Health Minister
Vexed over vaccines
The Directorate General of Health Services announced this week that Bangladesh’s stock of Covid-19 vaccines was running out, with only some 1.4 million jabs remaining in government hands. Given the current crisis in India, there is little to no hope of receiving the next consignment in accordance with the contract signed between Beximco Pharmaceuticals and the Serum Institute of India anytime soon.
Speaking at a virtual press briefing, DGHS spokesperson Robed Amin said, “We had around 10.02 million vaccine doses in our hands…around 8.8 have already been administered as the first and second doses. Now we have some 1.4 million doses in stock.”
He went on to warn that there would be a vaccine crisis if a fresh consignment does not arrive in the country before the existing stock is exhausted. Robed said around 5.8 million people have so far received the first dose of the vaccine while 3 million of them have got the second, booster dose to complete their course of the Oxford University-AstraZeneca vaccine. That leaves 2.8 million people yet to complete the course, of which 1.4 million can be covered from the current stock, since the government has stopped registering any new recipients through the Shurokkha app.
Clearly, the priority has shifted to covering these people rather than reaching a situation where a large number of them are left in limbo, considering the uncertainty over when Serum may resume supplies. As reported before, the government is now looking at alternative suppliers, something they would possibly have been well-advised to do earlier, from Russia and China, as well as others. But in the absence of any clear data yet on whether the vaccines can be mixed or matched, concentrating the remaining doses on letting as many people as possible complete their course is only the right thing to do.
Till Eid, which is about when supplies are estimated to lost, you’re unlikely to see any new faces popping up on your social media feed with their ‘vaccine selfie’. Unless they skipped it the first time, which is unlikely.
From pillar to post
Reaffirming that the government is making all-out efforts to collect Covid-19 vaccines from different sources, Health Minister Zahid Maleque on Thursday (May 6) said they are now “at the stage” of signing a deal with Russia to procure the Sputnik V vaccine.
Speaking at a virtual discussion arranged by Bangladesh Private Medical College Association, he said they are also trying to procure the Oxford–AstraZeneca vaccine from other countries besides India – AstraZeneca has licensed production in some 15 countries already.
Also read: Russian Vaccine Sputnik V: Things we should know to fight COVID-19
“We’ve been using the AstraZeneca vaccine as we had placed an order for 3 crore (30 million) doses of it. We’ve got only 70 lakh (7 million) jabs in addition to 30 lakh (3 million) that came as a gift…but now we don’t have that much vaccine in our stock and whatever is left will be given as the second dose,” the minister said.
He said the prime minister, Health Ministry, Foreign Ministry and other relevant ministries are making joint efforts to procure vaccines from other sources.
“We’ve already made a huge progress in discussions with Russia over procuring its vaccine … now we’re at the stage of signing a deal in this regard,” Maleque said.
He said they are also in talks with China to have Sinopharm’s Covid vaccine. “They informed us that five lakh (500,000) doses will arrive in Bangladesh by May 12. We’ve also sent a letter to them seeking more vaccine doses.”
The minister said the Chinese government is now assessing the possibility of vaccine export to Bangladesh. It must be observed that it sounds like an uncharacteristically conservative offer from Beijing, for which the episode back in August 2020 comes to mind, when it all seemed very close to an agreement with the Chinese for vaccine supply, before the government seemed to get cold feet.
Getting back to Maleque, he was desperate to explain the government’s all-out efforts to get the vaccine. “Even, we’re trying to have AstraZeneca’s vaccine from other countries as it’s being manufactured in different countries. So, every effort is there to bring vaccines. We hope our efforts will yield good results, and we may be able to give you good news over the vaccine very soon,” he said.
The minister also said they will encourage the private sector if it tries to manufacture vaccines in Bangladesh. “If anyone can produce vaccines, we’ll provide all-out support, and it’s my commitment.”
Speaking at the same programme, State Minister for Disaster Management and Relief Dr Enamur Rahman said there is no alternative to vaccinating people to control the coronavirus. He too tried to assure everyone the government is working sincerely on procuring vaccines from Russia, China and other sources as there has been a crisis of AstraZeneca’s jabs in India.
Also read: What does it feel like to get COVID-19 after taking the vaccine?
He gave some hint as to what the government is looking at as a way to get past the pandemic, saying that all the pandemics that emerged in the world earlier had been brought under control through vaccination, although that’s not entirely true. “We hope we’ll be able to control the corona pandemic by vaccinating 60-80 percent of our people.”
