Summary
The first COVID-19 case in Nigeria was confirmed on 27th February, 2020 in Lagos. COVID-19 is caused by a virus that spreads through droplets released when an infected person coughs or sneezes. A person can become infected with this new coronavirus by being in close contact (within 2 metres) with a person infected with COVID-19. Infection can also spread by touching a surface that an infected person coughed or sneezed on.

Skilled public health teams, led by the Nigeria Centre for Disease Control, are monitoring the situation daily. The most important advice is for all schools to encourage their students to maintain good hand and respiratory hygiene to remain safe.

School proprietors, headmasters, and head mistresses must ensure that students have access to clean water and soap at all times while on the school premises. The best way for schools to avoid COVID-19 infection is to:

 Ensure students and teachers wash their hands frequently
 Show students how to cough or sneeze into a tissue, or to cough into their elbow if they cannot get tissue
 Clean and disinfect their premises often
 Encourage sick students and teachers to stay home

As of today (05/03/20), it is not necessary to close schools or to cancel large gatherings. Symptoms of COVID-19 are cough, shortness of breath, difficulty in breathing, fever, and muscle pain within 14 days of exposure to someone infected with the virus or returning from a country with ongoing community transmission.

If anyone has been in contact with a suspected case in a school, they should contact NCDC on 0800 9700 0010. While laboratory test results for COVID-19 are awaited, there is no need to close the facility or send students or staff home.

You can find the latest information and advice by contacting NCDC on:
 NCDC Toll-free Number: 080097000010
 SMS: 08099555577
 WhatsApp: 07087110839
 Website for additional resources: www.ncdc.gov.ng
 Twitter and Facebook: @NCDCgov

The Nigeria Centre for Disease Control offers the following guidance to schools and learning institutions in Nigeria:

1. WHAT IS COVID-19?
Coronaviruses are zoonotic, meaning they are normally transmitted between animals and people. The 2019 coronavirus disease (COVID-19) is a disease caused by a new strain of coronaviruses that has not been previously identified in humans. It was first detected on the 7th of January, 2020 in Wuhan, China. Some coronaviruses can be transmitted from person to person, usually after close contact with an infected patient, for example, in a household or healthcare setting. For this coronavirus disease (COVID-19), while most initial transmission appeared to be zoonotic, personto-person transmission is the most common mode of transmission currently.

2. WHAT ARE THE SYMPTOMS OF COVID-19?
The incubation period of COVID-19 is between 2 and 14 days. This is the time between when a person gets infected and when they start showing symptoms. If a person remains well 14 days after contact with someone with confirmed COVID-19, it is unlikely that they have been infected.

The following symptoms may develop in the 14 days after exposure to someone who has COVID19 infection:
 cough
 shortness of breath or difficulty in breathing
 fever
 muscle pain

Generally, these infections can cause more severe symptoms in people with weak immune systems, older people, and those with long-term conditions like diabetes, cancer and chronic lung disease. There is no evidence that children are more affected than other age groups –few cases have been reported in children.

3. HOW IS COVID-19 SPREAD?
The spread of COVID-19 is most likely to happen when there is close contact (within 2 metres) with an infected person. The risk increases the longer someone has close contact with an infected person. Droplets produced when an infected person coughs or sneezes (respiratory secretions) containing the virus are most likely to be the most common means of transmission.

There are two routes by which people could become infected:

 Secretions can be directly transferred into the mouths or noses of people who are nearby (within 2 metres) or could be inhaled into the lungs
 It is also possible that someone may become infected by touching a surface or object that has been contaminated with respiratory secretions (such as touching a doorknob or shaking hands with an infected) and then touching their own mouth, nose or eyes.

COVID-19 is spread only by people who have been exposed to the virus. People do not get sick with COVID-19 based on their nationality or any other characteristic!

4. HOW CAN YOU PREVENT THE SPREAD OF COVID-19?
The best way to prevent infection and spread of COVID-19 is to avoid being exposed to the virus by following basic hand and respiratory hygiene measures. The NCDC recommends that schools and other learning institutions take the following measures:

 Ensure that students and staff wash their hands often; it is advised that the teachers supervise younger children.
 Ensure that an alcohol-based sanitizer is made available at all entrances to the school.
 Students and teachers should cover their mouth and nose with tissue when coughing or sneezing. Throw the used tissue away into a closed bin and wash your hands. If you don’t have a tissue, cough or sneeze into your flexed (bent) elbow. Have tissues available. A demonstration should also be done on how to sneeze into their elbow if no tissue is available.
 Students and teachers who feel unwell should stay at home and should not attend school or any educational or public setting.
 Students, staff and visitors should wash their hands:

o before leaving home
o on arrival at school
o after using the toilet
o after breaks and sporting activities
o before preparing food
o before eating any food, including snacks
o before leaving school

 Avoid touching eyes, nose, and mouth with unwashed hands
 Avoid close contact with people who are unwell
 Schools should clean and disinfect frequently touched objects and surfaces
 Limit the number of visitors to your school; parents, care-givers and drivers should drop students off at the school entrance.

The only items you need in order to prevent the spread of COVID-19 are your usual household goods: soap, water, hand sanitizer, tissues, and everyday cleaning items. There are no medications or solutions you can take to prevent COVID-19. Taking medications or other measures may be harmful.

