On the 23rd of July 2021, the Nigeria Centre for Disease Control (NCDC) published her weekly epidemiological report with the editorial titled “Tips for preventing 3rd wave in Nigeria amidst global surge”. This was informed by the rising cases of coronavirus disease (COVID-19) and hospitalisations amidst the emergence of highly transmissible and deadly Delta variant. While we had recorded cases in two digits in June and previous months, it is however becoming worrisome that we are beginning to witness hundreds of cases from July. On 4th August, 2021 alone, Nigeria recorded 747 confirmed cases (cumulative -176,011) with four (4) deaths (cumulative - 2,167).
To arrest the above trend, the NCDC has continued to intensify efforts with emphasis on public awareness to ensure Nigerians, including healthcare workers, take necessary preventive steps to protect themselves. Rapid Response Teams have also been deployed to support states’ response.
Given the continuous rising daily incidences and the need to expedite urgent public health actions across board, the Presidential Steering Committee (PSC) on COVID-19 swiftly met on 2nd August 2021 and officially announced the 3rd wave of COVID-19 outbreak in Nigeria. Credited to the Director General of the NCDC, Dr. Chikwe Ihekweazu, “We are now in the third wave of #COVID-19 in Nigeria with an average test positivity of 6%”. He also attributed the timely detection of cases and emerging variants across states to improved epidemic intelligence (through effective surveillance system) and already established system for genetic sequencing respectively.
With the 3rd wave in the early phase, all hands must be on deck to nip it in the bud. The NCDC working closely with the states’ colleagues now share timely information for prompt decision making geared towards taming the current trend. To curtail the spread, the PSC has placed the six high burden states and the Federal Capital Territory on red alert. These are Lagos, Oyo, Akwa Ibom, Rivers, Kano and Plateau. This implies an urgent need for heightened surveillance as well as enforcement of COVID-19 protocol.
Again, the public is advised to continue to comply with all recommended infection prevention and control guidelines. We MUST continue to adhere to following measures to reduce the spread of the 3rd wave of COVID-19:
1. Consistent and correct wearing of face mask in public settings
2. Maintaining physical distance of at least 2 metres
3. Avoiding crowds or large gatherings
4. Regular hand hygiene
5. Mandatory temperature checks in public spaces
6. Immediately call your states specific hotlines in case you notice any of the symptoms of COVID-19
To this end, we urge Nigerians to continue to take responsibility by strictly adhering to the above public health and social measures. We also encourage states not currently on red alert to remain cautious and compliant due to the high transmissibility of the virus.
Notes
1. Information for this disease was retrieved from the Technical Working Group and Situation Reports
2. Case Fatality Rate (CFR) for this disease is reported for confirmed cases only
3. Information for this disease was retrieved from IDSR 002 data
4. CFR for this disease is reported for total cases i.e. suspected + confirmed
5. Information for sentinel influenza was retrieved from the laboratory
Key points
● There were 70 suspected cases, five were laboratory confirmed and no death were recorded from three LGAs in two states
Actions
To date:
● Conducted 2021 Lassa fever (LF) high burden states preparedness/response engagement meeting
● Dissemination of reviewed case management and safe burial practices guidelines
● Ensured all five LF molecular laboratories in the NCDC network are working at full capacity for timely testing of samples with reduced turnaround time
Planned:
● Finalise LF five-year strategic plan
Key points
● There were five suspected cases of cerebrospinal meningitis (CSM) reported from three LGAs in three states (Enugu – 1, Osun – 1 & Oyo – 3). None were laboratory confirmed and no death was recorded.
Actions
To date:
● National CSM TWG meets weekly to review reports from states and plan appropriately
● Enhanced surveillance in all states
Planned:
● Continue harmonisation of the national line list and SORMAS data
● Continue to ensure that states reporting cases send their line lists and collect CSM samples
Key points
● There were 32 suspected cases of Yellow Fever (YF) reported from 30 LGAs in 13 states. None were laboratory confirmed and no death was recorded
Actions
To date:
● National YF multi-partner Technical Working Group (TWG) continues to coordinate activities across states.
● Ongoing plans to strengthen orientation of at-risk states on YF surveillance
● Ensured availability of reagents and consumables in all testing laboratories
Planned:
● Continue monitoring and analysis of YF (Yellow fever) data across all states and FCT to guide response
● Continue coordination of prompt transportation samples to the laboratories
Key points
● There were 534 suspected cases of cholera reported from 53 LGAs in eight states and FCT (Bauchi – 165, Borno – 22, Enugu – 90, FCT – 55, Kaduna – 57, Kebbi – 91, Kogi – 12, Kwara – 1 & Plateau – 41). 15 cases were laboratory confirmed and 18 deaths were recorded
Actions
To date
● National Cholera Multi-Sectoral Technical Working Group (TWG) is monitoring all states and supporting affected states
● National Rapid Response Teams (RRTs) with response commodities were deployed to support the response in all affected states
● Cholera jingles being aired in English and local languages across the country
Planned:
● Continue follow up and monitoring of non-reporting states
● Build capacity for sample collection, transportation, and laboratory diagnosis across states
Key points
● There were 498 suspected cases of measles reported from 62 LGAs in 15 states & FCT. None were laboratory confirmed and three deaths were recorded
Actions
To date
● National Measles TWG is closely monitoring measles surveillance data and providing feedback to relevant agencies and development partners
● Ongoing weekly surveillance and laboratory data harmonisation
Planned:
● Intensify follow up with states to update and transmit line list
● Continue monthly measles surveillance data review
Key points
● There was no suspected case of monkeypox reported this week
Actions
To date
● Enhanced Surveillance ongoing in Rivers, Delta and Bayelsa States
● National Monkeypox Technical Working Group (TWG) is monitoring activities in all states
Planned:
● Enhance surveillance for monkeypox in high burden states
● Continue harmonisation of the national line list and SORMAS data
Key points
● There were 98 suspected cases of AFP reported from 77 LGAs in 19 states and FCT. None were laboratory confirmed and no death was recorded.
Actions
To date:
● National COVID-19 multi-partner Emergency Operations Centre (EOC) continues to coordinate response activities across states
● Concluded review of the interim guideline for Clinical Management of COVID-19
● Disseminated COVID-19 articles on current variants and disease trends to health workers
● Ongoing review of IPC guidelines on suspected and confirmed cases of COVID-19
Planned:
● Deploy antigen-based rapid diagnostic test (Ag-RDT) kits and sample collection materials to the selected states
● Intensify genomic surveillance activities
● Conduct WASH (Water, Sanitation and Hygiene) assessment across all health facilities
● Finalise Local Government Area (LGA) / State transmission categorisation
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