What sort of timeframe they’re looking at to achieve that is up in the air, but it could be a good 2 years. Cases have been coming down in Bangladesh recently, but you never know when there can be another wave. The lesson we must heed going forward, is that never to close out any options during this crisis. And not to rest on our haunches. In that, the public has a role too, most evidently in maintaining the public health guidelines we’re now getting used to.
A shot at salvation?
It is of course well-documented by now that the pandemic has exposed some dangerous inequities between the rich world and the rest. The kind of problem the Bangladeshi authorities are dealing with today is scarcely seen in the West. While one in four citizens of rich nations have had a vaccine, just one in 500 people in poorer countries have done so, meaning the death toll continues to climb as the virus remains out of control. According to Oxfam, an international NGO, epidemiologists are predicting we have less than a year before mutations could render the current vaccines ineffective.
One of the reasons Pharma companies have been able to generate such large profits is because of intellectual property Last week, 175 former heads of state and Nobel Prize winners, including Gordon Brown, Ellen Johnson Sirleaf and Francoise Hollande wrote to President Biden to support the temporary waiving of intellectual property rights that restrict production to a handful of companies (those that develop the vaccine and others who obtain the license from them), to enable the rapid scale up of vaccine production across the world. They join the 1.5 million people in the US and other nations who have signalled their support for a People’s Vaccine.
Over 100 low- and middle-income nations, led by India and South Africa, are calling at the World Trade Organisation for a waiver of intellectual property protections on COVID-19 products during the pandemic, a move that had so far been opposed by the US, EU and other rich nations.
In a major shift, the Biden administration in the US this week joined the calls for more sharing of the technology behind COVID-19 vaccines to help speed the end of the pandemic, a shift that puts the US alongside many in the developing world who want rich countries to do more to get doses to the needy.
Also read: Can you mix-and-match COVID-19 vaccines?
US Trade Representative Katherine Tai announced the government’s position, amid World Trade Organisation talks about a possible temporary waiver of its protections that would allow more manufacturers to produce the life-saving vaccines.
“The Administration believes strongly in intellectual property protections, but in service of ending this pandemic, supports the waiver of those protections for COVID-19 vaccines,” Tai said in a statement.
She cautioned that it would take time to reach the required global “consensus” to waive the protections under WTO rules, and US officials said it would not have an immediate effect on the global supply of COVID-19 shots.
In a tweet, the director of the Africa Centres for Disease Control and Prevention, John N. Nkengasong, said the Africa CDC welcomed the waiver and called the decision “leadership in action.” He added: “History will remember this decision as a great act of humanity!”
Tai’s announcement came hours after WTO Director-General Ngozi Okonjo-Iweala spoke to a closed-door meeting of ambassadors from developing and developed countries that have been wrangling over the issue, but agree on the need for wider access to COVID-19 treatments.
The WTO’s General Council took up the issue of a temporary waiver for intellectual property protections on COVID-19 vaccines and other tools, which South Africa and India first proposed in October. The idea has gained support among some progressive lawmakers in the West.
More than 100 countries have come out in support of the proposal, and a group of 110 members of Congress — all fellow Democrats of Biden — sent him a letter last month that called on him to support the waiver.
Opponents — especially from industry — say a waiver would be no panacea. They insist that production of coronavirus vaccines is complex and can’t be ramped up by easing intellectual property. They also say lifting protections could hurt future innovation.
Stephen Ubl, president and CEO of the Pharmaceutical Research and Manufacturers of America, said the US decision “will sow confusion between public and private partners, further weaken already strained supply chains and foster the proliferation of counterfeit vaccines.”
Dr. Michelle McMurry-Heath, chief executive of the Biotechnology Innovation Organization trade group, said in a statement that the decision will undermine incentives to develop vaccines and treatments for future pandemics.
“Handing needy countries a recipe book without the ingredients, safeguards, and sizable workforce needed will not help people waiting for the vaccine,” she said.
Also read: More support easing vaccine patent rules, but hurdles remain
Pfizer declined to comment on Biden’s announcement, as did Johnson & Johnson, which developed a one-dose vaccine meant to ease vaccination campaigns in poor and rural areas. Moderna and AstraZeneca didn’t immediately respond to requests for comment.
The companies have made some efforts to provide vaccine doses to poor countries at prices well below what they’re charging wealthy nations.
For instance, Johnson & Johnson agreed last week to provide up to 220 million doses of its vaccine to the African Union’s 55 member states, starting in this year’s third quarter, and agreed in December to provide up to 500 million vaccines through 2022 for low-income countries via Gavi, The Vaccine Alliance.
Shares of Pfizer, AstraZeneca and Johnson & Johnson — huge companies with many lucrative products — fell less than 1% on the news. But Moderna, whose vaccine is the company’s only product, fell 6.2% in late-afternoon trading before gaining back two-thirds of a percent in after-hours trading.