5. WHAT TO DO IF STUDENTS OR STAFF BECOME UNWELL AND SHOW SYMPTOMS OR BELIEVE THEY HAVE BEEN EXPOSED TO COVID-19 (EITHER THROUGH TRAVEL TO A COUNTRY WITH CONFIRMED CASES OR ONGOING COMMUNITY TRANSMISSION)

People who within 14 days before the onset of illness have returned from to any country* with confirmed or ongoing community transmission should contact NCDC immediately on 0800 9700 0010 and self-isolate (stay at home for 14 days on returning from one of these countries, before returning to school). Do not attend classes or an educational setting until after 14 days of return.

This measure will help protect your household and your local community. If a student becomes unwell, they should be taken to the school clinic/medical officer and a parent contacted. If they have a travel history to a country with confirmed cases or ongoing community transmission, proper procedures should be followed, notifying NCDC for further guidance.

If a staff member becomes unwell in the facility and they have a travel history to a country* with confirmed or ongoing community transmission of COVID-19, the individual should be kept in a room on his/her own, and NCDC notified.

Whilst you wait for advice from NCDC, ensure the student or staff member is isolated in a separate room, behind shut doors, reducing contact with other people. Keep the room they are in well ventilated. If they need to go to the bathroom whilst waiting for medical assistance, they should use a separate bathroom if available. Make sure that students know to tell a member of staff if they feel unwell.

6. WHAT TO DO IF A CASE OF COVID-19 (STUDENT OR STAFF) IS SUSPECTED IN YOUR SCHOOL
If anyone has been in contact with a suspect case in a school, they should contact NCDC on 0800 9700 0010. While laboratory test results for COVID-19 are awaited, there is no need to close the facility or send students or staff home. Until the outcome of test results is known there is no action that staff members need to take apart from ensuring basic hygiene advice is followed and school premises are kept clean and waste is disposed of. Once the results arrive, where tests are negative for COVID-19, parents will be advised and return to school classes as normal.

7. WHAT TO DO IF A CASE OF COVID-19 (STUDENT OR STAFF) IS CONFIRMED IN YOUR SCHOOL
NCDC will contact the school to discuss the case, identify people who had been in contact with the student or staff member, and advise on actions or precautions that should be taken. Appropriate measures to isolate and identify other contacts will be advised. NCDC will be in touch with any contacts of the patient to provide them with appropriate advice. Advice on cleaning of communal areas such as classrooms, changing rooms and toilets will be given by NCDC.

If there is a confirmed case, a risk assessment will be undertaken by the school with advice from NCDC. Closure of the educational setting will be advised based on the findings of the risk assessment.

8. WHAT TO DO IF STUDENTS OR STAFF IN YOUR INSTITUTION ARE CONTACTS OF A CONFIRMED CASE OF COVID-19 WHO WAS SYMPTOMATIC WHILE ATTENDING YOUR SCHOOL
The definition of a contact includes:
 any student or staff member in close face-to-face or touching contact including those
undertaking small group work (within 2 metres of the case for more than 15 minutes)
 talking with or being coughed on for any length of time while the individual is symptomatic
 anyone who has cleaned up any of the bodily fluids of the individual
 close friendship groups
 any student or staff member living in the same household as a confirmed case, or equivalent setting such as boarding school dormitory or other student accommodation

Contacts are not considered cases and if they are well, they are very unlikely to have spread the
infection to others, however:

 they should be asked to self-isolate at home, or within their boarding school dormitory room,
for 14 days from the last time they had contact with the confirmed case
 they will be actively followed up by NCDC
 if they develop any symptoms within their 14-day observation period they should contact NCDC
on 0800 9700 0010
 if they become unwell with cough, fever or shortness of breath they will be tested for COVID19
 if they are unwell at any time within their 14-day observation period and they test positive for COVID-19, they will become a confirmed case and will be treated for the infection.

Family and friends who have not had close contact (as listed above) with the original confirmed case do not need to take any precautions or make any changes to their own activities such as limiting attendance at school or work, unless they become unwell.

If a confirmed case occurs in a school, NCDC will provide further advice and will work with the headteacher, principal and or proprietor for further guidance. Outside those that are defined as close contacts, the rest of the school does not need to take any precautions, apart from basic hand and respiratory hygiene practices. No further changes to activities linked with attending school or work as usual, unless they become unwell, will be necessary.

9. WHERE DO I GET ACCURATE INFORMATION FROM?
Be aware that media speculation is common about COVID-19 and not everything you read in the newspapers or online, or hear is accurate or verified. Trusted and accurate information will always be released by the Federal Ministry of Health or the Nigeria Centre for Disease Control. You can find the latest information and advice by contacting NCDC on:

 NCDC Toll-free Number: 0800-97000010
 SMS: 08099555577
 WhatsApp: 07087110839
 Website for additional resources: www.ncdc.gov.ng
 Twitter and Facebook: @NCDCgov

After self-isolation and there are no symptoms, individuals can return to work, school and everyday activities. Tests are not necessary and should only be done in the case where the individual has symptoms and meets the case definition.

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