent process to receive compensation for rare but serious adverse events associated with COVAX-distributed vaccines until June 30, 2022.

By providing a no-fault lump-sum compensation in full and final settlement of any claims, the COVAX programme aims to significantly reduce the need for recourse to the law courts, a potentially lengthy and costly process.

ESIS, as the independent administrator of the programme, was selected in accordance with WHO’s procurement rules and procedures, and charges no fees to applicants.

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All vaccines procured or distributed through the COVAX Facility receive regulatory approval or an emergency use authorisation to confirm their safety and efficacy.

But, as with all medicines, even vaccines that are approved for general use may, in rare cases, cause serious adverse reactions.

WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, said: “The unprecedented nature of the COVID-19 pandemic has been matched by the largest-ever rollout of new vaccines under the ACT-Accelerator and its vaccines pillar, COVAX. This no-fault compensation mechanism helps to ensure that people in AMC-eligible countries and economies can benefit from the cutting-edge science that has delivered COVID-19 vaccines in record time.

“We are pleased to be collaborating with Chubb, which has the capabilities to support the COVAX facility through its global network and claims handling ability. WHO’s agreement with Chubb offers further protection and confidence in the life-saving power of vaccines.”

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Chief Executive Officer (CEO of Gavi, Dr. Seth Berkley, said: “The No-Fault Compensation fund is a massive boost for COVAX’s goal of equitable global access to vaccines: by providing a robust, transparent and independent mechanism to settle serious adverse events it helps those in countries who might have such effects, manufacturers to roll out vaccines to countries faster, and is a key benefit for lower-income governments procuring vaccines through the Gavi COVAX AMC.”

The COVAX no-fault compensation programme will be operationalised through its web portal (www.covaxclaims.com) by March 31, 2021, which will include resources such as the programme’s protocol, Frequently Asked Questions (FAQs) and information on how to submit an application.

Eligible individuals may apply for compensation under the programme once the portal becomes operational, even if a COVAX-distributed vaccine is administered to them before March 31, 2021.

The programme is financed initially through Gavi COVAX AMC donor funding, calculated as a levy charged on all doses of COVID-19 vaccines distributed through the COVAX Facility to the AMC eligible economies until June 30, 2022.

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WHO is working with Chubb to secure insurance coverage for the programme with Chubb as lead insurer.

Chairman and Chief Executive Officer of Chubb, Evan G. Greenberg, said: “Chubb is proud and honoured to work with the World Health Organization and its partners on the critically important COVAX programme.

“The COVID-19 pandemic has had a devastating effect on people and economies around the globe, and the development and deployment of efficacious vaccines is a crucial step toward ending this crisis. However, a vaccination strategy is only as effective as the number of people it reaches, which is why the COVAX facility is so critical. Access to the protection offered by a vaccine should not be limited or restricted. All countries, regardless of income levels, should have equal access to these life-saving vaccines.”

The delivery of COVID-19 vaccines during 2021 will be the fastest and largest global deployment of novel vaccines in history. The COVAX Facility aims, by the end of 2021, to deliver at least 2 billion doses of safe, effective and quality-assured vaccines to all participating countries, including at least 1.3 billion doses to the 92 AMC-eligible countries and economies, at the same time as wealthier nations.

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