It remained unclear how some countries in Europe, which have influential pharmaceutical industries and had previously shared U.S. reservations about the waiver, would respond.
WTO spokesman Keith Rockwell said a panel on intellectual property at the trade body was expected to take up the waiver proposal again at a “tentative” meeting later this month, before a formal meeting June 8-9. That means any final deal could be weeks away at best.
Authors of the proposal have been revising it in hopes of making it more palatable.
Okonjo-Iweala, in remarks posted on the WTO website, said it was “incumbent on us to move quickly to put the revised text on the table, but also to begin and undertake text-based negotiations.”
“I am firmly convinced that once we can sit down with an actual text in front of us, we shall find a pragmatic way forward” that is “acceptable to all sides,” she said.
Co-sponsors of the idea were shuttling between different diplomatic missions to make their case, according to a Geneva trade official who was not authorized to speak publicly on the matter. A deadlock persists, and opposing sides remain far apart, the official said.
The argument, part of a long-running debate about intellectual property protections, centres on lifting patents, copyrights and protections for industrial design and confidential information to help expand the production and deployment of vaccines during supply shortages. The aim is to suspend the rules for several years, just long enough to beat down the pandemic.
The issue has become more pressing with a surge in cases in India, the world’s second-most populous country and a key producer of vaccines — including one for COVID-19 that relies on technology from Oxford University and British-Swedish pharmaceutical maker AstraZeneca.
Michael Yee, a Jefferies Group biotech analyst, wrote to investors that the key access issues for developing countries aren’t patents or price, but an inadequate supply of the materials needed and the know-how to produce the vaccines and keep quality high — which one of Johnson & Johnson’s contract manufacturers in the U.S. failed to do, ruining millions of doses.
“Manufacturing supplies, raw materials, vials, stoppers, and other key materials are in limited supply for 2021,” and may still be next year and beyond, Yee wrote. That’s partly because it takes time to make all those components, and Moderna and Pfizer have commitments to buy them “from major suppliers in huge bulk over the foreseeable future.”
He added that Pfizer previously sought authorization to sell its vaccine to India, which rejected its application and asked that additional studies be run. The U.S., European Union and many other countries have given that emergency authorization.
Proponents, including WHO Director-General Tedros Adhanom Ghebreyesus, note that such waivers are part of the WTO toolbox and insist there’s no better time to use them than during the once-in-a-century pandemic that has taken 3.2 million lives, infected more than 437 million people and devastated economies, according to Johns Hopkins University.
“This is a monumental moment in the fight against COVID-19,” Tedros said in Wednesday statement. He said the U.S. commitment “to support the waiver of IP protections on vaccines is a powerful example of American leadership to address global health challenges.”
Additional reporting by Masudul Hoque and AP.
Mall crowds may bring back Covid nightmare, warns minister
Voicing concerns over huge crowds at shopping malls violating health safety rules, Health Minister Zahid Maleque on Thursday warned that the coronavirus transmission may spike again if this trend continues till Eid-ul-Fitr.
“The government has allowed reopening shops and shopping malls on the occasion of eid, but the crowds we’re seeing there will surely contribute to the virus surge again,” he said.
The minister said, “What if you don’t buy clothes for an Eid? The government has reopened markets, but it’s up to us whether to go or not there. Many women go shopping with children without wearing masks. Though we’ve given various instructions in this regard, people aren’t maintaining the health safety rules accordingly.”
Speaking at a virtual discussion arranged by Bangladesh Private Medical College Association, he said people must cooperate with the government in containing the virus by maintaining health safety rules, physical distancing and wearing masks.
Describing lockdown as the most effective way of controlling coronavirus transmission, he said the ongoing lockdown has helped reduce the coronavirus infections and death rates in the country. “But lockdown is not a long-term solution as it affects the economy and the livelihoods of people.”
Also read: Covid-19: Bangladesh sees 41 deaths in 24 hours, lowest in 39 days
The minister said the government resumed bus services in the capital and districts due to pressure from various quarters.
Zahid Maleque said the coronavirus infection came under control early this year, but the second wave of the virus has created due to people’s reckless attitude, travelling spree, mass gathering, and apathy to the health safety rules.
“We forget the past and didn’t take a lesson from it. We should keep in mind how people are suffering and dying due to the oxygen crisis in India. So, we should keep our country well by following the health safety guidelines,” he said.
Deal with Russia soon over Covid vaccine: Health Minister
Reaffirming that the government is making all-out efforts to collect Covid-19 vaccines from different sources, Health Minister Zahid Maleque on Thursday said they are now at the stage of signing a deal with Russia to procure Sputnik-V vaccine.
