Interview: Mushtuq Husain
'Increase in Covid transmission means increase in deaths'
Mushtuq Husain, advisor at the Institute of Epidemiology, Disease Control and Research (IEDCR), in an interview with Prothom Alo, speaks about the recent rise in the Covid transmission rate, the possible reasons behind this increase, what is to be done and rules of health and hygiene
Why has the rate of Covid transmission suddenly shot up?
We have noticed a speedy increase in the rate of Covid transmission in our country and in many other countries of the world. According to the World Health Organisation, the infection rate has gone up by 15 per cent. Vaccine programmes have begun worldwide. So one of the reasons of this increase may be that many people imagine they are safe after the vaccine and don’t bother about the health and hygiene rules.
In Bangladesh the rate of transmission had fallen below 5 per cent and deaths had decreased too. After the vaccine programme began in Bangladesh, we noted that participation in family and social events increased. Then again, the warmer weather has arrived. When we gather in a closed space, we turn on the fan or air conditioning. The air circulates within the room and the rate of Covid transmission increases. It seems that the increased infections are a result of laxness regarding health and hygiene rules after the vaccination, an increase in social and family gatherings, and fans and air conditioning being used in closed spaces during the warm season.
New strains of the virus are also said to be behind the spike in transmission, particularly of the UK variant.
We still do not have any evidence that the increased infection rate is caused by any new variant of coronavirus. The UK variant was detected in our country in January, but nothing unusual was marked after that to indicate this caused the transmission rate to go up. The South Africa and Brazil variants have been detected too. Without the appropriate research it is not possible to say that the infection rates have gone up because of any particular variant.
Did the experts have any indication that the transmission may increase at this time?
Perhaps no specific time was mentioned, but experts had cautioned of a possible increase. It was common knowledge that if the measures that were required to keep the transmission under control were relaxed, the infections would increase. Countries like Thailand, Japan, China, Vietnam, Australia or South Korea have displayed significant success in keeping transmissions under control. Even so, the infection spread at various times due to the virus coming in from outside. I have always maintained that carelessness can lead to an increase in the spread of the virus.
When the UK variant emerged, many countries shut down flights and other modes of travel. Bangladesh didn’t take any such measures. Those arriving from the UK are supposed to be quarantined, but that is hardly being followed. What is your opinion about this?
When the pandemic first broke out, there were a lot of unknown factors and so we shut down many things at the outset. It is not scientific to simply shut down everything. We have to look at the matter from public health and social considerations. We have seen that the UK variant has spread to around 150 countries of the world. So just halting travel to and from the UK will not be of any use. The virus can come from any other country. That means we would have to stop people coming from anywhere and block all entrance points. People are coming from all over, but quarantining only those coming from the UK is discriminatory.
What can be done to ensure people follow the health and hygiene rules?
It has to be supportive. At one time everything was shut down, but that will be difficult to do now. Many people will not be able to carry on if work is shut down. The law enforcement agencies must also contribute to raising awareness. There can be exemplary punishment in certain cases. If poor people are seen on the streets without masks, they can be provided with cheap and washable masks. On the streets they may be maintaining a distance from others and there is less risk of infection, but they are going somewhere or the other where they should be wearing masks. It is important to ensure that everyone wears a mask. And I emphasise that this must be done through motivation and awareness.
What are guidelines to follow in the prevailing circumstances? What are the factors people should be careful about?
Firstly, the health department keeps in contact with those who have contracted Covid and gives them guidelines to follow. They must follow those instructions. Covid patients must be strictly kept in isolation so they cannot infect others.
Secondly, many people are not getting tested despite showing symptoms of Covid and are roaming around freely. So people are getting infected from unknown sources. If anyone has symptoms, testing is a must. If infected, isolation is a must.
Thirdly, there must be no gatherings in closed spaces. If this is required for the sake of medical treatment or any other services or for any other reason, the doors and the windows must be kept open. And everyone must wear masks. One third of the space’s capacity is to be occupied, that is only one third of the people it can accommodate must be allowed and it must be managed in a way that no one stays for more than 15 minutes in the place. The door knobs and other places that are normally touched must be regularly sanitised.
Fourthly, public transport cannot be filled to passenger capacity. If necessary, the government can pay the transport owners compensation. And all passengers must wear masks.
How far is the vaccination programme in the country effective in preventing the transmission of Covid?
The vaccines might not have an impact right now in preventing the infection, but it will bring down the death rate. So everyone should be motivated to take the vaccine. If 70-80 per cent of the people in the country are brought under the vaccine coverage, then this might contribute to controlling the spread of the virus. So far less than 3 per cent of the people have been covered by the vaccine. We have to simultaneously reduce the spread of the virus and increase the vaccine coverage. An increase in transmission of Covid means an increase in deaths. Adherence to the health and hygiene rules and increasing the vaccine coverage must be done simultaneously and in a coordinated manner.
There is a fear that the virus becomes more powerful if the infections increase. A Bangladesh variant may emerge and this vaccine may not be effective. Is that a risk?
That certainly warrants consideration. The vaccine is effective against the variants that have been identified so far. But if the transmission continues, the virus may mutate and become more powerful. A new variant may emerge. The vaccine manufacturing companies are researching on new generation vaccines with all that in mind. We need to increase genome sequencing in our country. If that can’t be done, we won’t be able to understand whether a new variant is emerging or not or how powerful it may be.