Background
Since the coronavirus disease (COVID-19) was first reported in Wuhan,
China in December 2019, it has spread rapidly across the globe, leading
to over a million confirmed cases in three months. On the 27th of February
2020, Nigeria confirmed its first case of COVID-19. Since then, the number of
confirmed cases has gradually increased, with more sporadic cases reported
across more states in Nigeria.
Nigeria is a densely populated country with about 200 million people across
774 Local Government Areas (LGAs) in 36 states and the Federal Capital
Territory (FCT). This context and other socio-economic factors make the
country particularly vulnerable for a highly transmissible virus such as SARS-
CoV-2 to spread.
According to the World Health Organization (WHO), medical face masks
should be worn primarily by people who show symptoms of COVID-19, health
workers and people who are taking care of people with COVID-19 in close
settings (at home or in a health care facility). The Nigeria Centre for Disease
Control recommends the use of face masks by members of the public, as an
optional additional layer and not as a compulsory measure, in addition to
physical distancing, hand and respiratory hygiene measures in Nigeria. This
is not a compulsory advisory, but it is an added recommendation in addition
to the above measures.
Principles of prevention of COVID-19
SARS-CoV-2, the virus that causes COVID-19 is most frequently transmitted
from one person to another, through droplets from coughing or sneezing. The
virus can also be transmitted by touching surfaces that have been infected
(e.g., door handles, countertops) or more rarely, from singing or speaking
loudly.
Given what is understood about this new virus, the Nigeria Centre for Disease
Control has advised on the following measures to prevent transmission:
• Physical distancing – i.e. people should keep a minimum distance of
2 metres from one another
Handwashing with soap and water should be performed as
frequently as possible or using an alcohol-based sanitizer where
no water is available.
• If someone is coughing or sneezing, they should cover their cough,
using a disposable tissue and discarding in a waste bin and washing their
hands or using their bent elbow.
• Normal practices like greeting one another with handshakes or
hugging should be avoided.
Evidence relating to the community use of masks for
prevention of COVID19
Globally, there is ongoing debate on the effectiveness of masks as a
preventive measure for the coronavirus disease. The evidence in favour of
the use of masks includes the possibility of asymptomatic (a person never
develops symptoms) and pre-symptomatic (before a person develops signs
and symptoms) transmission and emerging evidence of the ability of a mask
to prevent contact with respiratory droplets. Ecological comparisons also
appear to suggest better outcomes in countries that have used masks as a
general policy. Sources of concern have been that people who wear face
masks may feel protected and ignore physical distancing advice. In addition,
if face masks are not worn correctly, disposed of appropriately or if people
touch their faces more frequently due to adjustments of the face masks they
are wearing, they run a higher risk of infecting themselves.
Increased anxiety among the public
The daily real-time reporting of the COVID-19 pandemic has heightened
panic and fear in people, as the numbers of cases and deaths recorded
globally continues to increase. There is a lot that remains unknown about
this disease. Authorities and scientists do not yet have all the answers to the
many questions being asked. The instinct for self-preservation and protection
from harm and the basic need to survive has brought about a need for self-
defence against this novel virus. Many people will be resorting to the use of
face masks to gain some control and confidence in their ability to protect
themselves (and family) from contracting the coronavirus disease.
Recommendations
In view of these, the Nigeria Centre for Disease Control offers the following
advice to members of the public:
1. The wearing of face masks, (or equivalent) is recommended as an optional
additional layer to be used in addition to other measures such as physical
distancing, hand and respiratory hygiene measures in Nigeria. The
primary rationale for the advice on face masks is to prevent those who
are infected but asymptomatic from spreading the virus. Masks have to
be properly disposed of in waste bins. Improper handling and frequently
touching masks can increase the risk of infection. Improvised masks are
also an option – as long as they are properly washed regularly. They can
be made out of cloth or other materials.
2. The usage of face masks is particularly advised while attending large
gatherings (where it is absolutely necessary to attend). These include but
are not limited to shopping outlets, markets, shops and pharmacies among
others.
3. Given the global shortage of personal protective equipment including
medical masks, public sector resources should be preserved to procure
medical masks for patients and healthcare workers who need them the
most.
4. The wearing of face masks alone will not protect against COVID-19, but
must be combined with physical distancing, handwashing, respiratory
hygiene, cleaning and disinfecting frequently touched surfaces and other
advice from NCDC.
5. Older persons (> 60) with existing medical conditions such as diabetes
are particularly encouraged to wear masks as they are at higher risk
of infection. It is also further advised that face masks are used by more
vulnerable members of the society, citizens with ongoing respiratory
problems, and those already exhibiting symptoms and awaiting testing.
It is important to remember that the usage of face masks alone cannot be
relied upon to avoid the COVID-19 virus; physical distancing, hand and
respiratory hygiene measures are necessary for protection from the virus.
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