COVID-19: the implications and consequences of prolonged lockdown and COVID-19 vaccine cost in a low-middle income country.

Lockdowns and just recently, the COVID-19 vaccines, are amongst the disease containment measures instituted globally to check the spread of COVID-19. Prolonged lockdowns are however, not sustainable in low resource economies like Nigeria, where up to 70% of her population live on less than a dollar a day, with the majority, either unemployed, or working in the private/informal sector and depending on daily earnings for survival. If the lockdown remains sustained, it would not be long before the largely poor citizens starve to death. Also, spending over US $3.9 billion on COVID-19 vaccines for more than 200 million Nigerians, as intended by the Nigerian government, is not plausible, given that neglected tropical diseases (NTDs) like Lassa fever, and other more common causes of morbidity and mortality, continue to kill more Nigerians than COVID-19. Public enlightenment of the populace on the need to strictly adhere to non-pharmacologic preventive measures, including social distancing, use of face masks, good personal hygiene, covering of the mouth and nose when coughing and sneezing, frequent hand washing and sanitizing with alcohol-based hand-sanitizers and disinfection of surfaces, is what is sustainable, feasible and compatible with the economic reality in our setting. As Sir Robert Hutchison, the highly revered doyen of medicine, wrote in his petition over 85 years ago, "And from making the cure of the disease more grievous than the endurance of the same, Good Lord, deliver us", we must be careful not to make the cure of COVID-19 worse than COVID-19 itself.