The number of COVID-19 cases reported at the beginning of the first wave of the pandemic dropped rapidly towards the end of the year 2020. This trend was however reversed during the yuletide season (Christmas and New year celebrations) with many countries, including Nigeria reporting a high number of cases, signalling a second wave of the pandemic.
The situation in Kano state was not different from other states in Nigeria, several cases reported, dropped between the months of September to November 2020, and an increase in the number of reported positive cases in the State from December 2020 across January 2021.
The Kano State Government responded to the first wave of COVID-19 pandemic in the state by deploying different strategies, including the inauguration of a state task force on COVID-19 on the 30th of March, 2020 by the state governor, Dr Abdullahi Umar Ganduje. The task force was guided by an incident action plan, supported by the Nigeria Centre for Disease Control (NCDC), the Federal Ministry of Health, the Presidential Task Force on COVID-19, and partners.
At the beginning of the pandemic in Kano state, the COVID-19 response hinged on five pillars; coordination, surveillance, point of entry, risk communication, and logistics. These pillars were later scaled up with additional pillars including monitoring and evaluation, research, and security, making a total of eight response pillars. There were far-reaching measures in addition to the non-pharmaceutical measures employed by the state authorities. Kano State was under partial lockdown between April and July 2020 on alternate days, then 3 days per week, and then total lockdown. During the 2020 Ramadan, congregational prayers were suspended.
These measures yielded results and helped to halt the transmission in the state, with almost zero reported cases at some point leading to the scaling down of response activities. With the second wave of the pandemic in the state, all committees within the task force were reactivated. The Kano State task force was on alert. This time around, the Governor led the fight against the second wave of the pandemic says Dr Imam Wada Bello, Director Medical Services at the Kano State Primary Health Care Management Board and Secretary to the State Task Force on COVID-19.
As the state reopened its economy, there were series of engagements to ensure a safe reopening, including engagement of stakeholders in different sectors, e.g. religious leaders, teachers unions, school principals, and trade unions. The Kano state government focused on targeted risk communications activities dealing with groups directly, as well as community dialogues and engagements.
Different measures were adopted to prevent escalation of cases in the state, including enforcement of the COVID19 preventive measures. According to Dr Bello, ‘’The state government enacted a law making the use of face masks in public places mandatory in line with the President’s directive on the use of face masks.’’ The Kano State government also launched a COVID-19 Vanguard in January 2020 as part of the enforcement strategy. This group was saddled with the responsibility of enforcement of COVID19 protocols in public places such as markets and hospitals. He added, ‘’Mobile courts were established as well, to try defaulters. Hundreds were remanded for their refusal to wear the face mask.’’
The state embarked on active case searches across health facilities, community testing activities started across LGAs. About fifteen secondary health facilities across the state were selected and prioritised for COVID-19 to enhance case detection and sample collection. COVID-19 sample collection were decentralized in all LGAs in the state, specifically at secondary health facilities to ensure efficiency and easy referrals to collection sites. This enhanced case detection and sample collection in Kano state.” in the state.
The government provided linkages for referrals at secondary health facilities, between the local government Disease Surveillance and Notification Officer (DSNO), the LGA rapid response team, and the clinicians within these hospitals. The task force conducted training for these cadres of people as part of the response. Tuberculosis (TB) officers in health facilities were also directed to refer all suspected TB cases with a cough so that they could be screened for COVID-19. The number of Rapid Response Teams (RRTs) were increased and deployed to these secondary health facilities with complete sample collection kits to collect samples.
LGA DNSOs are responsible for transporting the samples collected in the facility to collation sites. Patients with symptoms or exposure are kept at the holding area of the secondary health facilities using the appropriate IPC protocols, if a person tests positive to COVID-19, he/she could be managed at home or taken to an isolation centre depending on the assessment of medical personnel.
The Home-Based Care Assessors, also known as Home Based Care Riders launched on 19th February 2021 was a game-changer in the fight against COVID-19 says, Dr Bello. The initiative was established during the second wave of the COVID-19 pandemic, aimed at reaching confirmed cases on home management in remote places. Healthcare workers were trained and provided with motorcycles and medication to reach confirmed cases in every part of the state to render home-based care.
The state response team is committed to collaborating with different stakeholders including the private in providing adequate care to patients as well as supporting responders in the fight against COVID-19. Currently, misconceptions and misinformation circulating on social media and with communities, gains made by the state government. There is a need to intensify awareness creation and education in the state, especially in remote villages.
This narrative was done in January 2021 as part of the #COVID19NigeriaStories documentation project on state-level responses to COVID-19, implemented by the Nigeria Centre for Disease Control and Nigeria Health Watch with support from the Ford Foundation.