Why are we seeing so many deaths in the third wave?

The third wave of the Covid-19 pandemic with the Delta variant has started almost simultaneously in Bangladesh and in the UK. The infection rate is similar in both countries. The viral reproduction rate in the UK is currently 1.43, and in Bangladesh it is 1.42. Although the rate of transmission is similar, there is a stark difference in the number of fatalities. Bangladesh is witnessing a record high number of deaths in the third wave of the pandemic.

In the UK, since the beginning of the third wave, five lakh and sixty thousand people have been infected; of them, around six hundred died with the lowest death rate of 0.10 percent. In Bangladesh, in that time, one lakh and eighty-seven thousand people have been infected; of them, three thousand and one hundred people died with a death rate of 1.7 percent. As such, the death rate in Bangladesh is currently 17 times higher than in the UK.

Before the beginning of its mass vaccination programme in December, the Covid mortality rate in the UK was 3 percent. To date, 67 percent of the population of the country have got one shot of vaccine and 50 percent got two shots. Some 85 percent of the country's adult population have now developed antibodies against coronavirus through natural infections and vaccines. Consequently, the death rate has dropped dramatically from 3 percent to 0.10 percent, meaning that vaccination has reduced fatality by 30 times.

The pandemic scenario of Bangladesh is quite the opposite. Both infections and deaths are increasing rapidly. To date, 3.5 percent of the country's population have received one dose of vaccine and only 2.7 percent got two doses. Currently, the government has 56 lakh shots in its stock, which are sufficient for 28 lakh people. But Bangladesh needs 20 crores of additional shots to fully inoculate the country's 70 percent of population.

A little over one crore shots have been delivered across the country in the last four months. If the vaccination programme continues at this pace, it will take six and a half years to reach the target! Apparently, the speed of vaccination must be increased manifold. If 5 lakh shots are delivered every day, it will take until December next year to reach the goal of national Covid-19 immunisation set by the government.

India, meanwhile, is eight and a half times larger than Bangladesh in terms of population. But the country managed to vaccinate 22 percent of its population with one dose and 5 percent with two full doses within a short time. When Bangladesh is giving only a few thousand doses every day, India is giving 30 to 35 lakh doses daily. To date, India delivered 37 crores of vaccine shots.

A recent country-wide serosurveillance conducted by the World Health Organization revealed that 67 percent of adults in India developed antibodies against coronavirus. Amongst them, 79 percent people were from urban areas, and 63 percent from rural areas. They also found that the vaccinated people had 80 percent less chance of hospitalisation. It is a relief for India that a large portion of its population has developed immunity against Covid. This mass immunity will reduce mortality in the forthcoming pandemic wave in India which is going to occur in a few months.

What is the seroprevalence status of our country? Do we know how many people in the urban and rural areas have developed immunity against Covid? An accurate answer is absent as there hasn't been any nation-wide serosurveillance conducted in our country to date. A vital piece of information is missing—one that is required for successful immunisation.

Vaccines save lives. In fact, mass vaccination has saved an estimated 27 thousand lives in England so far. If the elderly and those in the high-risk group in Bangladesh had been vaccinated on a priority basis in the last four months, the death toll from the third wave could have been greatly reduced.

Bangladesh must procure enough vaccines and speed up its mass vaccination drive. Currently, our vaccination drive is going on at a snail's pace. Vaccination at a slower rate reduces its ability to control the epidemic. If India can jab 35 lakh people every day, why can't we give at least 5 lakh doses daily?

The lack of essential healthcare services can also be attributed to higher deaths in the third wave. The last two waves were mainly Dhaka-centric. But the current wave is affecting mostly the border districts, where lack of high-flow nasal cannula, oxygen supply and ICU facilities are evident. If the necessary actions were taken promptly, many lives could have been saved.

Moving forward, the government must take the following actions immediately to reduce further deaths from the forthcoming waves: (1) Accelerate the mass vaccination programme and inoculate 3-5 lakh people per day (vaccine should be offered first on a priority basis to all people in their sixties and high-risk groups; (2) Covid treatment facilities across the country must be increased by three folds; and (3) Country-wide serosurveillance should be conducted to assess the immunity status of the nation.

It is unfair to compare Bangladesh with a country like the UK. But isn't it true that we are also way behind India—with which we share many socioeconomic similarities—in terms of the above three points in managing the pandemic?

Dr Khondoker Mehedi Akram is a Senior Research Associate at the University of Sheffield, UK.