Lax Lockdown Enforcement, Poor Infra And Bad Decisions Take Bangladesh To Brink Of Covid Disaster

Bangladesh is hurtling towards a disaster, and there is little that the impoverished nation can do to avert it. Epidemiologists in that country say that the virulent virus has spread and infected tens of thousand, and the official statistics are just the tip of the proverbial iceberg.

According to official statistics, 8790 Covid-19 positive cases have been recorded till Saturday (May 2) in the country of 17 crore people, and 175 of them have died while 177 have recovered. The infection rate is thus 0.005 per cent and the case fatality ratio (CFR) is 3.29 per cent.

But, say epidemiologists at Bangladesh’s premier Institute of Epidemiology, Disease Control & Research (IEDCR), these statistics belie the true extent of the affliction that is about to assume catastrophic proportions in the country.

The testing rate is abysmally low—just 76,066 swab samples have been tested till Saturday making this rate (0.04 per cent) one of the lowest in the world. “Because adequate tests have not been carried out, the number of positive cases is so low.

Professor Ridwanur Rahman, former head of medicine at Shaheed Suhrawardy Medical College Hospital in Dhaka, says that it is quite possible that many times the number of positive cases detected so far have actually contracted the virus and are carriers now.Apart from low testing rate, the manner in which Bangladesh has handled the pandemic so far has also contributed to the cataclysmic spread of the deadly virus. The first Covid-19 positive case was detected in the country 8 March and the first death recorded ten days later.

The government ordered a countrywide lockdown on March 23, but enforcement was inexplicably lax. Markets even in Dhaka were allowed to stay open, rickshaws and auto-rickshaws plied merrily, tens of thousands were allowed to move around the country and despite appeals, religious gatherings continued with impunity.

Late last week, in an ill-advised move that virologists feel has only compounded the disaster, the government allowed textile and garments factories to reopen. Lakhs of workers returned to Dhaka and its neighbouring areas (where most of these factories are concentrated) and are living in cramped conditions in slums (ideal for quick transmission of the virus) near the factories.

Friday (May 1) saw seven workers of a garment factory at Savar upazila (sub-district) of Dhaka testing Covid-19 positive. But the factory was not sealed and no effort has been made to ensure that the garment and textile factories that have been allowed to reopen maintain social distancing and other protocols.

Professor Saif Ullah Mushi, chairman of the virology department of Bangabandhu Sheikh Mujib Medical University at Dhaka points to the country’s poor healthcare infrastructure that is already on the brink of collapse.

“The number of positive cases is doubling every three days and given our weak healthcare infrastructure, we will not be able to control the pandemic,” he warned.

There are less than 2000 ventilators available in the critical care units (CCUs) of all hospitals in Bangladesh put together. Of these, just 20 per cent (or just 400) are free. Epidemiologists say that on an average, five percent of Covid-19 patients turn critical and require ventilators.

“Since testing is so low, early detection of cases is not happening and most patients who are coming in for treatment are already serious. Quite a large number of them need to be put on ventilators and we just don’t have enough ventilators in our hospitals,” said Dhaka Medical College principal Professor Khan Abdul Kalam Azad.

Newspapers, TV channels and social media are rife with reports of scores of people dying of severe respiratory failure all over the country every day. All these cases had not been tested, and virologists say all of them would have turned out to be Covid-19 positive had they been tested.

People all over the country are flouting lockdown restrictions and even the deployment of the country’s army to enforce restrictions has not worked.

“People are crowding the markets, tens of thousands are out on the streets of Dhaka and other cities and towns across the country, people are travelling from one place to another in trucks, buses and boats packed like sardines in them and people are going to mosques in large numbers. A disaster of unimaginable proportions is inevitable,” said Prof Rahman.

Alarmingly, more than 500 doctors, most of them in Dhaka, have tested Covid-19 positive. “This is due to the very poor quality or even absence of PPEs, community transmission of the virus and tendency among many patients to hide symptoms of Covid-infection while being examined by physicians,” said Nirupam Das, chief administrator of Bangladesh Doctors’ Foundation.

More than 700 doctors are in home or institutional quarantine, resulting in Bangladesh facing a severe shortage of physicians at this critical time when they are needed most. The Bangladesh Public Service Commission has now green-lighted recruitment of 2000 medical graduates and more than 5000 nurses.

More than 500 policemen, at least half of them with the Dhaka Metropolitan Police (DMP) have also tested positive and more than 1100 are in home or institutional quarantine. The country is facing a severe shortage of N95 masks and doctors are having to do with cheap ‘equivalents’ imported from China.

Professor Munshi of Bangabandhu Sheikh Mujib Medical University fears there will be a sudden explosion of cases after about ten days.

“The widespread community transmission occurring now will result in Covid-19 positive cases peaking in about ten to 12 days. But due to inadequate testing and testing facilities--there are only 29 testing laboratories in the country and all face an acute shortage of testing kits and reagents--most cases will go undetected and untreated,” he said.

Professor Munshi added that one Covid positive person can infect 20 others.

“If a large number of such positive cases remain undetected and untreated, can we imagine the huge numbers who will get infected and will turn critical? This is why we are all warning that the situation is critical and will turn catastrophic,” he said.

But for the Bangladesh government, reviving the export-oriented economy seems to be more important. Despite serious concerns voiced by experts, markets have been allowed to remain open and garment factories have been allowed to reopen.

The country’s health minister has convened a meeting with heads of many other departments and trade and industry bodies Sunday to decide on reopening factories and resuming economic activities across the country.

If that happens, warn virologists and epidemiologists, there is no saving the country. But such warnings are likely to go unheeded by the country’s rulers who seem to have accorded precedence to livelihoods over lives.