Speaking at a virtual discussion arranged by Bangladesh Private Medical College Association, he said they are also trying to procure the Oxford–AstraZeneca vaccine from other countries besides India.
Also Read: Bangladesh seeks immediate delivery of 4 mn vaccine doses from US: FM
“We’ve been using the AstraZeneca vaccine as we had placed an order for 3 crore doses of it. We’ve got only 70 lakh jabs in addition to 30 lakh that came as a gift…but now we don’t have that much vaccine in our stock and whatever is left will be given as the second dose,” the minister said
He said the Prime Minister, Health Ministry, Foreign Ministry and other relevant ministries are making joint efforts to procure vaccines from other sources.
“We’ve already made a huge progress in discussions with Russia over procuring its vaccine … now we’re at the stage of signing a deal in this regard,” Maleque said.
He said they are also in talks with China to have Sinopharm’s Covid vaccine. “They informed us that five lakh of doses will arrive in Bangladesh by May 12. We’ve also sent a letter to them seeking more vaccine doses.”
The minister said the Chinese government is now assessing the possibility of vaccine export to Bangladesh.
Also Read: Serum to return money if it fails to provide vaccine: Finance Minister
“So, we’re making all-out efforts to collect the vaccine. Even, we’re trying to have AstraZeneca’s vaccine from other countries as it’s being manufactured in different countries. So, every effort is there to bring vaccines. We hope our efforts will yield good results, and we may be able to give you good news over the vaccine very soon,” he said.
The minister also said they will encourage the private sector if it tries to manufacture vaccines in Bangladesh. “If anyone can produce vaccines, we’ll provide all-out support, and it’s my commitment.”
Speaking at the programme, State Minister for Disaster Management and Relief Dr Enamur Rahman said there is no alternative to vaccinating people to control the coronavirus.
He said the government is working sincerely on procuring vaccines from Russia, China and other sources as there has been a crisis of AstraZeneca’s jabs in India.
Also Read: Efforts intensified to get Oxford-AstraZeneca vaccines from US: FM
Besides, he said, Bangladesh Medical Research Council (BMRC) has already approved local company Globe Biotech’s 'Bangovax' vaccine. “We hope we’ll be able to vaccinate most of our people by collecting the vaccines within a few months.”
He said all the pandemics that emerged in the world earlier had been brought under control through vaccinations. “We hope we’ll be able to control the corona pandemic by vaccinating our 60-80 percent people.”
No chance of oxygen crisis unless any dramatic change: Minister
As Bangladesh grapples with the second wave of coronavirus infections with hospitals overstretched, one major concern that has arisen is the availability of medical grade oxygen for critical Covid-19 patients.
Amid the growing worries over a steady supply of the lifesaving element, Health Minister Zahid Maleque has assured the people of the country that there will not be any shortage of oxygen unless the situation worsens dramatically.
His clarification came at a time when India, struggling with an acute oxygen crisis, stopped its export to Bangladesh.
Also read: DNCC Market Hospital to get 200 new ICU beds: Health Minister
"We don’t import oxygen from India all year long. We needed to import oxygen from India during a huge upsurge in Covid cases. But if the situation remains stable, there’ll be no shortage of oxygen in the country," he told UNB.
Maleque said Bangladesh is not that much dependent on liquid oxygen. “In fact, we rely more on gas oxygen. So, even if we face a shortage of liquid oxygen, it won't be a big deal," he added.
Medical grade oxygen is needed for treating critical Covid-19 patients who develop hypoxaemia – the shortage of oxygen in the blood – which is one of the main causes of death.
The minister said the demand for medical-grade oxygen is currently around 100-150 tonnes.
The government produces 250 tonnes of gaseous and 150-200 tonnes of liquid oxygen every day. The private sector also produces around 40-50 tonnes of oxygen a day. "So, unless there’s any dramatic upsurge in Covid-19 cases which forces the demand to double overnight, we’ll be fine," he assured.
He said the government has asked hospitals to increase the use of gaseous oxygen in order to avoid misuse of liquid oxygen.
Also read: No crisis of oxygen in hospitals: Health Minister
Minister Maleque said the health authorities are in constant touch with industries so that liquid oxygen can be collected on short notice when needed.
‘Minor oxygen crisis’
However, Senior Secretary Md Anisur Rahman of the Energy and Mineral Resources Division admitted that there is a minor oxygen crisis in the country following the Indian export ban.
"We’ve told private companies that produce liquid oxygen to supply it to the hospitals and clinics at the moment," he said.
Rahman said there is nothing to worry as the government will deal with the situation very swiftly.
