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Covid-19 Outbreak in Nigeria Is Just One of Africa’s Alarming Hot Spots Covid-19 Outbreak in Nigeria Is Just One of Africa’s Alarming Hot Spots
(about 20 hours later)
DAKAR, Senegal — In the northern Nigerian city of Kano, some people say they now get four or five death notices on their phones each day: A colleague has died. A friend’s aunt. A former classmate.DAKAR, Senegal — In the northern Nigerian city of Kano, some people say they now get four or five death notices on their phones each day: A colleague has died. A friend’s aunt. A former classmate.
The gravediggers of the city, one of the biggest in West Africa, say they are working overtime. And so many doctors and nurses have been infected with the coronavirus that few hospitals are now accepting patients.The gravediggers of the city, one of the biggest in West Africa, say they are working overtime. And so many doctors and nurses have been infected with the coronavirus that few hospitals are now accepting patients.
Officially, Kano has reported 753 cases and 33 deaths attributed to the virus. But in reality, the metropolis is experiencing a major, unchecked outbreak, according to doctors and public health experts. It could be one of the continent’s worst.Officially, Kano has reported 753 cases and 33 deaths attributed to the virus. But in reality, the metropolis is experiencing a major, unchecked outbreak, according to doctors and public health experts. It could be one of the continent’s worst.
The coronavirus has been slower to take hold in Africa than on other continents, according to the numbers released daily by the World Health Organization.The coronavirus has been slower to take hold in Africa than on other continents, according to the numbers released daily by the World Health Organization.
But blazing hot spots are beginning to emerge. Kano is only one of several places in Africa where a relatively low official case count bears no resemblance to what health workers and residents say they are seeing on the ground.But blazing hot spots are beginning to emerge. Kano is only one of several places in Africa where a relatively low official case count bears no resemblance to what health workers and residents say they are seeing on the ground.
In Somalia’s capital, Mogadishu, officials say that burials have tripled. In Tanzania, after cases suddenly rose and the United States Embassy issued a health alert, the Tanzanian government abruptly stopped releasing its data.In Somalia’s capital, Mogadishu, officials say that burials have tripled. In Tanzania, after cases suddenly rose and the United States Embassy issued a health alert, the Tanzanian government abruptly stopped releasing its data.
Kano’s state government, until recently, claimed a spate of unusual deaths was caused not by the coronavirus, but by hypertension, diabetes, meningitis or acute malaria. There is little social distancing, and few people are being tested.Kano’s state government, until recently, claimed a spate of unusual deaths was caused not by the coronavirus, but by hypertension, diabetes, meningitis or acute malaria. There is little social distancing, and few people are being tested.
“The leadership is in denial,” said Usman Yusuf, a hematology-oncology professor and the former head of Nigeria’s national health insurance agency. “It’s almost like saying there is no Covid in New York.”“The leadership is in denial,” said Usman Yusuf, a hematology-oncology professor and the former head of Nigeria’s national health insurance agency. “It’s almost like saying there is no Covid in New York.”
He said he thought a significant portion of the population was probably infected in Kano, a city with an estimated five million people (though there has been no census since 2006).He said he thought a significant portion of the population was probably infected in Kano, a city with an estimated five million people (though there has been no census since 2006).
Though they have now acknowledged they have a problem with Covid-19, the disease caused by the coronavirus, the authorities in Kano spent precious weeks denying it, despite the surge in what Abdullahi Umar Ganduje, the state governor, called “mysterious deaths.”Though they have now acknowledged they have a problem with Covid-19, the disease caused by the coronavirus, the authorities in Kano spent precious weeks denying it, despite the surge in what Abdullahi Umar Ganduje, the state governor, called “mysterious deaths.”
“So far, there’s been nothing to suggest that they are linked with Covid-19,” Mr. Ganduje posted on Twitter on April 27, when, according to doctors in Kano’s hospitals, the city was already firmly in the grip of a serious coronavirus outbreak.“So far, there’s been nothing to suggest that they are linked with Covid-19,” Mr. Ganduje posted on Twitter on April 27, when, according to doctors in Kano’s hospitals, the city was already firmly in the grip of a serious coronavirus outbreak.
