Halfhearted lockdown: Does it help?
The national advisory committee, made up of health experts to fight the coronavirus pandemic, has been ignored
When it comes to limiting the spread of the Covid-19, a half lockdown is worse than a no lockdown. It is because when a country cannot properly enforce stay-at-home order it hurts itself in two ways.
First its economy is ruined because business and commerce are halted and disrupted. An economy, unfortunately like many other things, cannot function at 90 percent, as The Economist's current cover story says. It has to be 100 percent.
Secondly, a half lockdown nevertheless keeps the infection rate high, as people do not or can not maintain social distancing, go out in hordes to markets, to everywhere and that puts the health system under tremendous pressure.
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In Bangladesh, both seem to be happening right now.
The economy is suffering enormously, leaving millions destitutes again.
The worst part of the pandemic experience for us is, the virus bit into us just when the biggest retailing bonanza was about to begin in advance of the Eid.
People's incomes have eroded as much as 75 percent as studies show.
On the other hand, the infection rate is rising. Discussing the number of infected people has little meaning now as Bangladesh could not ramp up its testing capacity because of a no visible early initiative to procure the testing kits (the number of available kits is now a secret kept close to the chest).
But even this small sample, if extrapolated against the total population, will give a rough idea of how many people are probably carrying the virus right now, most or many of them asymptomatic.
The infection rate increases because more and more people are getting exposed to the virus, a sinister Kafkaesque scenario because it is neither a living thing nor a dead thing that is causing so much havoc.
The lockdown has been here for 39 days but the infection curve has not displayed any flattening tendency as yet. It remains bizarrely plateaued at a high level.
That is the expected outcome unless a proper lockdown was in place for either 49 days at a stretch or 67 days in three phases with relaxation of five days in between.
Yes, deaths are low in Bangladesh, as in the rest of South Asia and there are only speculative answers as to why. But scientists are yet to fully understand the virus which is so new and infectious. It is still a little understood germ that emerges with newer features every day (whether smoking hinders or helps the virus is an example of all the speculations surrounding its tremendous virulence).
Countries thought to have succeeded in taming the virus, such as India, are again reverting back into infection spikes.
In this populous country with people of low social awareness, it is also difficult for authorities to impose restrictions for both the reasons mentioned.
Policing the streets is difficult and also the question of feeding so many people with no or little savings is an enormous job given our nature of labyrinthine bureaucracy that works at snail's pace.
This newspaper has reported how relief for the slum dwellers in the city made paper circuits for 22 days before reaching the hungry and that too in inadequate quantities.
Late action?
So, we are actually running behind the virus, not ahead of it. Countries that were late to respond, such as the US, Italy or Spain and France are all walking the shadowy valley of nightmare.
We are sure of one thing, the virus was an imported one, it is not a local syndrome. It had entered the country from outside. What could we have done to stop its entry?
The answer was ridiculously simple but escaped the authority. We could have immediately cancelled all flights the moment it became known that the disease was highly contagious.
The outbreak was declared by the WHO a Public Health Emergency of International Concern on 30 January 2020. On 11 March, the WHO characterised the Covid-19 outbreak to be a pandemic.
We did not do anything.
Incoming air flights remained open until the end of March allowing returnees to enter Bangladesh from affected countries.
We could have force-quarantined the passengers. We did not. We left it up to their conscience to go home and quarantine themselves, an astonishing proposition that even a child would laugh at.
Many of the African nations such as Senegal, Rwanda, Uganda and Sierra Leone, who had learned their lessons earlier in the Ebola outbreak, knew what a pandemic might mean and went for early actions. They closed borders and started strict contact tracing and quarantine. They are the safest places on earth now. The same thing can be said of Vietnam.
In Bangladesh, eventually a lockdown was declared from March 26 but it was called a general holiday.
Holiday and lockdown are two different things, carrying different connotations.
On holidays you go out on vacation, you enjoy life with others. Lockdown means something more serious, something sinister that led to its announcement. It means stay wherever you are, no movements for any reason whatsoever unless in extreme emergency.
An unintended consequence: general healthcare breaks down
Non-coronavirus health care has today become an unintended victim and patients are being unfairly deprived of treatment.
Hospitals are scared to take in patients because they do not know if the patients were infected with the virus. Had there been a quick test system (even airlines are carrying out quick tests before boarding their passengers), the situation could have been different.
But it now seems, more people will die of non Covid-19 causes than the virus itself. We have read several stories of how even simple complications during childbirths have led to maternal deaths.
Health warnings ignored
In the time of an unprecedented health crisis like this pandemic, consultations of epidemiologists, virologists, public health experts, scientists, and medical researchers must be sought and their opinions must be given priority to decide the next course of action. But here the protocols seem to be operating on some obscure reasoning.
The national advisory committee, made up of health experts to fight the coronavirus pandemic, has been ignored. The health minister, who is leading the committee, on April 6 expressed his frustration that they were not aware of the decision regarding the time for reopening of the factories.
Talking to this newspaper on Sunday, Prof ABM Abdullah, a member of the committee, again expressed the same frustration. He warned that infections might spread if the health advisory was not followed strictly.
Prof Be Nazir Ahmed, former director, Communicable Disease Control, DGHS, fears that the risk of spreading infection will increase due to lack of coordination among the health authorities and the administration.
"Garments and restaurants were permitted to reopen without consulting with the health division. We have to pay a price for these uncoordinated actions."
A few hundred RMG factories were allowed to reopen on April 26, a month after the lockdown, in Dhaka, Gazipur and Narayanganj—the three areas were already declared virus hotspots.
They were allowed to reopen five days after an inter-ministerial meeting warned that infections and deaths may spike in May.
At the meeting on April 21 chaired by the health minister, two types of projections prepared by health experts were presented by Professor Dr Abul Kalam Azad, director general of the health directorate.
The first was conservative, according to which 48,000-50,000 people may be infected and 800-1,000 may die by May 31.
Another projection says infections may rise to around one lakh.
"Many factors were considered to prepare the projections, such as lockdown, carefulness, social distancing and their present state. We are preparing for curbing the pandemic and treating patients based on the estimations," Prof Azad told the meeting.
In spite of the warnings, the health ministry went ahead on Sunday and asked the RMG factories to ensure medical teams in each factory to check the health of workers and keep the national advisory committee updated.
It remains uncertain whether the instructions would properly be followed by the factories that had earlier ignored advice to ensure health safety of workers to reopen the factories.
Earlier in April, factory owners asked RMG workers, who had left their workplaces following the factory shutdown after the announcement of general holidays, to return. The workers returned to Dhaka, Narayanganj and Gazipur in hordes from different districts. And then they were told the factories were not opening.
Again, such an exodus was noticed on the streets after the factories reopened, this time for real, on April 26, breaking down the social distancing caveat amid the knowledge that the virus spreads fast in a crowd.
It might have been presumed that the virus has been weakened here as the fatality rate is comparatively low. But this is a case of complacency as is clear from the warnings from experts.
"We are really early in this disease," said Dr. Ashish Jha, the director of the Harvard Global Health Research Institute. "If this were a baseball game, it would be the second inning and there's no reason to think that by the ninth inning the rest of the world that looks now like it hasn't been affected won't become like other places."
