The coronavirus pandemic is undoubtedly the most serious global crisis in our living history. It is both a public health crisis as well as a crisis in our everyday lives. The complacence that “this can’t happen to me” has been proven wrong. It has also become glaringly clear just how unprepared our health system is to deal with such a pandemic. Over a hundred countries were hit with this virus before it came to Bangladesh, so we do have some scope to adopt a strategy to contain the damages to a certain extent.
The worst hit countries
From last Thursday there have been no new coronavirus cases in Wuhan, the city in China where the outbreak began. The World Health Organisation (WHO) director general Tedros Adhanom Ghebreyesus has said Wuhan has turned around from the worst condition in fighting against coronavirus, giving the rest of the world some hope. He said that every day we are learning from this virus. China’s authoritarian system of rule and its huge wealth do not apply to other countries. China managed to restrict the epidemic to Wuhan, but this is not so in other countries.
Outside of China, the countries hit hardest by the virus are Italy, Iran and South Korea. It is unsure how things will turn out in Europe, the United Kingdom and the United States. Iran’s condition cannot be compared to that of other countries due to the embargo imposed by the US. However, these countries have taken lessons from the China, Italy and South Korea experience and have adjusted their strategies accordingly.
South Korea adopted a strategy of testing for the virus and rapidly isolating those infected and treating them. They were also successful in using mobile apps to monitor people in home quarantine upon entering the country from outside.
In Vo, the village in Italy where the coronavirus outbreak first emerged, the 3000 or so residents were tested for the virus and they were fairly successful in controlling the spread there. But unfortunately in Lombardy, where there is a wealthy population and a well-reputed health system in place, the epidemic took on devastating proportions. It is said that an entire generation of persons over 80 years of age has been wiped out there.
The US and the UK both dealt with the crisis wrongly from the outset and so the situation deteriorated. In US the main reasons for this situation was that president Trump and his Republican Party were in denial of the gravity of the crisis. And the government of prime minister Boris Johnson adopted a strategy to allow the virus to spread and build up immunity among the people. It was said that if anyone developed the symptoms they were to go into self-quarantine or maintain social distancing.
The research that changed everything
The UK government rapidly changed its strategy when a research carried out by Imperial College, led by professor Neil Ferguson revealed the impact and the serious threat of coronavirus. The ‘contain’ strategy was replaced by the ‘suppression’ strategy, heading towards lockdowns. At first large gatherings were prohibited, then people were encouraged to work from home rather than office, and persons over 70 and those suffering from incurable diseases were encouraged to self-quarantine themselves.
From Saturday, bars, restaurants and clubs were shut down. With the virus spreading most in London, a form of lockdown prevails there. On Saturday night, Boris Johnson personally requested the people to follow social distancing.
New York and a few other densely populated cities in the US and Europe from last week officially went into lockdown. Fines are being imposed if the regulations are violated. Neil Ferguson has said that unless the chain of the disease’s transmission is broken, 60 per cent of the people in the UK would be affected and there would be over 250,000 deaths. Unless a strategy of suppression was adopted, the deaths could reach 500,000. The study posed a grim picture for the US too and the Trump government hurriedly took measures.
Important steps adopted
1. These countries have recognised the coronavirus crisis as the worst crisis in a hundred years. The crisis has been divided into two clear categories and strategies. One is related to public health and the other to economy.
2. All-out efforts have been taken to tackle this crisis through political and social consensus and unity at a national and local level. Efforts are being made for a national unity to involve all quarters, as in wartime circumstances. In the US, president Trump is coordinating with the Democrat speaker Pelosi and the governors of various states to take various measures. In the UK, Boris Johnson is consulting with opposition leader Jeremy Corbyn and other opposition parties and the ministers are consulting the shadow ministers and taking steps accordingly.
3. Science-related advisors and health department officials are giving explanations about the scientific basis of the government’s health-related directives.
4. The highest transparency is being maintained in the data regarding number of those infected and deaths.
5. Priority is being given to the test kits as well as the personal protective equipment (PPE) of the medical workers. These are being procured directly from the producers due to the urgency of the matter.
6. In order to ensure an increased number of hospital beds, all surgeries which are not immediately required, are being postponed. The National Health Service has made agreements for 8000 beds in private hospitals and for the services of a few thousand physicians and medical workers. And letters have been issued to around 35,000 physicians and nurses who retired over the last three years, requesting them to rejoin their duties.
7. In Italy where there are 12 hospital beds to provide critical care to every 1000 patients, in the UK this is less than half that number. Apprehending a serious shortfall of ventilators, the government last week requested the local industries to make such changes and manufacture ventilator machines. Formula One, the car racing establishment, has announced that they will manufacture ventilators.
8. At the directives of the health department, the armed forces supply planners have been employed to arrange to provide supplies to 1.5 million families who are in home quarantine.