There was nothing mysterious about what doctors said they were seeing at Aminu Kano Teaching Hospital, the city’s main public hospital. Starting well before Kano’s first case was reported on April 11, the hospital saw a steady stream of older patients with fevers, coughs, difficulty breathing and low oxygen saturation levels, many of them with underlying health conditions.There was nothing mysterious about what doctors said they were seeing at Aminu Kano Teaching Hospital, the city’s main public hospital. Starting well before Kano’s first case was reported on April 11, the hospital saw a steady stream of older patients with fevers, coughs, difficulty breathing and low oxygen saturation levels, many of them with underlying health conditions.
Doctors at the hospital called the government’s response team. Sometimes it took 24 hours to get a call back. Sometimes, the team refused to test or isolate patients, saying they did not qualify because they had not traveled recently.Doctors at the hospital called the government’s response team. Sometimes it took 24 hours to get a call back. Sometimes, the team refused to test or isolate patients, saying they did not qualify because they had not traveled recently.
About 60 to 70 percent of the elderly patients who went to the hospital and later died had arrived with full symptoms of Covid-19, said a doctor in the medical department, who, along with another doctor, spoke on condition of anonymity because they feared retribution.About 60 to 70 percent of the elderly patients who went to the hospital and later died had arrived with full symptoms of Covid-19, said a doctor in the medical department, who, along with another doctor, spoke on condition of anonymity because they feared retribution.
One doctor said the department’s death registers for April showed far more patients had died than normal. Most patients were sent home, he said, and the hospital’s staff members often would hear later that they had died.One doctor said the department’s death registers for April showed far more patients had died than normal. Most patients were sent home, he said, and the hospital’s staff members often would hear later that they had died.
With no personal protective equipment except surgical masks, the doctors said they knew the risks they were running in treating these patients. They said that they begged the hospital management for N-95 masks, face shields, gloves and aprons, but that none came. They asked for an isolation center at the hospital, scared that patients with other ailments would be infected. They wanted the facilities fumigated. Nothing happened.With no personal protective equipment except surgical masks, the doctors said they knew the risks they were running in treating these patients. They said that they begged the hospital management for N-95 masks, face shields, gloves and aprons, but that none came. They asked for an isolation center at the hospital, scared that patients with other ailments would be infected. They wanted the facilities fumigated. Nothing happened.
And then it was too late. The doctors began to get sick.And then it was too late. The doctors began to get sick.
“All of us were exposed,” said the other doctor. “Ultimately, what we feared has happened.”“All of us were exposed,” said the other doctor. “Ultimately, what we feared has happened.”
Twenty of the 91 doctors in the hospital’s medical department tested positive, the doctors said. Overall in Kano, 42 doctors and 28 nurses have tested positive, and one doctor has died, according to Dr. Sanusi Bala, chairman of the Kano branch of the Nigerian Medical Association. Laboratory technicians in what was then Kano’s only testing laboratory got sick too, and it closed for several days. The city’s health system, already extremely limited, was crippled.Twenty of the 91 doctors in the hospital’s medical department tested positive, the doctors said. Overall in Kano, 42 doctors and 28 nurses have tested positive, and one doctor has died, according to Dr. Sanusi Bala, chairman of the Kano branch of the Nigerian Medical Association. Laboratory technicians in what was then Kano’s only testing laboratory got sick too, and it closed for several days. The city’s health system, already extremely limited, was crippled.
Nigeria, a country of about 200 million people, says it can in theory do 2,500 tests a day, and Kano up to 500. But it has been conducting far fewer tests, typically 1,000 to 1,200 daily. Test results in Kano can take two weeks. Doctors awaiting their test results cannot go to work. People in quarantine cannot leave.Nigeria, a country of about 200 million people, says it can in theory do 2,500 tests a day, and Kano up to 500. But it has been conducting far fewer tests, typically 1,000 to 1,200 daily. Test results in Kano can take two weeks. Doctors awaiting their test results cannot go to work. People in quarantine cannot leave.