Diverting oxygen to hospitals
Chief Inspector of Explosives Department Abul Kalam Azad told UNB that they asked five oxygen producing companies on April 23 to cut off the supply of oxygen for industrial use and direct it to hospitals.
According to the letter, hospitals and clinics are in need of rapid medical oxygen supply as the number of Covid-19 patients has recently increased.
It was sent to Linde Bangladesh, Spectra Oxygen Limited, Islam Oxygen Limited, DR Industries Limited, and M/S Bangladesh Industrial Gas Limited.
Also read: No alternative to increasing hospital capacity: Health Minister
According to sources at the health ministry, the daily production capacity of Linde Bangladesh is 90 tonnes, Islam Oxygen Ltd 40 tonnes and Spectra 37 tonnes.
Saiqa Mazed, General Manager (Human Resources) of Linde Bangladesh, told UNB that they are not giving it to industries following the government’s directive. “The whole amount now goes directly to hospitals and clinics,” she said, hoping that if the number of Covid cases remain as it is, there won't be any shortage of medical oxygen.
When asked about oxygen import from a source other than India, she said it would be expensive since Bangladesh can bring oxygen from the neighbouring country by road.
No crisis of oxygen in hospitals: Health Minister
Health Minister Zahid Maleque on Tuesday said there is nothing to be worried over the sudden halt in oxygen import from India since the country has the capacity to meet the current demand of it from the internal sources.
“Coronavirus has devastated India for lack of oxygen. We’re now not getting oxygen from India. But there’s nothing to be worried about. We don’t import oxygen from India round the year. When corona reached its peak, we imported 40-50 tonnes of oxygen,” he said.
Speaking at a press briefing on the premises of Bangladesh College of Physicians and Surgeons (BCPS), the minister said, “Oxygen has not been coming from India for four-five days, but we’re managing everything and we’ve no crisis of oxygen.”
He said hospitals not only use liquid oxygen, but also gas oxygen. “There’s no dearth of gas oxygen in Bangladesh due to the huge production capability of it.”
Before installing the oxygen lines at the hospitals, Maleque said gas oxygen were mostly being used in the country’s hospitals. “We’ve planned to buy the liquid oxygen from local producers and provide it to our hospitals. Our 40-50 hospitals have the facilities to use the gas oxygen and we've asked them to use gas oxygen.”
Also read: Liquid oxygen import from India suspended at Benapole
He said so far Bangladesh is in a fairly good position in terms of Oxygen supply and production.
The minister said they have also booked 40 tonnes of oxygen in the industrial sector for the use of patients in case of emergency.
He said there is now no crisis of oxygen in the country’s hospitals to deal with the Covid patients. "If the number of Covid patients rises three times and reaches 21,000 from the current 7,000 then we won’t be able to meet the demand for oxygen. So, we must take steps to reduce the Covid infections."
Maleque said the DGHS has already contacted industries that use liquid oxygen to collect it from using it during the crisis. "We’re planning to import small oxygen plants.”
Also read: 25 die in Delhi hospital due to oxygen shortage
He said the government has set up central oxygen lines in 100 hospitals so that the covid patients can have it whenever necessary. “We’re installing the oxen plants in some other hospitals and it’ll be completed by 10-15 days.”
The minister said there was no high-flow nasal cannula and oxygen concentrator in the country when the coronavirus first hit it, but now around 3,000 such equipment are being used in Bangladesh to provide treatment to the Covid patients.
He said coronavirus cannot be controlled by giving treatment to the affected patients. “We’ve now 7,000 beds. If the number of patients increases to 21,000, we won’t be able to accommodate them. We should keep it in mind.”
Maleque said all must maintain the health safety rules, social distancing and wear masks to contain the virus transmission.
He said the coronavirus infection came under control early this year, but the second wave of the virus has created due to people’s reckless attitude, travelling spree, mass gathering, and apathy to the health safety rules. If we don’t take a lesson from such mistakes, the third wave may come.”
The health minister said 70 to 80 percent of infections and deaths have been reported in Dhaka, Chattogram, Rajshahi, Sylhet and Khulna City Corporation areas. “So, people in these areas need to remain aware and strictly follow the health safety rules."
Will soon come out of uncertainty over vaccine availability: Minister
Health Minister Zahid Maleque on Tuesday said the uncertainty over receiving coronavirus vaccine jabs from the Serum Institute of India is likely to be over soon.
“We placed an order for three crore doses of vaccine (from Serum Institute) and paid money. But it’s a matter of regret that we’re not getting the vaccine in due time, disrupting our vaccination activities. The local agent, Beximco, and we’re trying our best to have it,” he said.
