Fighting the Delta variant: Do we have a plan?

Covid-19 cases in the country are on the rise again. While infections had seen a drop in May with the infection rate coming down to 7.91 percent on the 29th of that month, the infection rates are back on an upward trajectory: as of June 21, 2021, it stands at an alarming 19.27 percent, as reported by this daily. The death rates have also spiked—on June 20, the daily death toll from Covid-19 was 82, whereas a month before that on May 20, this number was at 36. Not that this development was unanticipated. With government-imposed "restrictions" becoming slacker by the day—not that one can remember the last time when the "lockdowns" were properly imposed this year—people are now out and about, dining with family and friends, shopping, enjoying hangouts and partaking in other social activities.

It is only natural that with increased social activities, Covid cases will see a rise. It's a contagious disease after all. While the reality that Covid-19 infection rates are spiking is distressing in itself, what is even more disturbing is the fact that the super-spreading Delta variant is being found in most of the cases: a factor that might be contributing to the sharp rise.

In a study earlier this month, Icddr,b revealed that of the Covid-19 patients in Dhaka, more than 60 percent have been infected with the Delta variant. And this study was conducted between the last week of May and the first week of June, when the situation was not as bad as it is now: on June 7, the infection rate stood at 11.47 percent.

This time, the rapid spread of the virus beyond the borders of the capital and its peripheries have shattered our illusion that the rural areas are not impacted as much by the virus. In December last year, the then Health Services Division Secretary Abdul Mannan was quoted as saying, "coronavirus has not spread as rapidly in the rural areas", when elaborating on why Covid vaccinations would be more city-centric in nature. 

Infection rates across the country remain high, with a DGHS press release on June 21 suggesting that Khulna division has the highest infection rate at 40.04 percent, Rangpur has an infection rate at 38.94 percent and Rajshahi's rate stands at 24.18 percent. Rangpur division's Kurigram has an infection rate of 52.38 percent. And the highest positive rate in the country has been registered at Rajbari at 63.11 percent.

The statistics look grim and the areas bordering India are highly exposed to the Delta variant. While the infection rates in the border areas can be attributed to the virus travelling all the way from India, we cannot discount the possibility that the people travelling from Dhaka to their villages to celebrate Eid carried the virus with them. The spike in the divisions can be the result of both these factors.

While the capital itself, with its better-equipped medical facilities, is under intense pressure to cater to the health needs of its residents, the situation in the divisions and districts are more than miserable. There have been reports of under-staffed and insufficiently equipped hospitals scrambling to accommodate Covid-19 patients or provide them with the medical care needed.

According to DGHS, of the 64 districts in Bangladesh, only 27 have ICU facilities to treat Covid-19 infected patients. In total, the country has 105 Intensive Care Units, according to a Prothom Alo report, of which 67 are in Dhaka, and the rest outside. The same Prothom Alo report quoted the DGHS, suggested that only three of the seven hospitals selected by the government for treating Covid-19 in Dhaka have ICU facilities—"There are 26 ICU beds at the 200-bed Bangladesh Kuwait Friendship Hospital, eight at the 250-bed Sheikh Russel Gastroliver Institute and Hospital, and 22 at the 500-bed Kurmitola General Hospital. Outside of this, there are six ICU beds in Uttara and Mirpur branches of Regent Hospital and five ICU beds at Sajeda Foundation in Kanchpur, Narayanganj."

And the situation is worse in the outskirts, "There is not a single ICU bed in 16 hospitals in Gopalganj, Faridpur, Manikganj, Shariatpur and other parts of Dhaka district outside of Dhaka metro and Gazipur, Tangail Narsingdi and Madaripur. The situation is the same in district hospitals in Barisal, Rajshahi and Rangpur divisions", the Prothom Alo report added.

Given the situation, it comes as no surprise that Covid-19 patients are often being deprived of access to treatment—a basic human right—due to shortage of medical facilities. But the question remains, who is responsible for this sordid state of affairs?

As early as May 29, it was recommended by the Epidemiology and Public Health Committee of DGHS to implement immediate lockdown in seven districts where the Delta variant has started community transmission. But the authorities decided otherwise. It was mango-harvesting season, and in the choice between saving lives or livelihoods, the government prioritised livelihoods, putting millions of lives at risk—that too in places where the healthcare infrastructure required to contain an outbreak does not exist. By the time the lockdowns were imposed, the situation had already spiralled out of control.

While it is important to support the livelihoods of people, saving lives comes first. The government has been reluctant this year in rolling out its social safety mechanisms to support the people whose lives have been affected by the pandemic. The one-off amount of BDT 2,500 that was provided to 3.5 million families before Eid was insufficient to live through a pandemic, to say the least. This year, the government could not even support the poor with the OMS programme due rice stocks falling to a 13-year low. The overall social safety nets put forward this year have been disappointing. And the government's repeated reluctance to impose hard lockdowns in the name of saving livelihoods has been nothing short of irresponsible.

And why has the health ministry not taken enough measures to strengthen its healthcare facilities, both within and outside Dhaka? Except for a handful of measures, even the capital's healthcare system was overwhelmed trying to provide treatment to Covid-19 patients at the height of the pandemic. In the first nine months of the outgoing fiscal year, the Health Services Division put up a miserable performance of not being able to exhaust more than 21 percent of the ADP allocation of Tk 11,979.34 crore, citing the fight against the pandemic as the roadblock.

Covid-19 is here for the long haul, and with inept and irresponsible decision-making, the haul might even be longer than expected. And no one knows how many lives this grim reaper will claim before it leaves us for good.

It is a fact that the fight against the pandemic is one full of complicated challenges, where often the decision is between saving lives and livelihoods. But with the right planning and resource allocation, the government can rise above this generational challenge and shield its people from the sharp scythe of Covid-19. While we cannot just make Covid-19 go away overnight, how well we contain or even manage it is up to the farsightedness, pragmatism and political will of the government. 

With the vaccine programme rolling out again, and lockdowns imposed in various parts of the country, one hopes that this extension of the second wave—or perhaps the beginning of the third wave—is contained before it snowballs.

The government needs to have a Plan B to counter the rise of the Delta variant, because Plan A—if there is one in the first place—does not seem to be working.

Tasneem Tayeb is a columnist for The Daily Star. Her Twitter handle is: @tasneem_tayeb