Emergency measures for the economy
A policy is being followed to consult trade unions and various business associations and professionals and keep them involved. The first priority is saving lives for which all-out efforts are being taken for the health sector to take the unprecedented pressure. Alongside that, special measures are being announced to ensure people’s basic requirements of food, clothing and shelter as well as to save the economy from a collapse. All the developed countries have announced unprecedented economic packages. The US economic package exceeds one trillion dollars. Arrangements have been made to provide people with cash so the market demand remains intact. The central bank is dramatically slashing interest rates and increasing the flow of loans in order to keep the industrial sector and the share market running. The central banks and governments in the European Union are doing the same.
Initially the British government had announced an allocation of 30 billion pounds in its budget, but within the week the finance minister Rishi Sunak said that they would do whatever was needed to keep the economy running. In the new package, allocation of another 350 billion pounds was announced to increase the loan availability. On the day of the budget, the central bank had lowered interest rates from 0.75 per cent to 0.25 per cent. However, on Friday this was lowered further to 0.01 per cent, something that never happened in the last 235 years. The central bank governor requested all industrialists and businesspersons not to lay off any of their employees. The government has taken responsibility to pay up to 80 per cent of the wages of all employees in private sector. This applies to the next three months, but will be extended if necessary. A three-month grace has been given on the repayment of mortgage and fixed assets. Commercial establishments have been exempted from paying taxes at the business rate on their premises. Grants and loans on easy terms have been arranged for small and medium businesses. The time for tax payment has been extended. No tenant can be evicted if failing to pay rent. Solo entrepreneurs and tradesmen like carpenters, etc, will be provided with unemployment allowances and other benefits.
Bangladesh, prepared or unprepared?
The experiences of these countries could have certainly helped Bangladesh in dealing with the crisis. But the government has been apparently complacent in recognising the magnitude of the pandemic. It has displayed a foolhardy confidence. The virus began to spread all over the world from December, but our government failed to comprehend the gravity of the matter. Even when the World Health Organisation declared a global emergency regarding public health on 31 January, the government very confidently overlooked taking any preparations.
After the careless handling of the quarantine for those returning from Wuhan on 1 February, still not efforts were made to improvement arrangements. Minimum preparations were not even taken at the hospital and testing laboratories. When the first patient was identified in the country on 8 March, the weakness in preparing health personnel, facilities and other services was more than apparent. And it is still not clear what the strategy the government has adopted in this regard.
With over-confidence on one hand and total lack of preparedness on the other, the people have lost confidence. Though there have been directives for self-quarantine, quarantine and social distancing, the ministers are going about attending public rallies and gatherings and elections are being held. It has not been possible to arrange minimum safety measure for the physicians and medical workers or to arrange rest kits. Only some concessions have been announced for industrialists to repay their loans, but no initiative to look into the livelihoods of thousands and thousands of workers and employees.
Time has not run out as yet
There is no visible initiative to involve everyone in tackling a possible national disaster. It is essential that all political parties, civil society and professional groups unite to give the people courage and confidence amid their panic and uncertainty. It is doubtful how effective any initiative will be if it is restricted to bureaucracy rather than involving top public health experts, economists and persons experienced in disaster management. If the people are given a clear picture of the situation, they will feel compelled to follow the health-related regulations. Rumours and speculations can be controlled then.
The World Health Organisation’s message to all countries is test, test and test. Testing must be increased as fast as possible to identify the patients. The testing arrangements of private institutions must be included within the government’s communicable disease control division and at government rates so one can use this to make profits which will discourage the common people from testing. The locally manufactured testing kits must also be hurriedly given for WHO approval.
It is imperative that preparations be made for a lockdown, as in other countries, so as to ensure social distancing. Vehicle movement must be cut to the minimum. As in Arab countries, religious prayer gathering should be avoided, particularly by the old and ailing. Changes must be made in the madrasa and orphanage residential facilities to ensure healthy and hygienic surroundings.
Not providing personal protective equipment to the physicians, medical workers and cleaners working in the health sector mean putting their lives at risk. This is unacceptable. These must be imported on an emergency basis and the local garments manufacturers must take up the task in making these too. As in other countries, the government can consider taking over for at least three months private hospitals and clinics to equip these to face the pandemic. Help from the armed forces can be taken for this too.
Unless support is provided for those who are compelled to work simply to feed themselves and their families, they will not follow the rules to avoid infection. Special allowances must be provided to such needy unemployed persons.
If the health safety of the over one million Rohingya refugees is overlooked, the local people adjacent to the camps will be affected too. International assistance must be sought for special attention in this area.
With countries prisons holding thrice more than capacity, these jails are extremely at risk of the epidemic. Many of the inmates are simply under trial. Other than those charges which rape, murder and such serious crimes, the others can be granted bail and released. In Iran large numbers of prisoners have been set free.
A national plan must be drawn up to keep the economy running and protect it from a possible recession. This will require necessary allocations. Incentives and assistance will be required particularly for small businesses, small and medium industries, the export sector, as well as for agriculture and agriculture products. This will require the involvement of all, in order to determine development priorities.
It is already proven that we are not outside of the global pandemic. But there is still hope that the time has not run out to avoid massive devastation and to minimise damage. Global experience can be a lesson to us. But that we need to include all in the efforts.
· Kamal Ahmed is a senior journalist. This piece has been rewritten in English by Ayesha Kabir