'Lockdown lacks clarity'

There is a lack of clarity regarding lockdowns being imposed as part of the measures against the spread of coronavirus. There are questions about the efficacy of the East Rajabazar lockdown in the capital city. Among the samples tested on the last day of the lockdown, 11 out of 18 were positive. The rate of cases detected was 61 per cent. This is not normal, experts have said.

And now Wari of Old Dhaka has been placed under lockdown from Saturday. There are lockdowns in various other areas of at least 9 districts in the country. The lockdown in East Rajabazar was under strict surveillance, but there is not such strict surveillance in these districts. And the Directorate General of Health Services (DGHS) is now preparing to lock down a number of other localities too.

Several officials of the government’s Institute of Epidemiology, Disease Control and Research (IEDCR) as well as several members of the health directorate’s central technical group have said that experts have twice drawn up maps indicating the number of patients in different areas of Dhaka city. The lockdown method has been finalised anew. However, when this will come into effect, if ever, remains uncertain.

Speaking to Prothom Alo on Saturday, member secretary of the central technical group, Mohammed Zahirul Karim, said, “The lockdown SOP (Standard Operating Procedure) has been sent to the health ministry for approval. Hopefully it will be approved in a day or two.”

Lockdown is being in many countries used as a means to prevent the spread of coronavirus. The purpose is to isolate infected persons and persons at risk. Lockdown has an impact on livelihood and the hardest hit are the poor and low income people who depend on daily wages. There are differences of how long a lockdown should be in place, 14 days or 21 days.

The first coronavirus case was detected in the country on 8 March. In April, Tolarbagh in Dhaka city went into lockdown and this was successful. Dhaka North City Corporation, the local member of parliament, the flat and house owners association and the mosque committee all assisted IEDCR in ensuring an effective lockdown. IEDCR officials have repeatedly said that the lockdowns in Dhakeshwari of Dhaka city, Shibchar in Madaripur and Sadullapur in Gaibandha, were successful too.

East Rajabazar experience

Dhaka North City Corporation (DNCC) mayor Atiqul Islam spoke to Prothom Alo about the lockdown at East Rajabazar. He said, “We have successfully completed the lockdown at East Rajabazar. The chain of transmission has been broken.”

When asked how so many persons tested positive on the last day, Atiqul Islam said that many persons in isolation did not maintain the rules. They may have stayed at home but they did not avoid contact with the rest of the family.

DGHS and IEDCR officials, however, said that they were looking into the cause of the higher rate of coronavirus detection at the end of the lockdown. An official of DGHS said. “East Rajabazar has taught us many lessons.”

Around 40,000 to 50,000 people live in East Rajarbazar. Before the experimental lockdown, 31 patients were detected here, according to official records, though the accuracy of the numbers is questionable. The lockdown began on the night of 9 June. A sample collection and testing booth was set up at Nazneen School . Towards the beginning, every day 5 to 6 patients were detected. Then after some days, this went down to 2 to 4 patients a day. The numbers dwindled. Till 27 June, while the lockdown was in force, 55 new cases were detected.

DGHS sources said that 30 June was the last day of the lockdown and on that day 18 samples were collected. Of these samples, 11 were positive. The rate of detection was 61 per cent. Nationally this rate is 19.12 per cent. One of the yardsticks of a lockdown’s success is the lessening of the ration between ratio tests and detections. IEDCR’s website recorded 85 confirmed coronavirus cases in the area on Saturday.

Former World Health Organisation (WHO) consultant for South East Asia, Muzaherul Huq, told Prothom Alo, “According to the last tests carried out at East Rajabazar, the spread of the virus has not decreased there. The number of detections is abnormally high. It is evident from these statistics that the lockdown has not been a success.”

Health ministry sources said that IEDCR and Dhaka City Corporations are trying to assess whether the transmission did not decrease or whether there were discrepancies in management. A resident of East Rajabazar told Prothom Alo that the management was faulty. He said that when the samples of his family were taken, their e-mail addresses or ID numbers were not taken. They had to make their own arrangements to find out the results, but till Saturday had received no certificates. It was found out that the local ward commissioner’s email was being used on the sample forms, but the certificates were not sent on to the relevant people.

Public health expert Muzaherul Huq said, “This is absolutely unethical. It is a violation of the people’s privacy.”

Stuck in preparations

DGHS’ public health advisory committee on 15 May advised lockdowns in Dhaka and other large towns of the country. Nearly a month later on 11 June, a 13-member central technical group was formed with the director general of DGHS as the head.

DGHS then spoke about identifying red, yellow and green zones and beginning lockdowns accordingly. They identified 45 areas in the capital city as red zones and the matter was widely discussed when it appeared in the media. There were several questions as to how such large areas would be managed and also whether DGHS’s statistics were accurate.

Now the lockdown definition is being changed. An area with 5 coronavirus cases will be considered a red zone. It will be a small and specific area.

Several persons involved in this process have said that it is more convenient for the people if smaller areas are locked down, but harder to enforce. It is more expensive and workforce is also a problem.

Lockdown in 9 districts

Several wards and unions of 9 districts – Bogura, Chuadanga, Munshiganj, Brahmaputra, Magura, Kushtia and Khulna – are under lock down.

Public health experts and physicians are questioning not only the success and failure of the lockdowns, but also the enforcement. President of Bangladesh Medical Association’s Khulna branch, Sheikh Baharul Alam, speaking to Prothom Alo, said, “Red flags are being hoisted in front of the homes of patients with coronavirus. This is social ostracizing. They can’t leave their homes to buy medicines, food or other essentials.”

Public health expert and former chief scientific officer of IEDCR, Mushtaq Hossain, said, the word ‘lockdown’ has negative connotations to the people. A different term could be used, like ‘health belt’. The people of the area need to be motivated and included in the process, or it will not be a success.

*This report, originally published in Prothom Alo print edition, has been rewritten in English by Ayesha Kabir.