“If I say thousands of people are dying from Covid, I don’t think I exaggerated the figure,” said the doctor who begged for P.P.E. “So many people are dying without being tested, without even going to the hospital.”“If I say thousands of people are dying from Covid, I don’t think I exaggerated the figure,” said the doctor who begged for P.P.E. “So many people are dying without being tested, without even going to the hospital.”
While the government loosened lockdowns on May 4 in the capital, Abuja, and biggest city, Lagos, it extended the one in Kano. But few people observe it. The many funerals are well attended, residents said.While the government loosened lockdowns on May 4 in the capital, Abuja, and biggest city, Lagos, it extended the one in Kano. But few people observe it. The many funerals are well attended, residents said.
Many in the city think the coronavirus is a hoax, perhaps because public messaging about it is mostly in English, which most Kano residents do not speak, health experts said.Many in the city think the coronavirus is a hoax, perhaps because public messaging about it is mostly in English, which most Kano residents do not speak, health experts said.
Others believe that a Covid-19 diagnosis is a death sentence, the experts said, and do not want their neighbors to think they are infected. So they avoid being tested, and try to behave as if all is normal.Others believe that a Covid-19 diagnosis is a death sentence, the experts said, and do not want their neighbors to think they are infected. So they avoid being tested, and try to behave as if all is normal.
They go to burials, and shake fellow mourners’ hands because it would be socially unacceptable not to. They shop, barefaced, in crowded markets. They hold soccer tournaments — a recent one was called the “Coronavirus Cup.”They go to burials, and shake fellow mourners’ hands because it would be socially unacceptable not to. They shop, barefaced, in crowded markets. They hold soccer tournaments — a recent one was called the “Coronavirus Cup.”
While the situation in Kano is grim, the picture varies greatly from one country in Africa to another.While the situation in Kano is grim, the picture varies greatly from one country in Africa to another.
From the numbers gathered by the World Health Organization and other groups, Djibouti, in East Africa, looks as if it has the highest infection rate per capita on the continent, at 1 in 746 people. But public health officials interviewed there attribute that to aggressive testing and contact tracing. Anyone who tests positive is hospitalized, even if no symptoms are apparent.From the numbers gathered by the World Health Organization and other groups, Djibouti, in East Africa, looks as if it has the highest infection rate per capita on the continent, at 1 in 746 people. But public health officials interviewed there attribute that to aggressive testing and contact tracing. Anyone who tests positive is hospitalized, even if no symptoms are apparent.
Tanzania has reported 509 cases, but it stopped releasing data two weeks ago, and the United States Embassy there said on Wednesday that the risk of contracting Covid-19 was “extremely high.” A government spokesman told the BBC that testing had been suspended while the authorities investigated the many testing kits, but denied that Tanzania was doing too little to stop the virus’s spread.Tanzania has reported 509 cases, but it stopped releasing data two weeks ago, and the United States Embassy there said on Wednesday that the risk of contracting Covid-19 was “extremely high.” A government spokesman told the BBC that testing had been suspended while the authorities investigated the many testing kits, but denied that Tanzania was doing too little to stop the virus’s spread.
In Somalia, more than 1,200 people have tested positive and, officially, 53 have died. But doctors, officials and humanitarian workers think these numbers are way off. Thousands of people with the virus are staying home and not getting tested, they say.In Somalia, more than 1,200 people have tested positive and, officially, 53 have died. But doctors, officials and humanitarian workers think these numbers are way off. Thousands of people with the virus are staying home and not getting tested, they say.
The office of the Somali prime minister, which is overseeing the response to the outbreak, has dismissed the notion of a hidden toll, saying Mogadishu has already reached its peak.The office of the Somali prime minister, which is overseeing the response to the outbreak, has dismissed the notion of a hidden toll, saying Mogadishu has already reached its peak.
