Preventing Second Wave: Govt words not reflected in action

The government's preparations for tackling a possible spike in Covid-19 cases in the coming winter appear to be limited to rhetoric as efforts to control virus transmission and ensure treatment are still far from satisfactory.

In the wake of a second Covid wave in many parts of the world, especially in Europe, the government high-ups fear a likely rise in infections in Bangladesh too, but insist that they have taken all-out preparations for that.

However, the measures taken by the ministries concerned hardly reflect their claims.

Firstly, the government could not strictly enforce the health safety rules, a key instrument in the fight against virus transmission. A large section of the population is still reluctant to wear masks though it is mandatory to use face coverings in public places.

Another important aspect of the preparedness is hospital management.

Here too, the government falls short of the required preparations in case the health system gets overstretched due to a spike in infections.

The health directorate has not been successful in ensuring adequate tests, central oxygen supply and other life-support equipment at public hospitals across the country.

Yet, Health Minister Zahid Maleque on Sunday claimed that the government was "completely ready" to tackle a possible second wave.

Experts, however, say the health authorities' handling of the pandemic since its outbreak in March was not satisfactory, and that they took many inappropriate decisions and steps.

A repetition of that could lead to dire consequences this time, warned experts.

They say the government has to take effective preventive measures based on projections and experience gained over the last eight months so that it can act fast to control a possible second wave in the coming winter and provide healthcare services to Covid patients.

The deadly virus has so far infected more than four lakh people and claimed nearly 6,000 lives in the country. However, the rate of infection and fatality fell recently. But experts caution that there is no room for complacency.

They point out that it cannot be said for sure that the first Covid wave in the country is over. According to the World Health Organisation, the number of people testing positive has to be below 5 percent to reach such a conclusion. The daily infection rate in Bangladesh is still around 12 percent.

"There is no scope for complacency as virus transmission in the country is still going on... We are still among top 18 countries in terms of Covid cases and among top 30 countries in terms of Covid deaths," said Prof Mushtaq Hussain, a consultant at the Institute of Epidemiology, Disease Control and Research (IEDCR).

"Efforts to control virus transmission must be the number one priority until there is a cure for the virus…," he told The Daily Star.

TRANSMISSION CONTROL

Prime Minister Sheikh Hasina on several occasions asked the relevant agencies to ensure mandatory use of masks. On October 25, the cabinet meeting chaired by the premier adopted a "no mask, no service" policy for all to avail services at public and private offices.

Over the last couple of days, the premier gave directives to the agencies concerned about quarantining inbound passengers from abroad and also about wearing masks.

Following her instructions, the relevant authorities seem to have started making some preparations.

The prime minister has been urging people to follow the health guidelines and use face masks in public places to prevent a possible second wave of the pandemic.

Yesterday, the issue of quarantining inbound passengers from abroad was discussed at an inter-ministerial meeting chaired by the health minister. The meeting also discussed a proposal for giving people masks free of charge, said meeting sources.

Experts believe strict implementation of the health safety rules is the key to containment of virus transmission. 

"These announcements usually remain as mere announcements. These will not yield any results unless the government monitors their implementation," noted virologist Prof Nazrul Islam told The Daily Star.

On the health ministry's part, there has been no strong awareness campaign. Instances of punishing people for not complying with the health safety rules are only a few. The majority of people are still unconcerned and continue to disregard the health safety guidelines amid a lack of monitoring mechanism.

Besides, the health directorate is not conducting adequate Covid tests. Rather, the number of tests has declined over the last few months whereas neighbouring India and many other countries around the globe have adopted a widespread testing policy.

On July 2, there was 0.11 test per thousand people in the country and it fell to 0.08 as of October 27, according to ourworldindata.org.

Besides, the introduction of antigen-based rapid testing in 39 public hospitals is still uncertain as the testing protocol has not been finalised yet. Moreover, antigen testing kits are yet to arrive from abroad, said DGHS sources.

Contacted, Farid Hossain Miah, director (hospitals and clinics) of the DGHS, said, "The draft testing protocol has been sent to the health ministry recently. It is yet to be finalised."

OXYGEN SUPPLY STILL INADEQUATE

Experts have long been stressing the need for uninterrupted oxygen supply at hospitals for critical Covid patients.

Putting emphasis on it, the prime minister on June 2 ordered setting up of intensive care units (ICUs) at all district hospitals.

Subsequently, the health ministry took steps to set up central oxygen supply systems in 79 district hospitals.

Nearly five months have gone by but only 24 Covid dedicated hospitals in the country have central oxygen supply systems, according to the latest data from the Management Information System of the DGHS.

Setting up of the system in district hospitals is still at primary stage, said DGHS officials.

Prof Nazrul, also member of the National Technical Advisory Committee on Covid, said, "Despite the prime minister's directives, ICU facilities are yet to be expanded to the expected level. If there is a spike in Covid cases, it will not be possible to ensure uninterrupted oxygen supply to critical Covid patients without setting up of central oxygen systems at public hospitals."

Many Covid patients would not have died if there were central oxygen supply systems in all district hospitals, he said.

According to DGHS data, oxygen supply situation in the Covid dedicated hospitals in the capital is a bit better than that of those elsewhere.

Of around 70 Covid dedicated hospitals or units in the country, only 24 have central oxygen supply systems with 322 ICU beds and 3,859 general beds.

Seventeen of the 24 are in the capital, four in Chattogram, and one each in Keraniganj, Gazipur, Narayanganj, show data.

Prof Ridwanur Rahman, an infectious disease specialist, said, "The figures indicate that the overall situation is good, yet these arrangements will not be enough if the number of patients rises again.

"If they [the government] really mean that they have made preparations, setting up of central oxygen supply systems in public hospitals up to the upazila level should not be that difficult."

Asked, DGHS Director Farid Hossain Miah, said, "The process [of installing the system in public hospitals up to the upazila level] is underway. But it's not possible to give a specific time frame for its completion."