There will no longer be handshakes or other personal contact at Mass, Catholic Church authorities in Lagos State announced this week, amid growing fears that the deadly coronavirus could be spreading in Nigeria, a regional economic hub and Africa’s most populous nation.
The church’s announcement comes after Lagos State confirmed its first case of the respiratory virus. The timing is not great. The Lenten season has begun, and more Nigerians are likely to attend religious gatherings. To stall a possible outbreak, however, Archbishop Alfred Martins of the Archdiocese of Lagos said contact should be restricted: Holy Communion must now be received on the palm, rather than on the tongue, and priests across the state must halt the sprinkling of holy water for now.
“We have to take proactive steps to protect ourselves from infection,” Archbishop Martins said in a statement on Saturday. “To reduce the number of gatherings in church to the barest necessary, we encourage people to do Stations of the Cross privately on Wednesdays while public celebrations will take place only on Fridays.”
Nigeria is the first country in sub-Saharan Africa to confirm a case of the novel coronavirus, known as Covid-19. The virus, which originated in Wuhan, China, has spread to over 70 countries; more than 87,000 people have fallen ill, and some 3,000 have died since January.
“We have to take proactive steps to protect ourselves from infection,” Archbishop Martins said. “To reduce the number of gatherings in church to the barest necessary, we encourage people to do Stations of the Cross privately on Wednesdays while public celebrations will take place only on Fridays.”
An outbreak in Lagos, a city of 20 million, would be devastating, health experts here say.
On Feb. 27, an Italian man working for a cement company in Nigeria tested positive for the virus, Nigeria’s health ministry said, dashing hopes that the virus could be kept out of a region where health services are already stretched thin because of malaria and other serious illnesses. Health workers in Nigeria have their plates full combatting Lassa fever, a viral hemorrhagic illness that is contracted through exposure to rodent droppings. The Lassa virus, endemic in west Africa, has killed some 132 people in Nigeria since an outbreak in January that has spread to 11 states.
The coronavirus case in Lagos was confirmed just two days after the Nigeria Center for Disease Control and other health agencies conducted training with health teams from all over Africa on handling the disease. Officials are now scrambling to trace and isolate a possible chain of transmission: those who were on the same flight as the Italian patient and those he came in contact with after—some 100 people in total. The Italian man flew in from Milan on Feb. 24 and was quarantined two full days later. During that time he had traveled to a location outside Lagos and fallen sick before he was transferred to a containment facility in the city.
“His condition is stable,” health minister Osagie Ehanire told reporters, emphasizing that the patient is being monitored and that there was no need to panic.
But his statement did little to ease the high levels of anxiety wracking Lagos, where people spend commuting hours in extremely close quarters. As the news broke over the weekend, hundreds flooded stores to purchase hand sanitizers and masks. Stocks sold out in markets across the city even as prices doubled.
Nigerian authorities, who had long anticipated potential cases arriving from China, were blindsided by the case from Italy, now the coronavirus epicenter in Europe. Nigeria legislators, trying to stop the virus from entering the country, had voted down motions to repatriate Nigerian citizens now stranded in China, and health workers had been rigorously screening passengers arriving on flights from Wuhan.
The World Health Organization listed 13 African countries, including Nigeria, as high-priority states because of the large volume of travel to and from China—Africa’s biggest trading partner. Twenty-six cases have been confirmed on the continent so far, many of them just this week. In Algeria, 17 people have contacted the virus. There are five more cases reported in Egypt, Morocco and Tunisia to the north and another four in Nigeria and Senegal to the west.
Nigerian officials are now scrambling to trace and isolate a possible chain of transmission: those who were on the same flight as the Italian patient and those he came in contact with after.
African states are cooperating at the continental level to battle the virus. The Africa Center for Disease Control activated emergency protocols in January, prompting African health ministers to meet and agree on common response strategies, rapid detection being the main focus.
And while there is still limited testing capacity, W.H.O. said it has helped to increase the number of countries that can test for potential cases to 26 from just two in January. Senegal, which confirmed a second case early on March 4, is well positioned to manage the virus because of the presence of its leading biomedical research center, Institut Pasteur de Dakar. Africa C.D.C. is working with health teams from around the continent, training them and distributing test kits to help with detecting the coronavirus.
Those countries without the capacity to test for the virus are keen to prevent the disease from popping up on their doorsteps. Tanzanian officials said 2,000 trained health officials and a number of isolation facilities are on standby. And Uganda, battle-tested by its efforts to contain the Ebola outbreak that raged in the neighboring Democratic Republic of Congo, increased airport surveillance and testing. Officials have isolated almost 700 people entering the country’s Entebbe International Airport, including more than 450 Chinese nationals.
Other countries are taking more direct action. Rwandair, South Africa Airways, Egypt Air and Morocco’s Royal Air have suspended flights to China altogether. But Ethiopia Airlines, which shuttles about 1,500 people between the capital Addis Ababa and China, has continued to operate despite criticism and pressure from Ethiopia’s neighbors to suspend flights.
“Our worry as a country is not that China cannot manage the disease,” Kenya’s President Uhuru Kenyatta said, reacting to the airline’s announcement to keep flying to China. “Our biggest worry is diseases coming into areas with weaker health systems like ours.”
Still, experts say some African countries, particularly Nigeria, are well-equipped to deal with viral outbreaks. When Ebola struck West Africa in 2014 and killed thousands in neighboring Liberia and Sierra Leone, Nigeria’s health officials sprang into action, doggedly tracking and isolating exposed persons. The virus was squashed in three months and mortality was mercifully low. The country’s health officials are confident that the Ebola crisis provided enough experience for its teams to manage a coronavirus outbreak.
“Africa has learned from the last Ebola outbreak. I will say we are better prepared today than in 2014 when we had Ebola,” said Dr. Abimbola Bowale, the medical director of the Mainland Infectious Diseases Hospital Yaba, where the Italian patient is now quarantined. Dr. Bowale was on the team that led the intervention against Ebola. After the 2014 crisis, Lagos State built the biocontainment facility where this first coronavirus victim was transferred, he told America.
Betty Nicholas, a 26-year-old Lagos resident, said the church is also falling back on emergency measures established during the Ebola outbreak. Ms. Nicholas, who attends St. Gerald Church in Gbagada, a Lagos suburb, said it has been easy to fall back into the preventative routines previously used to contain Ebola: Utilizing sanitizer dispensers that have reappeared at the church’s doorways, listening attentively to safety tips offered between sermons and avoiding contact with other parishioners. “We now just put our hands together and bow rather than hug each other. And when we meet for church gatherings and meetings, they’re less crowded and as short as possible.”
Ms. Nicholas said the measures are reducing panic levels, but many are choosing not to take any chances. “The last service was not as full,” she added. “Some people came wearing full face masks and gloves.”
Correction, March 6 (5:03 p.m. EST): This article has been updated to reflect the end of the Ebola outbreak in the Democratic Republic of Congo on March 3, which the original report suggested was ongoing.