Controlling the third wave: Learning from Nigeria’s response to COVID-19 outbreaks
On the 27th of February, 2020, the first case of coronavirus disease (COVID-19) outbreak was recorded in Nigeria. Since then, a multi-partner incident management system hosted at the Nigeria Centre for Disease Control (NCDC) has been leading national response. We are working closely with all the 36 states and Federal Capital Territory to ensure national health security. Given the novelty and epi-dynamics of the virus, the national response plan has been continuously revised through different stages of the outbreak. The level of control during the first and second waves of the outbreak can be attributed to the instituted public health measures.
With the ongoing third wave, it is critical to assess the national readiness for outbreak control. In line with this, the national team from the Nigeria Centre for Disease Control in collaboration with the World Health Organisation recently conducted an Intra Action Review (IARs) with key stakeholders across the six regions in Nigeria. The sub-national stakeholders included Incident Managers, State Epidemiologists, and leads of Risk Communication, Surveillance, Laboratory and Research pillars from each of the 36 States and the FCT. The objectives of the regional IARs were to:
Provide an opportunity for national and subnational stakeholders to share experience and collectively analyse ongoing in-country COVID-19 response;
Facilitate consensus building and lesson learning amongst the response stakeholders to improve the current response by preventing recurrent errors and reproducing success;
Document and apply lessons learning for health systems strengthening.
Specifically, the regional IAR provided a unique opportunity to provide updates on overall response activities, what went well, what went less well and why, and what can be done to improve current response. The states were also able to update their incident action plans through IAR to inform public health measures for the control of the ongoing third wave.
Subsequently, the national COVID-19 response team convened a national IAR meeting to discuss findings from the states and update the national COVID-19 plan. Through interactive sessions, the IAR provided an opportunity to review outbreak response around key ten technical – Coordination, Surveillance, Laboratory, Risk communication, Point of Entry, Logistics, Vaccine, Case management, Infection prevention and control, and Research pillars.
An important outcome of the meeting was the joint revision of COVID-19 response plan, with clear roles for every stakeholder involved in outbreak preparedness and response. The critical next step is to finalise the workplan and work with states and WHO to mobilise resources for the implementation of the revised plan for the control of the third wave.
The NCDC remains committed to working with state epidemiologists, state Ministries of Health, partners and other relevant stakeholders towards improving Nigeria’s preparedness and response to infectious disease outbreaks. More importantly, states are enjoined to improve ownership and ensure implementation of the revised workplan.
Summary of Incidents
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