Despite the toll of almost a thousand deaths from COVID-19 complications, only 10 of the 36 states in Nigeria have teams of trained staff for handling COVID-19 burials, a report has found.

The latest Health Preparedness Index for states published by SBM, Nigeria’s leading intelligence platform, made this disclosure.

It is not clear yet how coronavirus infected bodies can transmit the virus, but forensic experts believe a lack of guidelines and contingency planning could trigger a chain infection, especially among mourners.

They believe that corpse mismanagement has serious implications for broader efforts to contain COVID-19, and for grieving families.

Nigeria recorded its first fatality from the virus about 24 days after its index case, an Italian national, was confirmed on February 28.

As of Saturday, the number of confirmed deaths from the virus had reached 997.

All the states in Nigeria and the federal capital, Abuja, have reported at least two fatalities.

The NCDC had put in place an interim guideline for the safe management of copies in the context of COVID-19.

According to the guideline, only burial team members that have been trained in Infection Prevention and Control (IPC) and safe burial practices can handle corpses and conduct burials. The team should have resources such as PPE, body bags, disinfectant and appropriate transportation.

The guidance document also stated how corpses should be prepared and conveyed by the burial team to ensure the safety of burial attendees.

The World Health Organisation (WHO) also issued an elaborate guide for COVID-19 burials.

Early signs of abuse of hygienic and physical distancing protocols during funerals came in April during the burial of President Muhammadu Buhari’s Chief of Staff, Abba Kyari.

Despite the government’s initial announcement that the burial would be conducted in private in compliance with safety guidelines, several clips showed brazen disregard of the NCDC guidelines and the WHO advisory at the event.

The Report

Majority of states are yet to constitute burial teams, the SBM report, containing data collated in late June, showed.

“It would mean that the backlog of the dead to be buried will keep rising, clogging temporary mortuary facilities across the country and creating a crisis to rival the challenges the country has faced with testing and contact tracing”, said Ikemesit Effiong, head of research, SBM Intelligence.

The report tagged ‘Nigeria’s COVID-19 journey, mid – 2020’ covered a range of health and economic issues in response to Nigeria’s fight against COVID-19, from health preparedness to economic measures designed to mitigate the effect of a prolonged lockdown.

The report identified measures by federal and state governments, highlighting a state by state health preparedness index.

According to the data, 26 states do not have at least a burial team and or identified and trained staff in place.

Of the 26 states, 17 do not have any of the above.

They include Nassarawa; Ogun; Osun; Oyo; Bayelsa; Enugu; Ebonyi; Anambra; Abia; Cross Rivers; Ekiti; Taraba; Ondo; Kogi; Kano; Imo; and Bauchi.

While the following nine states of Sokoto, Kebbi, Rivers, Yobe, Niger, Gombe, Adamawa, Delta, Jigawa, Akwaibom said they have a burial team, the researcher could not find any trained staff in the teams.

Only 10 states: Lagos, Borno, Kaduna, Edo, Katsina, Benue, Kwara, Plateau;and Zamfara have identified and trained a burial team, according to the report.

Lack of Cohesion

Health experts blame the lack of cohesion between the NCDC response strategy and that of the state governments for the gaps in dead body management which have been further exposed by the SBM report.

The NCDC is supposed to coordinate the national response to epidemics and pandemics. But the infectious disease outfit has not been able to work fully with state authorities.

States such as Cross River and Kogi have continued to dispute NCDC statistics on COVID-19 as state and federal officials have mutual suspicion.

Tolu Fakeye, a public health physician, said while states are to coordinate safe burials, it is the role of the NCDC to monitor the process.

“The problem is that the NCDC needs the buy-in of the 36 states – with differing concerns and contexts – to effectively execute a coherent COVID-19 burial strategy. It will be interesting to see if they can pull this off”, said Mr Effiong, the SBM researcher.