The minister said, “Our government is also trying to bring the vaccine jabs and the PMO and the Foreign Ministry have been working on it. Our Prime Minister Sheikh Hasina has repeatedly requested the Indian Prime Minister to ensure the vaccine supply. So, we hope we may get the vaccine quickly, but we couldn’t know the exact time. We’ll be able to know about it within a few days.”
Also read: Bangladesh to suspend administering Covid vaccine 1st dose from Monday
He made the remarks while talking to reporters on the premises of Bangladesh College of Physicians and Surgeons (BCPS).
Not possible to increase bed number so often: Minister
It will not be possible to increase the number of beds all too often to accommodate the growing Covid-19 patients, Health Minister Zahid Maleque said on Thursday.
“We’ve managed to tackle 10 times more patients this time as we raised the number of beds from 2,500 to 7,000 in a short period of time, but it’s not possible to do it so frequently,” the minister said.
Zahid Maleque came up with the remark while addressing a virtual discussion arranged on the occasion of National Nutrition Day.
Also read: DNCC Market Hospital to get 200 new ICU beds: Health Minister
To avoid the ‘third’ wave of the Coronavirus pandemic, people of the country must be more conscious, Zahid Maleque.
The second wave of Coronavirus hit the country as people failed to follow the health protocols properly, the minister said, adding: “We must become more aware to escape the third wave of the deadly virus.”
Currently, the second wave of Coronavirus is underway which is much deadlier compared to the first one, Maleque said.
Also read: Covid-19 surge lays bare another crisis: Scant ICU beds and specialists
“Now we must detect the cause behind the emergence of the second wave. We’ve restricted social functions, public gatherings and rallies to contain the virus,” he said.
The infection rate will come down if the restrictions are followed properly for a few days, he hoped.
Covid situation in Bangladesh
Ninety-eight more people died of Covid-19 in 24 hours until Thursday morning amid a sharp rise in the number of deaths from the deadly virus.
Also read: Covid-19: Bangladesh sees 98 more deaths, 4,014 new infections
The virus also infected 4,014 others during the period, the Directorate General of Health Services said in a handout.
With the latest figure, the mortality rate remained at 1.46 percent while the infection rate declined to 14.63 percent from Wednesday’s 15.07 percent.
Country's largest Covid-19 dedicated hospital opened in Dhaka
The country’s largest Covid-19 dedicated hospital with 1,000 beds was inaugurated at Dhaka North City Corporation's Mohakhali market on Sunday (April 18, 2021).
Health Minister Zahid Maleque opened the hospital as the chief guest in the morning.
Read DNCC Market Hospital to get 200 new ICU beds: Health Minister
The demand for ICU beds is rising after the second wave of Coronavirus hit the country. He said the Covid-dedicated hospital was completed in 20 days at the directive of the prime minister.
The hospital has 212 ICU beds, 250 beds in high dependency units (HDUs), 438 Covid-19 isolation rooms and 50 emergency beds, the minister said.
Also read: Covid-19 in Bangladesh: Death toll hits another new high of 102
DNCC Market Hospital to get 200 new ICU beds: Health Minister
Two hundred Intensive Care Unit (ICU) beds and 1000 new isolation beds will be added in the Dhaka North City Corporation (DNCC) Market Hospital within a short time, said Health Minister Zahid Maleque on Tuesday.
The minister came up with the information after sighting the new beds installation progress at the hospital in Mohakhali area in the afternoon.
The installation of new ICU beds was announced as the country witnessed record-breaking daily Covid-19 fatalities and infections with 66 deaths and 7,213 cases during the last 24 hours till Tuesday.
Also read: Covid-19 surge lays bare another crisis: Scant ICU beds and specialists
More than 7,000 new Coronavirus cases were recorded for the third consecutive day on Tuesday, according to a handout issued by the Directorate General of Health Services (DGHS).
The new beds will be inaugurated within the next two weeks, the minister hoped.
“No matter how many new beds are installed, Coronavirus won’t be controlled if people neglect the health guidelines,” he said.
Also read: 'Govt spending Tk 4.5 lakh on each Covid patient in ICU'
In many places people are creating agitation seeking withdrawal of lockdown, Maleque said, adding that in the present moment lockdown was mandatory so the government decided for it.
“The government will withdraw it in right time, if we don’t maintain the government directive now, Covid-19 infection and fatalities both might go beyond any control in the future,” the health minister added.
March Madness
Amid all the celebrations surrounding the Golden Jubilee of Independence and the Mujib Centennial in March, there is one undeniable that fact that we can no longer run away from: it was the month we allowed the Second Wave of COVID-19 get out of hand and out of control.
