How COVID-19 treatments cost government over N44.9b

Latest figures from the Nigeria Centre for Disease Control (NCDC) and the recent revelation of the cost of treating a COVID-19 patient by the Lagos State government indicate that the country is spending hundreds of billions of naira in tackling the pandemic.

The figures published yesterday on the NCDC website showed that Nigeria has 44,890 confirmed cases, with 11,798 being active and 32,165 discharged.

Last week, Lagos State said it spent between N100,000 and N1million daily, depending on the severity of the infection, to treat a coronavirus patient across its isolation centres.

If it takes at least N100, 000 and at most N1million to treat a patient daily in the country, and a patient is on admission for an average of 10 days in an isolation centre before being discharged, the amount spent so far on treatment can be calculated as 44,890 cases (dead while on admission, active and discharged) multiplied by N100, 000/N1,000,000, and again multiplied by 10. The result revealed that by yesterday, the country had spent between N44.9 billion (at least) and N449 billion (at most) in treating all the cases.

Some Nigerians have expressed grave concerns over the revelations in the NCDC report. Some said the amount quoted by the government must have been inflated while others said it could cost more to treat a coronavirus patient per day. Most of those who spoke on the issue said the country would not be able to sustain the spending if a cure for COVID-19 was not found soon.

Investigation showed over 80 per cent of the COVID-19 patients are being treated in government hospitals across the country. Though some leading private hospitals have treatment facilities, people who can afford to pay for their services and special cases, as directed by the health department of government, turn to them.

It was gathered that the cost of treating a COVID-19 patient varies from patient to patient, depending upon the severity of symptoms, load of virus, related ailments, age and other factors.

The Guardian investigation revealed that on an average, treatment of a COVID-19 patient, without ventilators or other life-saving equipment, costs between N104,000 and N130,000 daily, depending on the severity of the disease.

That means a 14-day treatment of a patient costs between N1, 456, 000 to N1,820,000. Usually, patients are discharged after three to five consecutive tests turn negative. In some cases, tests will go up to eight to 10 to get a definite result.

It was learnt that a swab or fluid test of a suspected patient costs between N25,000 and N50,000. If a person is tested or shows symptoms of COVID-19, he or she is supposed to travel only in an ambulance. Usually a hospital ambulance or a private one ferries him or her to the hospital at government’s expense.

Once moved to the isolation ward, there are certain specifications for such patients: each room should have a separate toilet and usually no other beds are allowed; if the patient is aged or suffering from multiple complications, ventilator is necessary.

The Guardian investigation also revealed that some aged people and those with underlining ailments are more likely to need ventilators and some may be on ventilators for more than a week.

Some of the private hospitals charge between N130, 000 to N260,000 per day for a ventilator. The cost of a hospital room depends on the classification of the hospitals, but the cheapest will cost between N6, 000 and N10,000 a day.

At least 200 Personal Protective Equipment (PPE) kits are required in a COVID-19 hospital with 100 beds and doctors and nurses will have to change their kits every four hours. If a health worker is nursing a critically ill with heavy load of virus, the PPE kits have to be changed frequently.

Investigation revealed that one standard PPE kit costs between N4,000 and N6,000. Prices of the medicines will also vary from person to person. Antibiotics, anti-vitriol and other medicines administered on each patient cost between N3,000 and N6,000 daily, besides his or her food.

Reacting to the situation, a consultant public health physician/epidemiologist and member of Lagos State COVID-19 Response Team, Prof. Akin Osibogun, said: “The full ramifications of the infection by the virus is not yet known. Health workers who go into the isolation wards must protect themselves from infection. If they wear Hazmat suits each time they go in to see patients, they must discard the suits once they come out. There is a protocol for going in and coming out of the ward. Because the suit generates a lot of heat, the healthcare worker cannot comfortably stay in the ward while inside the suit for an hour. Depending on how many times and how many healthcare workers go into the ward, you can begin to see that it is not cheap.

“Please research to find out the cost of Hazmat suits in Nigeria. Apart from the costs of the PPEs, including the Hazmat suit, there are other costs like running generators 24/7, remuneration and incentives for frontline workers, drugs, feeding and supportive staff. An outbreak is not what you want but it is something you just must combat vigorously to minimise greater mortality and economic costs. Detect, isolate and treat is a strategy to try and break transmission of the disease. It has worked in helping us keep the curve flat. Otherwise our health system would have been overwhelmed with an uncontrollable surge. Strategies will change at different stages of the outbreak and I believe the government is closely monitoring the evidence for decision-making.”

The Guardian gathered that it costs about N58,477.5 ($129.95) to buy one disposable Hazmat suit.

President, Nigerian Medical Association (NMA), Prof. Innocent Ujah, said: “It is difficult to give the real cost of treating one COVID-19 patient per day, but I can imagine that it will cost a fortune. It will include payment made to all health care providers (doctors, nurses, pharmacists, nutritionists and cleaners involved in the management), feeding of the patients daily, purchase of consumables and drugs, as well as payment for electricity, and even water.