Anticipated, Yet Unprepared
Each day breaks a new record as the coronavirus spread goes out of hand once again and the people of Bangladesh spiral into complete chaos, suffering and uncertainty. Continuing to characterize this crisis as “unprecedented” is just an excuse now. With more than a year into the pandemic, there is a precedent for how we should confront a COVID-19 infection spike and there should have been better plans by now. Scientists and public health experts have been warning about a potential second wave in Bangladesh since September and have repeatedly stressed on the need to develop proper protocols in advance. Yet, over the last few weeks my social media is flooding with cries for help; people are desperately searching for ICU beds, information on plasma donors, oxygen supply for their friends and family – similar to our experiences from one year ago.
A phenomenological study conducted by Economics Study Center in September, 2020 revealed the fault lines of the country’s healthcare sector. The interviewed doctors and patients shared their dissatisfaction over lack of PPE and other facilities, availability of beds, delays in test results, high cost of treatment, and overall mismanagement during the first wave of the COVID-19 pandemic. The same month, data gathered by the Financial Express showed that with 70% of ICUs located in Dhaka division and nearly 50% of oxygen cylinders only in Dhaka and Chattogram divisions, the facilities available elsewhere were extremely poor. Even in the cities, the mass public faced difficulties finding affordable oximeters, adequate information, hospital beds, or oxygen supply. The health ministry had assured, at that time, that the second wave would not be a problem for Bangladesh as they were actively working on increasing healthcare capacity across all districts to tackle any future surge. Yet, there are no signs of improvement.
In June 2020, the Directorate General of Health Services (DGHS) had decided to install central oxygen supply systems in 124 hospitals but only 59 of them got installed so far. These shortcomings are resurfacing now, and the helpless citizens are paying the price again. A recent news report revealed that the only government hospital in entire Netrokona Sadar does not have a single ICU bed or high flow nasal cannula, and that the hospital is operating with only one ambulance. It is because of such weak infrastructure that so many COVID-19 patients have been forced to rush in from outside Dhaka, adding further pressure to the overcrowded hospitals in the capital. Last week, Dhaka Tribune reported that around 11 ICUs and 201 general beds in government hospitals were unoccupied according to DGHS, whereas Kurmitola General Hospital and Rajarbag Police Hospital were seen providing services beyond their capacity. In the wake of increasing infection rates, the Health Minister recently announced that 3,000 more hospital beds would be
Prevention better than doom
The government’s response to the record-breaking infection and death toll was not speedy and its action plans have been criticized for being incoherent. Public transportation services were suddenly halted without thinking through how people would commute to work. In the meantime, gatherings for entertainment or non-essential purposes continued all over the country. Even the directive on tourist spots was incomplete according to the NTAC. Struggling small business owners and vendors started protesting when the week-long lockdown was announced because for them, hunger is far worse than a virus. We have seen earlier that the poor and middle-income groups are the ones who suffer most from such irregular and ambiguous guidelines. Around the same month last year, thousands of RMG workers walked to Dhaka as factory owners asked them to amid a lockdown while all transportation services were shut. They were compelled to do so out of fear of losing their jobs, only to find out that they would have to return.
Experts believe that focus should have been on preventive measures and health safety rules to avoid another country-wide lockdown and a consequent blow to the economy. If there were proper contact tracing and isolation when the number of cases were still within limits earlier this year, we may not have been in this situation today. Once community spread becomes rampant in the country, it becomes nearly impossible to do contract tracing – a lesson we failed to learn from the first wave. If we look at examples of some countries that have prepared well and successfully tackled a second wave, we see that identification, contact tracing, testing, and quarantining were prioritized above all. For instance, South Korea deployed social workers to track isolated patients and maintained an expansive and organized texting system to inform those who may have come in contact with the infected patient in recent times.
Communication during a crisis
Constant and reliable communication was necessary, but our government may have failed on that front. It issued a "no mask, no service" order to be followed by all service providers and seekers but non-compliance with mask wearing, hand washing or physical distancing norms remains alarmingly high. In a country where hundreds of men were allowed to gather around the mayor to inaugurate a handwashing station and take pictures with him when the infection rate was on its peak, you can hardly blame the common people for not taking the virus seriously. Mixed messages from authority – first downplaying the severity of the infection then suddenly announcing it as deadly – is bound to confuse the public. The national vaccination programme has been commendable thus far in terms of coverage and management and has been a model for many other countries. However, the vaccination guidelines may not have been communicated well enough during the drive. As a result, the majority of vaccinated people stopped following basic health safety rules after taking their first dose, under a misconception that they are now fully immune and can no longer spread the virus.
Taiwan, one of the first countries to implement proactive measures against COVID-19, spent millions to quickly improve internet and cellular services in remote areas of the country for more equitable access to information related to the pandemic. The Senegalese government has also set an example with its communications strategy. It cooperated with religious leaders, and made imams and priests share posts or videos in which they are washing their hands and maintaining social distance, and this proved to be successful in encouraging the mass people. Pashe Achi Initiative, a Bangladeshi student led organization, is
We should acknowledge that with the life versus livelihood tradeoff, policymakers’ hands are tied, and the choices are not always easy. But after thirteen months of learning, adapting, and fighting this pandemic, one would expect improved healthcare services, better contingency plans – or at the very least, for the government to not be caught completely off guard by it.
4/8/2021 09:06:51 pm
Informative. Thanks Farzina Didi💜
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