The hospitals are filling up as the country records a rising number of new coronavirus cases but the battle for survival is somewhat uncertain for the more serious patients who require intensive care.
As of March 30, hospitals dedicated for treating coronavirus patients in Dhaka have 108 ICU beds but at the moment, only four are available, according to the Directorate General of Health Services (DGHS).
The situation at private hospitals is no different. There are 188 ICU beds but 144 of them are occupied. People with low or fixed income prefer government hospitals where the treatment is cheap. The cost at private hospitals is much higher.
The acute shortage of much-needed ICU beds means that only a fraction of the serious and critical patients will get life-saving treatment. Bangladesh health authorities reported a record number of cases on three out of the four days till April 1, when it shattered the previous day’s record of 5300-odd cases by reporting a whopping 6,469.
Additionally it reported 59 new deaths, the second-highest toll in the entire outbreak since March 2020. The highest remains 62 last June 30 – but the way things are going, it only seems a matter of time before that is eclipsed. The second wave is well and truly here with a vengeance, and it seems set to be much worse than the first.
“It’ll be very difficult to manage the situation,” said Prof Dr Mohammad Robed Amin, DGHS Director of Non-Communicable Diseases and media cell representative.
Also read: Covid-19: Bangladesh records 6,000+ cases for 2nd straight day
ICU beds running short
Among the 10 dedicated hospitals, Bangabandhu Sheikh Mujib Medical University and Kuwait Maitree Hospital have 16 beds, Kurmitola General Hospital has 10, Dhaka Medical College Hospital (DMCH) has 10, Sheikh Russel Gastro Liver Institute & Hospital has 16, Sarkari Karmachari Hospital in Fulbaria has six, Central Police Hospital at Rajarbagh has 15.
Two beds each are available at Sheikh Russel Gastro Liver Institute and Hospital and the Central Police Hospital in Rajarbagh.
Meanwhile, the hospitals are running out of general beds as the number of patients increases. Of the 2,461 beds, 2,127 are currently occupied.
Among the private hospitals, Bangladesh Specialized Hospital has nine ICU beds, Anwer Khan Modern Medical College Hospital has 30, Square Hospital has 19, United Hospital has 22, Evercare Hospital has 40, Asgar Ali Hospital has 32, Ibn Sina Hospital has five, and Impulse Hospital has 35, and AMZ Hospital has 10.
Also read: Covid-19 surge lays bare another crisis: Scant ICU beds and specialists
Anwer Khan Modern Medical College Hospital has eight beds available, Square Hospital has five, United Hospital has eight, Evercare Hospital has six, Asgar Ali Hospital has 12, Ibn Sina Hospital has one, Impulse Hospital has three and AMZ Hospital has two.
Among the 925 general beds, 528 are occupied.
Health Minister Zahid Maleque warned that the rise in coronavirus cases at the current rate would overwhelm the healthcare system.
DGHS Secretary Abdul Mannan told our sister newsagency UNB that people must follow the health protocols and directives issued by the government to bring down the cases.
Dr Amin said they are emphasising setting up ICUs at hospitals which have additional space to meet the increasing demand. He noted that the number of ICU specialists must be increased along with ICU beds. “We don’t have enough ICU specialists,” he said.
Prof Amin said the government is planning to install new ICUs at the district hospitals. “The pressure on [hospitals in] Dhaka will lessen if we set up ICUs at district level.”
The recent spurt in cases prompted the Prime Minister’s Office (PMO) to issue an 18-point directive this week for the next two weeks to contain the spread. Health Minister Maleque said they proposed partial lockdowns for some places with higher Covid-19 transmission rates.
The government launched a countrywide vaccination campaign on February 7. Those who are 40 years or above and the frontline workers are being prioritised. Till March 29, 5,139,679 people received the first dose, according to government data.
What can be done?
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.
Also read: Fighting the Second Wave: Govt seeks stricter implementation of PMO directives
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.
According to public health expert Dr 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.
Dr Lenin 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 can the government ask people not to arrange social programmes and mass gatherings?
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?” he asked.
“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.”
Dr Be-Nazir said all-types of mass gatherings and unnecessary public movement must be stopped to overcome the situation.
Also read: Avoid public gatherings, wear masks to fight Covid surge, PM urges all
“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.”
‘Suspend the 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.”
Also read: Nat’l committee for stopping Ekushey Book Fair as Covid cases surge
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’.
“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.”
Dr 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.”
Prof Muzaherul Huq, a former adviser to WHO South-East Asia region, said the government should take all-out steps to tackle the 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.”
Too little, too late?
