A public health response to the global COVID-19 pandemic: the Nigerian story January-May,2020

Background: The novel coronavirus disease (COVID-19) was reported in Wuhan China in December 2019. SARS-CoV-2 is of a zoonotic origin and is transmitted between humans via respiratory droplets and fomites. As COVID-19 spread globally, Nigeria instituted its pandemic preparedness measures in January 2020 preceding detection of its index case on February 28, 2020. We report the emergence of COVID- 19 in Nigeria, describing the public health response up till May 2020. Method: We reviewed the Nigeria's country-level response to COVID- 19 at the National level from January - May 2020. Results: The national public health response to the COVID-19 pandemic rapidly progressed from initial containment measures, with early closure of the international airspace and intensive contact tracing, to lockdown in high-burden states, closure of schools, nonessential businesses, and non-pharmaceutical interventions. A level three EOC was activated, the highest level of response in the country intended for public health measures. Following the ease of lockdown, mitigation strategies to address ongoing community transmission include increased testing, isolating all confirmed cases and tracing all contacts. By May 31, 2020, Nigeria had recorded 10,162 confirmed COVID-19 cases from all but one state, with three states Lagos, Kano and Federal Capital Territory, accounting for 64.5% of the cases. Conclusion: Nigeria launched a swift and aggressive response to COVID-19, leveraging on its existing epidemic preparedness and learning from other parts of the globe where transmission began earlier. Future response efforts are focused on targeted non-pharmaceutical interventions at sub-national level. Mobilizing local governments, civil society, and citizens to take ownership of these strategies in addition to a cohesive whole-of-government approach is critical to combating the pandemic in Nigeria. By rapidly implementing this set of interventions, Nigeria likely slowed down the rate of virus transmission and bought extra time to implement a robust case detection, testing, and treatment centre capacity. Key words: COVID-19, Nigeria, Pandemic, Response.