Published:  01:21 AM, 02 April 2020 Last Update: 02:19 AM, 02 April 2020

Collectively we win or otherwise we fail

Government does not have Aladdin's magic lamp

Collectively we win or otherwise we fail

Tasmiah Nuhiya Ahmed

COVID-19 is a novel corona virus that emerged in China in 2019. On 7 January 2020, Chinese authorities confirmed COVID-19 and on 30 January 2020, the Director-General of WHO declared the COVID-19 outbreak a Public Health Emergency of International concern (PHEIC).

The corona virus COVID-19 is affecting 200 countries and territories around the world and 2 international conveyances: the Diamond Princess cruise ship harbored in Yokohama, Japan, and the Holland America's MS Zaandam cruise ship. Globally there are 786, 907 cases of Corona virus and 37,840 deaths. 1, 65, 892 people have recovered globally from Corona virus (as of March 31, 2020, Source: Worldometers).

According to Best Healthcare in the World by Population 2020, healthcare system of France appears to be on top of the list of 100 countries and then comes Italy. Singapore ranked 6th, Spain ranked 7th, United Kingdom ranked 18th, United States ranked 37th, Thailand ranked 47th, Malaysia ranked 49th, Bangladesh ranked 88th among 100 countries of the world (Source: World Population Review).

Now coming back to the corona virus pandemic, Worldometers data suggests that USA has the highest number of corona virus cases, which is 1, 64,266 and the number of total deaths in USA reached at 3,170. 101, 739 Covid-19 cases reported in Italy, which has the 2nd highest number.

And 3rd is the Spain which has 87, 956 corona virus cases.  In France, which has the best healthcare system, a total of 44, 550 Covid-19 cases have been reported. 22,141 cases of Coronavirus reported in UK. In Canada, 7,474 Covid-19 cases have been reported and 92 people have died due to Coronavirus.

The number of Corona virus cases is 4,557 in Australia, 2626 in Malaysia, 1865 in Pakistan, 1651 in Thailand, 1414 in Indonesia, 1251 in India, 879 in Singapore, 51 in Bangladesh.

The number of deaths from Corona virus is highest in Italy. The number of death from Corona virus cases is 11,591 in Italy, 7,716 in Spain, 3,305 in China, 3,170 in USA, 3024 in France, 1408 in UK, 122 in Indonesia, 22 in Canada and 5 in Bangladesh (Source: Worldometers as of March 31, 2020).

In the health system of Bangladesh, the Government or public sector is the first key actor which by constitution is responsible not only for policy and regulation but for provision of comprehensive health services, including financing and employment of health staff. Bangladesh has been growing through a health crisis for a long time.

About 3% of Bangladesh's GDP is spent on health, out of which the government contribution is about 1.1%. In term of dollar, the total health expenditure in the country is about US$ 12 per capita per annum, of which the public health expenditure is around US$ 4.

In Bangladesh, historically, supply-side financing of health care services has been the backbone strategy for improving the access of poor households to essential health care services. (Source: National Preparedness and Response Plan for COVID-19, Bangladesh, March 2020).

Bangladesh is currently fighting against COVID-19 pandemic with limited financial resources and a legacy of poor healthcare infrastructure. In an attempt to curb the spread of Corona virus, the government of Bangladesh has announced nationwide holiday from March 26 to April 4, which may further be extended until April 9.

During the period of general holidays, army is enforcing social distancing across the nation. When the first batch of mass returnees arrived from China in February, they were all quarantined at the Ashkana Hajj Camp in Dhaka. In mid-March when the second batch of foreign returnees-over a hundred and forty Bangladeshis evacuated from Italy-arrived, were allowed to leave with the promise of "home quarantine."

Bangladesh updated "Infectious Diseases Prevention, Control and Elimination Act, 2018" on communicable diseases. The Act provides that "keep or quarantine any suspected person infected with an infectious disease, at a specific hospital, temporary hospital, establishment or home".

This law empowers government in notification, isolation, quarantine, sample collection and testing in emerging diseases. The law forms an advisory committee, headed by Minister, Ministry of Health and Family Welfare including Ministry of Agriculture and Ministry of Fisheries and Livestock.

