Govt needs to step up initiatives to tackle COVID-19
The entire government machinery is now involved in tackling the coronavirus outbreak, albeit a bit late. However, there are no indications of any scientific assessment by the government about how the situation may emerge in the coming days. The health directorate wants to monitor the situation intensely over the next 7 to 10 days. It is felt that the government needs to take more initiatives at this stage.
What will happen after the government holiday ends? Will the people stream back into the cities? Will the educational institutions extend their holidays? What will the state of the coronavirus pandemic be then? The general people are anxious about these issues
The government has selected 10 hospitals in the capital city for treatment of coronavirus patients. It has also spoken about opening up isolation units in the upazila, district and government medical college hospitals. Four out of 14 institutions have started carrying out the COVID-19 detection tests. There are efforts to ensure a nationwide quarantine system.
The government has declared a nationwide holiday from 26 March to 4 April, having shut down educational institutions from beforehand. Health workers have also been given training among other initiatives taken up by the government.
In the meantime, the World Bank, Asian Development Bank (ADB) and the Islamic Development Bank have pledged financial assistance of over Tk 15 billion to Bangladesh to tackle the COVID-19 crisis.
The question which now looms large is what will happen after the government holiday ends? Will the people stream back into the cities? Will the educational institutions extend their holidays? What will the state of the coronavirus pandemic be then? The general people are anxious about these issues.
Officials of the health directorate feel that Bangladesh may not face a situation as dire as that of Italy or the rest of Europe or the US. But experts see no scientific basis for their contention.
Epidemiologist Benazir Ahmed said that if we assume one per cent of the people in the country will be infected, that means 1.7 million people are at risk. And 20 per cent of them will need to be hospitalised. And a percentage of them will need ICU facilities. Even by the most conservative estimate, 17,000 ICU’s will be required to be treated for COVID-19 patients
Situation on ground
COVID-19, after the initial outbreak in December in the Chinese city of Wuhan, has now spread to 177 countries of the world. No one could foresee where and how this would spread and how many people would be affected. However, based on past experiences, attempts were made to estimate how many people would be infected. The World Health Organization (WHO) also tried to draw up an estimate for Bangladesh too.
According to various UN organisations, donor agencies and a document handed over to the government by WHO, if the government does not take any initiative at all, there will be the risk of 500,000 to 2 million people dying of coronavirus in Bangladesh.
Director general of the health directorate Abul Kalam Azad, speaking on the issue to Prothom Alo on Saturday, said, “The World Health Organization quoted that estimate based on a certain model. It mentions what the situation could be if no steps were taken. But we have taken many steps, are taking further measures and will continue to do so.”
This correspondent asked Abul Kalam Azad at the health directorate on Sunday about what assessment had the government based its programme on, in dealing with the COVID-19. The DG of the health directorate replied that the government felt there was latest scientific evidence that this virus would probably not spread exponentially in Bangladesh due to the hot and humid weather.
He said that 6 to 7 per cent of the population in this country was above 60 years of age and they were the ones more at risk. But the positive aspect was these people were not isolated as in Europe or America. But the problem in the country was the density of the population.
The DG said they would be monitoring the situation for the next 7 to 10 days to assess how things would likely be in the coming days.
However, epidemiologist and former director of the government’s department of disease control, Benazir Ahmed, feels that there should be an assessment of the situation in order to devise a strategy. Speaking to Prothom Alo, he said that if we assume one per cent of the people in the country will be infected, that means 1.7 million people are at risk. And 20 per cent of them will need to be hospitalised. And a percentage of them will need ICU facilities. Even by the most conservative estimate, 17,000 ICU’s will be required to be treated for COVID-19 patients.
According to the health directorate, there are 432 ICU’s in the government hospitals and 737 in the private ones.
Dilemma over tests
The World Health Organization has stressed upon the need for testing. A person testing positive can be isolated and treated. If the infection is not detected, the virus will spread.
From the very outset, the health ministry had kept testing restricted to the Institute of Epidemiology, Disease Control and Research (IEDCR). IEDCR has so far tested 1,185 persons.
As in other countries of the world, there has been a shortage of test kits in Bangladesh. This shortage is gradually being overcome and the government has at least 30,000 kits in stock. However, it had not managed to increase the number of tests being conducted as all the laboratories are not prepared as yet.
Till Sunday, other than IEDCR, the Bangladesh Institute of Tropical and Infectious Disease in Sitakunda, Chattogram, tested 22 samples. The samples were rested at Shishu Hospital. The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) has tested samples from some of its own staff.
Experts said that it was better to have a higher number of tests. However, officials say the government does not plan to carry out large numbers of tests, but will issue directives to treat the patients after observing certain symptoms.
Shortage of hospitals, beds
Coronavirus spreads rapidly and keeping other patients in a hospital with COVID-19 patients is risky. That is why globally is being stressed to use separate hospitals for COVID-19 treatment.
Initially the government had announced that there would be isolation units in all government hospitals for COVID-19 treatment. The health ministry has changed that decision.
Last week the government announced that 9 hospitals in the capital city had been selected for COVID-19 treatment. These had in total 1000 beds and 60 ICU beds.
However, none of the selected hospitals, other than the Kuwait-Bangladesh Maitri Hospital, is fully prepared to start treatment.
The health minister has repeatedly said that the newly constructed building of the Sheikh Hasina Burn and Plastic Surgery Institute will be used for the treatment of COVID-19 patients, but that has not happened.
Private hospitals
Around three weeks ago, the health directorate held discussions with the authorities of private hospitals and instructed them to prepare isolation units in the hospitals. However the directorate has no records of how many hospitals have arranged such units.
A certain business house has taken initiative to set up a temporary hospital. The health directorate on Sunday issued its clearance in this regard.
DG of the health directorate Abdul Kalam Azad maintains that they have a specific plan to deal with the crisis. He said, “We are proceeding following the WHO guidelines. We do not apprehend any massive disaster.”
* This report appeared in the print edition of Prothom Alo and has been rewritten in English by Ayesha Kabir