In the wake of the alarming spike in Coronavirus cases, the government towards the end of the week decided to take a tougher position to implement the 18-point directive issued by the Prime Minister’s Office (PMO) in an effort to contain the spread.
The move came after the country recorded its highest-ever daily coronavirus cases (6,469) and registered more than 5,000 cases for the fourth straight day on Thursday (Apr 1).
Also read: Restriction on gatherings, quarantine rule among PMO’s 18-point directive to contain Covid surge
Following the health protocols, all ministries and organisations have been instructed to use only 50 percent of their manpower in office for two straight weeks by State Minister of Public Administration Farhad Hossain.
Strict instructions have been issued to all the ministries and associated organisations asking them to follow the directives, he said.
“We already started following the instruction from Wednesday and the rest of the ministries started implementing the directive from Thursday. All ministries and departments will form a duty roster for all their staffs,” he said.
One half of the staff will attend office three days and two days from home in the first week and the second half will work the same way in the second week, Hossain said, adding that pregnant and officials above 55 years old will work online from home.
Besides, all of the private and non-government organisations and offices were also directed to employ 50 percent workers in office and rest through online from home, the State Minister said. Pregnant employees and officials above 55 years old will work online from home.
“We will ensure that no one go outside after 10 pm unnecessarily and also launched monitoring programme on the grass root level. Law enforcers will work in this regard,” Farhad Hossain said.
The government will decide the next course of action after maintaining all the directives for two weeks and review the decision after April 12, he said.
The Home Ministry said as the 18-point directive landed on Monday, police already prepared a work plan to implement the instructions across the country including the capital.
Police check-posts have been installed at different places including Dhaka and a massive campaign is operated by cops and local administration to raise awareness among people, Home Minister Asaduzzaman Khan told UNB.
Moreover Health Minister Zahid Maleque said the administration will do everything to constant monitor the implementation of the health directives “The way number of patients is rising if the scenario continues, no hospitals will have seats to admit patients. All must act immediately to curb the massive transmission. The pandemic might take a devastating form if we fail to follow the 18-directives issued by the Prime Minister Sheikh Hasina,” the minister said.
Secretary of Health Services Division Abdul Mannan said they have already started following the health directive strictly.
Transport restrictions
Bangladesh Railway is operating keeping 50 percent of its seats vacant to curb the transmission of Covid-19 since Wednesday, said Railway Minister Nurul Islam Sujan.
Half of the 50 percent railway tickets will be available online and rest will be sold at the stations, the minister said adding that “We won’t carry any passenger without following the health guideline and take all necessary measures to ensure hygiene in trains and stations.”
Bangladesh Road Transport Owners Association Secretary General Khandakar Enayetullah said all buses are carrying 50 percent of passengers with the direction of the government.
BRTA Chairman Nur Mohammad Majumdar told UNB that they have taken overall measures in this regard and mobile courts will be operated to prevent transport workers from violating the instructions.
State Minister for Shipping Ministry Khalid Mahmud Chowdhury said they are also maintaining the 18-point directive by taking only 50 percent of passengers.
Passengers will have to step into launch after following all health guidelines otherwise legal action will be taken, he warned.
Meanwhile incoming flights from all countries of Europe except the United Kingdom have been prohibited to prevent coronavirus transmission, said Civil Aviation Authority Chairman Air Vice Marshal M Mofidur Rahman. The decision to exempt the UK has baffled observers.
Twelve other countries that have been placed on the list alongside Europe are Argentina, Bahrain, Brazil, Chile, Jordan, Lebanon, Peru, Qatar, South Africa, Turkey and Uruguay.
The prohibition will remain in action from April 3 to April 18, Rahman said, adding that the airlines can only carry transit passengers from these nations during this time and they will have to remain inside the Airport terminal during the transit period.
The returnees from foreign countries who are allowed in will have to remain in institutional quarantine for 14 days at a quarantine centre or specific hotel, he said.
Besides, all travellers must have Covid-19 negative certificates (Sample collected within 72 hours) for leaving or entering the country, he added. Passengers will have to wear face shields along with masks.
All the directives came into effect since March 30 and will remain in force until further notice, he said.
Besides, the Election Commission (EC) late in the week postponed all elections scheduled for April 11. The National Cricket League has also been postponed midway.
Movement of all tourist ships on Teknaf-Saint Martin's Island route have been suspended, and all tourist spots in places like Cox’s Bazar and Sylhet have been instructed to close.
However, movement of vessels carrying regular passengers and daily essentials will remain normal, subjected to maintaining health guidelines.
Additional Reporting by AR Jahangir and Masudul Hoque
(This article was first published on dhakacourier.com.bd)