As Bangladesh is experiencing record-breaking Covid cases, experts think ‘health emergency’, ‘nighttime curfew’ and area-based lockdown can be the right measures to slow down the virus transmission.

They think the 18-point directive issued by the government on Monday is not enough as the coronavirus situation is going from bad to worse with both high infection and mortality rates in the country.

The experts warned that Bangladesh may experience an ‘explosive’ Covid situation in the coming months, breaking down the already overwhelmed medical system, if unnecessary public movements and mass gatherings cannot be controlled with the strict enforcement of laws.

They also suggested ramping up contact tracing, mass testing, expanding ICU capacity and ensuring necessary treatment facilities and equipment in every hospital, including upazila health complexes, since the Directorate General of Health Services (DGHS) has identified 31 districts as risky for the virus outbreak with a high infection rate.

Directives not matching with ground realities

Public health expert MH Chowdhury (Lenin), chairman of the medicine department at Health and Hope Hospital, the government’s directives are inconsistent with the coronavirus transmission pace.

“When it’s necessary to stop all the social and political gatherings right now, it was said to be discouraged in the directives. When a nighttime curfew should be enforced from 6pm, people are only asked not to come out of their homes unnecessarily. The shopping malls should be allowed to remain open for at best six hours on a limited scale, but the government said both sellers and buyers in shopping malls must follow the health rules,” he said.

MH Chowdhury said all types of mass gatherings should be controlled strictly, but the government asked to hold public exams maintaining health hygiene rules, which is not possible.

 “People are discouraged to go to tourist and recreation spots, movie houses and theatres, and all kinds of fairs. But the Ekushey Book Fair is going on in full swing,” he pointed out.

Dr Lenin said the government has instructed all to maintain health safety rules in public transport, but people do not do that for lack of monitoring. “Strong enforcement of law is necessary to force people to abide by those rules.”

Dr Be-Nazir Ahmed, former director (disease control) of the DGHS, said, “The directives are not time-befitting and consistent with the current pandemic situation. “These instructions should have been given at least one month back when the virus cases started surging.”

Dr Be-Nazir said when elections can be held amid such a situation how the government can ask people not to arrange social programmes and mass gatherings.

Also read: Covid-19: Bangladesh’s caseload now 529,031, fatalities 7,942

The health expert said the government has given a directive to shift kitchen markets to open places, but the shopping malls will remain open. “When people can go to shopping malls in enclosed areas, where’s the problem if they visit the kitchen markets?

“I think the directives have not been formulated considering the severity of the current Covid situation. So, these directives may not help contain the virus outbreak.  We should take the corona situation seriously and come up with serious actions. Or else, we’ll have to pay a heavy price in the days to come.”

What can be done?

Dr Be-Nazir said all-types of mass gatherings and unnecessary public movement must be stopped to overcome the situation.

Also read: Covid-19: Bangladesh sees 1568 new cases, 18 deaths

 “We should announce a health emergency by forming a high-powered committee to enforce it by taking necessary decisions to tackle the situation. The committee should be given the power to issue orders to curtail different services and close shops, offices and restaurants, to involve any organisation in healthcare management. “Adequate funds should be allocated so that the committee can take necessary preventive and curative measures.”

He said the committee should also be empowered to convert any community centre, convention centre, hotel or other institutions into temporary hospitals, quarantine or isolation centres.

The expert said the government should engage police, Rab, Ansar, BGB and even the army to enforce the health emergency.  “A situation should be created so that people don’t venture out of home without masks and any valid reason.”

 

Suspending Book Fair

Dr Lenin said the Ekushey Book Fair should be suspended for at least two weeks while the tourist and recreation spots, movie houses and theatres should be closed right now as part of a move to control mass gatherings and mass movement.

He said people have long been asked to wear masks, but they are not paying heed to it. “So, a heavy fine should be realised from those who don’t wear masks.”

Imposing curfew, lockdown

Dr Lenin said putting the entire country under lockdown is the last weapon to control the mass gatherings, but it will harm the economy badly. “So, we should use other preventative measures like a curfew from 6pm to 6am to control the situation.”

Besides, he said, the government should identify the areas where the infection rate is very high and declare those as ‘red zones’.

Also read: Covid-19 in Bangladesh: Fatalities climb to 8,476

 “We need to now enforce area-based lockdown in the red zones. The situation has reached such a level that we won’t be able to control the infection rate without controlling the movement of people in corona hotspots.”

 Adopting Virtual Office

Lenin said the offices that can be run online should take immediate steps to keep their employees at home. “Other offices that can’t be run through online should follow skeleton duty schedules to lessen the presence of their staff.”

“The main thing is that we must control the mass movement and mass gathering as much as possible. We should take all possible steps in this regard. Or else, the pandemic will take a tsunami turn in Bangladesh.”

Focusing on Healthcare 

Prof Muzaherul Huq, a former adviser to WHO South-East Asia region, said the government should take all-out steps to tackle a worse situation in the days to come by ensuring proper treatment facilities in all the district and upazila hospitals since the virus case has been gradually growing across the country.

“If the virus continues to spread for two more weeks, it’ll put a serious pressure on the healthcare system. The Prime Minister has issued an instruction to ensure ventilators and ICU beds in every district hospital. The government should implement this instruction immediately. There should be sufficient oxygen supply and other necessary equipment in all the upazila health complexes to deal with the Covid patients,” he said.

Prof Huq said the Covid patients must be identified quickly and kept in isolation centres. “We also need to locate people who come in contact with the Covid patients and quarantine them.”