Covid-19 in Bangladesh: Muddled response marks 6 months

The present Covid-19 situation suggests actions taken by the government made little impact on containing the virus, say public health experts as today marks half a year since the first novel coronavirus cases were reported in the country.

A glimpse at the present daily case counts may give an impression that the situation is under control, but a deeper look, the experts say, would reveal otherwise: a large number of cases remain hidden and those help the virus spread fast.

Bangladesh was the 14th worst affected country in terms of total caseload as of yesterday. With a total of 327,359 confirmed cases, it remained, as of yesterday, between France and the UK, according to worldometer.info.

The country reported the first three Covid-19 cases on March 8. The number of casualties, however, still remains comparatively low at 4,516 with the Directorate General of Health Services (DGHS) reporting 37 new deaths in 24 hours till yesterday morning.

The percentage of daily tests that come out positive (positivity rate) is still high compared to the global trend. The positivity rate was 14.29 percent yesterday, though the World Health Organisation recommends achieving a positivity rate lower than 5 percent for two weeks before lifting Covid-19 driven shutdowns.

But the government has already lifted all restrictions on public movement and activities, which were imposed to contain the spread of coronavirus, on September 1, despite Covid-19 showing no sign of abatement anytime soon.

On the other hand, it has not yet launched the much-needed antigen-based rapid testing to effectively identify and isolate infected persons. Neither did it give nod to the antibody-based rapid testing.

Against the backdrop, experts said Bangladesh is now heading towards an "unpredictable destination" due to a lack of coordination among those handling the crisis, bureaucratic tangles, corruption, untimely and unscientific steps in tackling the virus outbreak from the very beginning.

"We have done well in tackling Covid-19 outbreak. But there has been a problem in command and control from the beginning," Dr Mushtuq Hussain, consultant at the Institute of Epidemiology, Disease Control and Research (IEDCR), told The Daily Star.

HANDLING OF COVID-19

The government's response to the coronavirus outbreak has been plagued by wrong decisions, delayed actions, and muddled thinking right from the beginning even though it got three months' time to take preparation.

The authorities trailed behind in taking decisions like closing airports, sending expats to compulsory quarantine, and imposing total shutdown.

And there was a clear lack of coordination among the government organisations everywhere.

Internal feud among different government entities also caused delays for the authorities in preparing the emergency response plan on Covid-19, say experts.

Initially, the IEDCR, the government's disease control agency, was dealing with the pandemic, but then a feud between the high-ups of IEDCR and DGHS delayed the finalisation of the emergency response plan.

Then came the quarantine fiasco. More than 2 lakh people entered Bangladesh since March when the virus was spreading across the world, prompting countries to shut their airports.

But as the Bangladeshi expatriates started coming in, the government let them come in and go home, without putting them into mandatory quarantine.

On March 23, the government announced a shutdown effective from March 26, but kept the public transport running. As a result, tens of thousands of people left Dhaka in crammed buses and other modes of transports having been exposed to the virus.

The government then extended shutdown in phases, which had a substantial impact on the country's economy.

For the first few months, cases were restricted to Dhaka and cities like Narayanganj and Gazipur. But there was no mechanism to control the exodus of the people leaving Dhaka city centring the Eid-ul-Azha.

This, according to experts, resulted in the spread of the virus across the country. Then came the influx of hundreds of thousands of garment workers to Dhaka with no safety guideline followed.

As the virus raged on, patients were let down as many of them couldn't get themselves tested, nor could they find beds despite the fact that the authorities had extended treatment facilities.

Also, the pandemic exposed the poor medical infrastructure in the country. Doctors and other medical staffers, leading the battle against the invisible enemy, were forced to treat patients without proper safety equipment.

So far, 44 different committees were formed -- mostly on behalf of the DGHS and the health ministry. But only a few are functioning currently and many of the committees never had any meetings.

Among all, the National Technical Advisory Committee (NTAC) made important recommendations from the beginning, but a very few of those were implemented.

On July 26, the health ministry formed a taskforce to coordinate the activities of the committees and make sure the implementation of recommendations.

"In the beginning, we had no preparation but we said we have. This gave all a wrong message. And we had to pay for this," Prof Nazrul Islam, member of NTAC on Covid-19, told The Daily Star yesterday.

He thinks the transmission is slowing down in the country.

"It is, however, clear that we could not contain the transmission [of the virus]. We cannot be satisfied considering the current situation," said this noted virologist.

Amid various mismanagement, there were allegations of corruption from the beginning of the outbreak.

Healthcare staffers raised questions about the quality of their personal protective equipment (PPE) and N-95 masks, leading to the removal of the then director of Central Medicine Store Depot.

Then came the fake Covid-19 certificate and test report scams involving Regent Hospital and JKG Health Care. The issue of Regent Hospital's fraudulence resulted in the resignation of the DGHS's DG Prof Abul Kalam Azad.

"Corruption is the major problem that hindered government efforts," said Prof Nazrul Islam.

Amid everything so gloomy, there is one thing that gives hope.

The country has a respectable recovery rate. Till yesterday, as many as 2,24,573 people defeated the virus, taking the recovery rate to 68.60 percent, which is one of the best globally.

Although there was no countrywide scientific survey to know the severity of the virus transmission, an IEDCR-icddr,b survey revealed last month that one in every 10 people in Dhaka city was infected with Covid-19.

The virus' mutation rate was recorded at 12.6 percent in a recent study by Bangladesh Council of Scientific and Industrial Research (BCSIR), nearly double  compared to the global average of 7.23 percent.

Experts assume this may be one of the natural reasons why the virus has not been so deadly here. But it might turn worse any time, they warned.