The Bangladeshi research institute spearheading the fight to test and detect coronavirus is the Institute of Epidemiology Disease Control and Research (IEDCR), a body under the Ministry of Health. IEDCR Director Meerjady Sabrina is claiming that Bangladesh has been following the WHO guideline and doing enough tests as WHO is repeatedly asking countries to test as many people as possible to get an exact bearing on the nature of infection and the geographic concentration.

However, several media reports quoted experts saying that Bangladesh is still not equipped with the necessary health care facilities and support to deal with serious cases of the novel coronavirus. Many have expressed concern that there is a serious lack of Intensive Care Unit (ICU) beds with facilities with ventilators, shortage of Personal Protective Equipment (PPE) for health care workers, testing kits and other resources, including a national fund to fight the COVID-19 outbreak.

"Bangladesh is facing these challenges because of a weak Health Ministry. There is a serious crisis of ICU beds prepared for patients and necessary training and supply of PPE to physicians and health care associates," Dr. Zafrullah Chowdhury, a Bangladeshi public health activist and founder of Gonoshasthaya Kendra, a rural health care organization with a modern medical facility, (Source: Anadolu Agency, 29 March 2020). According to some media reports, some local hospitals, including in the capital Dhaka, issued a notification for doctors to procure their own PPE due to a crisis of insufficient supply.

The Transparency International, Bangladesh (TIB) in statement criticized the way the government allowed returnees from abroad to travel to their villages as fears mount of a heightened outbreak. Moreover, it is also being reported that in the last two months, over eight lakh people had called the Covid-19 hotlines for tests.

IEDCR hotlines alone received over 70 thousand calls. But only less than 1,100 have been tested and 51 positive cases have been found. The report suggests that the reason behind this low number of coronavirus cases in Bangladesh is the low number of tests of Covid-19 (Source: The Business Standard, 29 March 2020). 

After the first reported case of infection, Bangladesh did not report any new cases for the next five days. Then on March 14 two cases were reported. The next day no cases were reported. New patients were detected in between March 16 to March 24. But then on March 25 & 26, no new cases were reported. Another new COVID-19 case in the country was reported on 30 March 2020.

Professor Benzir Ahmed, former director of the health directorate (disease control) said we are missing the scope to detect infected people while raising the risk of spreading the virus (Source: The Business Standard).

It is important to note that South Korea has become an example of containing the virus by conducting extensive tests immediately after the outbreak. It conducted more than three lakh tests. More than six persons every one thousand people were tested. Virologist Prof Nazrul Islam, former vice-chancellor of Bangabandhu Sheikh Mujib Medical University, also expressed concern over the small number of tests and warned that the battle against Covid-19 could be lost if testing capacity were not increased (Source: The Business Standard).

Now, let's look into the Covid-19 situation in Bangladesh through another lens.

The government of Bangladesh has formulated National Preparedness and Response Plan for COVID-19, Bangladesh, March 2020 (Plan March 2020) which states that the Government shall prevent entry of COVID19 case in Bangladesh from affected countries, limit human-to-human transmission including reducing secondary infections among close contacts and health care workers, prevent transmission & amplification events, and enhance infection prevention & control in community and health care settings; identify, isolate and care for patients early, communicate critical risk and event information to the communities and counter misinformation and minimize social and economic impact through multisectoral partnerships.

It also provides that Bangladesh will ensure emergency contingency protocols to support quarantine according to the "Infectious Disease (Prevention, Control and Elimination) Act 2018. In accordance with Article 32 of the International Health Regulation, suitable infrastructure will be selected for quarantine.

Accommodation, food and other necessary supplies will be provided. Ministry of disaster management and relief will be engaged along with other stakeholders for this.  Appropriate communication channels shall be established to avoid panic.

The Principal Scientific Officer (PSO) at the Institute of Epidemiology Disease Control and Research (IEDCR), Dr. A. S. M. Alamgir, said: "We are preparing doctors and other necessary initiatives according to our national preparedness policy, and the hospitals are getting prepared under the policy to deal with any possible situation".

Health Minister Zahid Maleque in a news conference in Dhaka said that the government has been working to increase the number of ICU bed for corona patient to 100 shortly and will gradually increase ICU units to 400.

Bangladesh has screened over 650,000 people in its international airports, ports and land borders, though there were only 28,483 people in quarantine and 47 in isolation, as of March 28. The country has 51 confirmed cases of COVID-19 and five deaths, according to the Directorate of Health.

According to the country's health ministry, the government has been working on right path to address the coronavirus pandemic in Bangladesh.