Dr. Mohamed Abdi Hassan, who is leading the medical response to Covid-19 at the prime minister’s office, said that “there might be cases here and there that abruptly died and then were buried,” but that the number of instances in which people had died of the coronavirus without being tested had been exaggerated. “We have as much as possible captured the real picture.”Dr. Mohamed Abdi Hassan, who is leading the medical response to Covid-19 at the prime minister’s office, said that “there might be cases here and there that abruptly died and then were buried,” but that the number of instances in which people had died of the coronavirus without being tested had been exaggerated. “We have as much as possible captured the real picture.”
Updated June 5, 2020Updated June 5, 2020
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
In Nigeria, some say that with the outbreak in Kano so widespread, the city may already be home to a giant, unintentional experiment in herd immunity.In Nigeria, some say that with the outbreak in Kano so widespread, the city may already be home to a giant, unintentional experiment in herd immunity.
“The disease is taking its natural course,” said Dr. Faruk Sarkinfada, a medical microbiologist who works in Kano.“The disease is taking its natural course,” said Dr. Faruk Sarkinfada, a medical microbiologist who works in Kano.
Eighty percent of tests conducted in the city are coming back positive, a presidential task force sent to Kano in late April told the BBC’s Hausa-language service.Eighty percent of tests conducted in the city are coming back positive, a presidential task force sent to Kano in late April told the BBC’s Hausa-language service.
But since no one trusts the official reports, Kano’s citizens have come up with their own ways of gauging the toll of the virus.But since no one trusts the official reports, Kano’s citizens have come up with their own ways of gauging the toll of the virus.
Nazir Adam Salih, a writer and engineer, conducted an impromptu survey of more than 100 acquaintances. Almost all said they had fever, cough and loss of smell. Almost none had gotten tested or treated.Nazir Adam Salih, a writer and engineer, conducted an impromptu survey of more than 100 acquaintances. Almost all said they had fever, cough and loss of smell. Almost none had gotten tested or treated.
Doctors phone relatives of the dead to conduct “verbal autopsies.”Doctors phone relatives of the dead to conduct “verbal autopsies.”
By late April, the Kano state government finally admitted there was a Covid-19 problem and asked the federal government for help. Dr. Sarkinfada, the medical microbiologist, said that the federal government focused its efforts on increasing Kano’s testing capacity, and that test results were now coming in sooner.By late April, the Kano state government finally admitted there was a Covid-19 problem and asked the federal government for help. Dr. Sarkinfada, the medical microbiologist, said that the federal government focused its efforts on increasing Kano’s testing capacity, and that test results were now coming in sooner.
“The Kano situation has seen us through deception, denial, defiance, denunciation, disagreement and finally acceptance and action to control the disaster,” said Oyewale Tomori, a virologist who leads a Nigerian government committee on Covid-19.“The Kano situation has seen us through deception, denial, defiance, denunciation, disagreement and finally acceptance and action to control the disaster,” said Oyewale Tomori, a virologist who leads a Nigerian government committee on Covid-19.
Kano’s location, population and connectivity to the rest of the region mean the consequences of an uncontrolled outbreak could be severe.Kano’s location, population and connectivity to the rest of the region mean the consequences of an uncontrolled outbreak could be severe.
Already there are reports of hundreds more people dying “mysterious deaths” in Nigeria’s northern states of Jigawa, Yobe, Sokoto and Katsina, including three emirs, or traditional Muslim rulers, and a former health minister.Already there are reports of hundreds more people dying “mysterious deaths” in Nigeria’s northern states of Jigawa, Yobe, Sokoto and Katsina, including three emirs, or traditional Muslim rulers, and a former health minister.
“If Kano falls, the whole of northern Nigeria falls. The whole of Nigeria falls,” Dr. Yusuf said. “It spreads into the whole of West Africa and the whole of Africa.”“If Kano falls, the whole of northern Nigeria falls. The whole of Nigeria falls,” Dr. Yusuf said. “It spreads into the whole of West Africa and the whole of Africa.”
Abdi Latif Dahir contributed reporting from Nairobi, Kenya, and Simon Marks from Addis Ababa, Ethiopia.Abdi Latif Dahir contributed reporting from Nairobi, Kenya, and Simon Marks from Addis Ababa, Ethiopia.