There is a lack of coordination within and outside of the government in tackling the coronavirus situation. There is no coordination between the ministries and the offices. Neither does the government have coordination with the non-government organisations nor hospitals.
Anxiety has increased among the people with the relaxation of the lockdown at a time when coronavirus transmission and deaths are on the rise. At this juncture it is imperative for the government to coordinate with various sectors in order to overcome the situation. It is not possible to overcome any calamity without involvement of the community.
The views were expressed by various eminent persons during a virtual dialogue on ‘Post general holiday health risks’. The dialogue held on Monday morning was organised by the Citizens’ Platform for SDGs, Bangladesh. Joining in the dialogue were epidemiologists, physicians, experts for various coronavirus-related committees of the government, economists, members of parliament, public health experts, business representatives, rights activists and others.
The SDG Platform convenor and distinguished fellow of the Centre for Policy Dialogue, Debapriya Bhattacharya, said that the objective of the dialogue was to discuss the impact of the pandemic after the relaxing of the so-called lockdown and what preparations should be taken to tackle the situation.
The virtual meeting was moderated by the South Asia regional director of Water Aid, Khairul Islam.
Core group member of the SDG Platform and public health expert Moshtaque Raza Chowdhury said the lockdown was a globally recognised system to tackle coronavirus. But in the case of Bangladesh, the ‘general holiday’ lacked clarity. However, given Bangladesh’s reality, he felt it would be impossible to enforce a complete lockdown. He offered a few proposals to overcome the situation.
Extensive research is required to understand the virus. I have seen that those who have not been affected as yet have zero antibodies. But we have to observe this after three months, six months or even three years. We have to see how much immunity we have gained. We need to understand the disease well through research.Firdaus Qadri, immunologist
He said, the lockdown or holiday should have been lifted in a partial manner and there should be zoning all over the country based on the extent of the virus transmission. The rate of infection was not the same in all districts. In districts where the infection was relatively lower, everything could be opened up. Then it would be understood where there are risks and problems.
Moshtaque Raza Chowdhury went on to say that in Bangladesh, 1,877 coronavirus tests were carried out per million persons. In India the rate of testing was 2,700 per million and in Pakistan, 2,500 per million. Bangladesh had the lowest testing rate in South Asia and this needed to be increased.
The public health expert went on to say that there was no social effort in Bangladesh to tackle coronavirus. There needed to be committees in every village to tackle coronavirus. The government needed to form a special scientific advisory group.
The unspoken strategy adopted by the government is herd immunity. But how applicable is, this given Bangladesh’s ground reality, questioned the moderator of the programme.
In reply, immunologist and icddr,b’s senior scientist Firdausi Qadri said, “It has only been 5 months since the coronavirus outbreak. We can consider herd immunity in the case of other diseases, but in the case of COVID-19, over 10 per cent of the patients develop complicated symptoms. Herd immunity is risky. This can be harmful for certain people.”
She went on to say, “Extensive research is required to understand the virus. I have seen that those who have not been affected as yet have zero antibodies. But we have to observe this after three months, six months or even three years. We have to see how much immunity we have gained. We need to understand the disease well through research.”
By separating COVID and non COVID hospitals, the scope for treatment has been decreased. He said that the lockdown should be extended by another 15 days and rapid testing should be taken up.MH Chowdhury, physician
The government has formed committees in eight divisions headed by eight experts. Head of the Sylhet division committee, Jamil Faisal, said that different ministries of the government are giving different directives and creating confusion. There is an administrative pandemic. There is a glaring lack of coordination. There has been no social inclusion. A successful example of social inclusion is Tolarbag in the capital city. Such cluster-based initiatives can be taken up.
Abu Jamil Faisal said, initiative should have been taken to distribute mass for free among the lower income people. The readymade garment factories could have made 10 million masks. There are 108 pharmaceutical companies in the country. They could have made sanitisers and these could have been distributed free.
Member of the national technical advisory committee and physician Raushan Ara Begum said that maternal health has been overlooked during this pandemic. Every hour 400 infants are born in the country and half of these are delivered at home. With healthcare facilities having shrunk in the health centres, now 35 per cent more are being born at home. This increases the risk of maternal mortality as well as fistula. All this can be serious problems in the future and must be addressed now.
Physician MH Chowdhury criticised the government’s decision regarding treatment of COVID-19 patients. He said that there were 270,000 beds in the country’s hospitals and two thirds of these were private hospitals. And of the 90,000 physicians, 26,000 to 27,000 were government physicians. The reset were in private hospitals or had private practice. But the private hospitals were kept away from the beginning. And by separating COVID and non COVID hospitals, the scope for treatment has been decreased. He said that the lockdown should be extended by another 15 days and rapid testing should be taken up.
NGO Dustho Shashtya Kendra’s director Dibalok Singh said that coronavirus hasn’t spread much in the slums. He also pointed to the successful examples of Kerala and Vietnam.
BRAC’s health division director Morsheda Chowdhury said in the coronavirus situation, financial paucity had driven child marriage up by 13 per cent and domestic violence up by 32 per cent.