The government has so far allocated Tk 9 crore in cash and 31,000 metric tons of rice for the low-income people across the country as they remained without any work following the restrictive measures taken to tackle the corona virus. Both the financial and food assistance are being allocated through the Disaster Management and Relief Ministry.

According to the statistics of the National Disaster Response Coordination Centre, the government has so far allocated Tk 88,972,264 and 31,217 metric tons of rice for the low-income people in 64 districts, according to a PID handout (Source: The New Nation, 31 March 2020).

Prime Minister Sheikh Hasina on 31 March 2020 said that the extension of holidays will be done to ensure that there will be no more death from COVID-19.

``We`re taking this decision for the welfare of all,`` she added.

The COVID-19 outbreak is an unprecedented global public health challenge. It is vital to have easy access to good, clear data and a good understanding of what can and cannot be said based on the available data, in order for governments, organisations and individuals to respond to it effectively. As this is a new challenge for the world, every government is struggling to fight against Covid-19.

I understand that we have legitimate concern over the spread of corona virus in our country. We also have the right to have opinions on government's actions taken to prevent spread of corona virus. However, we must also need to understand that there is no Aladdin's magic lamp for the government to win the battle against Covid-19. It depends on us also if we would win the battle or not. Let's not point our fingers always at government.

Let's work together for the betterment of our nation, country and the entire humanity. We can't win the battle against Covid-19 without being co-operative and tolerant. We must learn to appreciate to move forward.

It also provides that Bangladesh will ensure emergency contingency protocols to support quarantine according to the "Infectious Disease (Prevention, Control and Elimination) Act 2018. In accordance with Article 32 of the International Health Regulation, suitable infrastructure will be selected for quarantine.

Accommodation, food and other necessary supplies will be provided. Ministry of disaster management and relief will be engaged along with other stakeholders for this.  Appropriate communication channels shall be established to avoid panic.

The Principal Scientific Officer (PSO) at the Institute of Epidemiology Disease Control and Research (IEDCR), Dr. A. S. M. Alamgir, said: "We are preparing doctors and other necessary initiatives according to our national preparedness policy, and the hospitals are getting prepared under the policy to deal with any possible situation".

Health Minister Zahid Maleque in a news conference in Dhaka said that the government has been working to increase the number of ICU bed for corona patient to 100 shortly and will gradually increase ICU units to 400.

Bangladesh has screened over 650,000 people in its international airports, ports and land borders, though there were only 28,483 people in quarantine and 47 in isolation, as of March 28. The country has 51 confirmed cases of COVID-19 and five deaths, according to the Directorate of Health.

According to the country's health ministry, the government has been working on right path to address the coronavirus pandemic in Bangladesh.

The government has so far allocated Tk 9 crore in cash and 31,000 metric tons of rice for the low-income people across the country as they remained without any work following the restrictive measures taken to tackle the corona virus. Both the financial and food assistance are being allocated through the Disaster Management and Relief Ministry.

According to the statistics of the National Disaster Response Coordination Centre, the government has so far allocated Tk 88,972,264 and 31,217 metric tons of rice for the low-income people in 64 districts, according to a PID handout (Source: The New Nation, 31 March 2020). Prime Minister Sheikh Hasina on 31 March 2020 said that the extension of holidays will be done to ensure that there will be no more death from COVID-19.

``We`re taking this decision for the welfare of all,`` she added.

The COVID-19 outbreak is an unprecedented global public health challenge. It is vital to have easy access to good, clear data and a good understanding of what can and cannot be said based on the available data, in order for governments, organisations and individuals to respond to it effectively. As this is a new challenge for the world, every government is struggling to fight against Covid-19.

I understand that we have legitimate concern over the spread of corona virus in our country. We also have the right to have opinions on government's actions taken to prevent spread of corona virus. However, we must also need to understand that there is no Aladdin's magic lamp for the government to win the battle against Covid-19. It depends on us also if we would win the battle or not.

Let's not point our fingers always at government. Let's work together for the betterment of our nation, country and the entire humanity. We can't win the battle against Covid-19 without being co-operative and tolerant. We must learn to appreciate to move forward.

  Tasmiah Nuhiya Ahmed is an Advocate of Bangladesh Supreme Court. She is working as Junior Partner in FM Associates, Bangladesh.

 




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