Better equipped now, worries still there

The major challenges for the healthcare sector of Bangladesh in 2021 was ensuring supply of Covid vaccines, inoculating a huge chunk of the population, and making sure the infected got beds, ICU beds, and adequate oxygen.

Bangladesh is now better equipped to deal with surges in Covid cases, like the one caused by the Delta variant, but experts fear the country is not out of the woods yet.

On the fear of Omicron variant spreading, Prof Nazrul Islam, a member of the National Technical Advisory Committee on Covid-19, told The Daily Star that if the surge of infections was like that caused by Delta, the crisis would not be as severe but the fear remains.

"The oxygen production and supply situations are much better now. But keeping everything functional will be a challenge," Prof Ridwanur Rahman, an infectious disease specialist, told The Daily Star yesterday while reviewing the achievements and failures in the health sector in 2021.

Omicron will likely start creating pressure on the healthcare system early next year, he warned.

After the first wave, the deaths, new cases and infection rates were low when the new year had begun in 2021 with hope for some sort of normalcy.

The people of the country, the economy, and the businesses were eying a return to business as usual as the vaccination campaign rolled out on February 7.

But that was not to be, at least for some months, as the government practically put all its eggs in one basket. The supply of shots from India stopped and the campaign was in disarray by April. Things became grimmer with the emergence of the Delta variant in May.

Eventually, the supply of shots was ensured from various sources, including China, but the Delta raged on, shooting oxygen demand through the roof, costing lives and exposing again the government's incapacity in hospital management and timely project implementation.

"There were crises over vaccine supply and Delta variant transmission and hospital management initially. The government managed to deal with those issues well at last," Prof Nazrul told The Daily Star.

Now the Omicron variant has become a cause for concern. Seven cases have been reported so far in Bangladesh and experts warn of trying times ahead.

VACCINE ROLLOUT

The drive to properly inoculate 80 percent of the population began in February using Oxford-AstraZeneca's Covishield vaccine produced by Serum Institute of India (SII).

The campaign suffered frequent hiccups mainly due to a shortage of doses caused by a yawning gap between supply commitments and actual deliveries, forcing the government to stop administering the first of the two doses on April 26.

Gradually, the situation improved with supplies from the US, China and Japan, prompting the government to resume administering the first dose on June 19. The lion's share of the shots was bought from China.

As of December 27, around 4.87 crore or 28 percent of the targeted population received the two shots.

The government also introduced booster shots on December 28.

DELTA

The country started seeing a steady decline in the number of daily cases in February. People were expecting some sort of new normal in the days ahead and the government was even thinking about reopening schools that had been closed since mid-March 2020.

However, infections started rising from March amid disregard for health safety guidelines nationwide.

The government imposed restrictions on movement, initially between April 5 and 11, and then extended them in phases.

The transmission started to decline a little towards the end of April but things changed for the worse in the months that followed.

Despite lockdowns enforced on July 1, Delta swept across the country, taking lives. On July 28, the all-time highest 16,230 people tested positive for Covid. On August 5 and 10, the daily death toll was 264, the highest ever.

During this time, hospitals across the country were stretched to their limits. Nationwide ICU bed occupancy was more than 90 percent and general bed occupancy was over 80 percent until the end of July.

The demand for oxygen in hospitals rose to 210 tonnes a day when the local production capacity was around 120 tonnes a day.

The government had then failed to install in time the built-in oxygen supply systems in all the hospitals it had planned to. There was a high-flow oxygen supply device shortage, which has been attributed to the deaths of at least 16 Covid patients in Satkhira, Rajshahi and Bogura between June 30 and July 7.

Around 58 percent of the 28,062 Covid deaths, as of December 28, were recorded after the emergence of Delta.

MAJOR INCIDENTS

Irregularities in the health department did not stop even during the pandemic.

On September 20, the health ministry cancelled the process for appointing 2,839 people for the posts of medical technologists, technicians and cardiographers due to what it called ambiguity in the answer scripts of the written test.

The understaffed health department continued to struggle in delivering quality healthcare.

A total of 17 important documents, mostly related to purchases, went missing on October 28 from the health ministry.

The ministry formed an investigation committee and suspended four employees as per the committee's recommendation.

But the reason behind the files going missing is still shrouded in mystery.