Five weeks after the detection of the first COVID-19 case in Bangladeshhad only tested 11,223 people, constituting approximately 68 tests per million population .Itwas then among the worst-ranked countries for COVID -19 testing rate. However It should be noted that the situation has significantly changed for the better. When front rank developed countries were seen overwhelmed by the Corona threat, Bangladesh with its limited healthcare facilities was noted for acting exceptionally fast to gear up for the crisis.
In the first 3 weeks after the detection of the first COVID-19 case in Bangladesh, the IEDCR was the sole diagnostic facility in the country of 180 million people, and the daily testing rate remained below 100 per day .Currently there are some 40 testing laboratories and these are conducting on average 14,000 tests for day. All these were achieved in a matter of weeks. Much greater number of testing laboratories and testing of cases are being planned. The number of hospitals and improvised facilities to treat Corona patients have been also added greatly over the last one month. As it is, Bangladesh is now exporting personal protective equipment (PPE) gowns and Corona treatment medicines to USA and other countries which should give some idea of its capacity to innovatively and quickly stand up to the virus.
The situation in Bangladesh is rapidly evolving, and it is comparable with many other countries, e.g., France, Japan, which have lately seen a devastating impact from the virus. In this situation, most sensible governments would opt for a total lockdown for an undeclared time at very high financial costs under the precept that lives should be saved first, and counting the loss to businesses may wait. Some countries, e.g., Italy and Spain, have already adopted such measures . In fact, with no effective therapeutic strategies available for COVID-19, lockdown is perhaps the best-known measure that could mitigate the situation . However, in Bangladesh, where a significant proportion of the total population lives hand to mouth, lockdown is not a feasible idea. With no savings and work, how will poor and marginal people feed themselves if there is a prolonged lockdown? This is an issue that the Government must address when declaring any lockdown or emergency that may stay in place for 2 or more weeks.
Among the preventive measures for COVID-19, including aggressive tracing of cases and contacts, strict quarantine, and screening, as well as education to promote good hand hygiene practices, should be put in place in Bangladesh. Immediate expansion of testing labs to every district and major localities is urgently needed to test every patient with symptoms, and millions of testing kits are necessary for conducting aggressive detection of cases . Students at life science departments in universities can be trained to carry out COVID-19 case diagnosis. The molecular genetics, biochemistry, and molecular biology labs in the universities and medical colleges across the country should be quickly transformed into COVID-19 case detection labs.
We can also seek help from China and South Korea on how it can channel extensive detection surveys . With help from the armed forces and trained volunteers, the schools could be turned into quarantine centers. The Government will have to come forward to make sure that its marginal population has access to proper hygiene, maybe by supplying free sanitizer and mobile washrooms. All offices and businesses, except medical centers, pharmacies, and groceries, should remain closed until the situation mitigates. Home office laws should be imposed, whenever possible.
Additional measures must be taken promptly, anticipating the potential challenge that would be faced by the hospitals in the case of an upsurge of COVID-19 cases. The Government must source enough protective gear for the healthcare workers who will have to tackle COVID-19 patients in the frontline. With expert help from China and South Korea, Bangladesh should immediately organize specialized training for all physicians, resident doctors, and intern doctors.
A total of 7% of the country’s population are senior citizens . Most of these senior citizens and many mid-aged people in the country have non-communicable disorders, including chronic obstructive pulmonary disease (11.9%), cardiac disorders (4.5%), diabetes (9.7%), and asthma (5.2%), and they are especially vulnerable to COVID-19 . Besides, there are around 1.3 to 1.5 million cancer patients in the country . Moreover, the prevalence of smoking is highest in Bangladesh among the South Asian countries . Studies have reported that people who smoke and have cancer have a higher risk of developing serious complications. Although there is still a dearth of understanding of the association between COVID-19 severity and cancer and smoking, these could likely be correlated . In the case of an upsurge of people who belong to the vulnerable groups contracting COVID-19, they may require hospitalization and intensive care. Hence, ventilation supports in every hospital, clinic, and medical center is a must.
Bangladesh could so far arrange only 112 beds across the country in intensive care units for patients with COVID-19 . The tech start-up and innovation companies emerging in the country should take it as a challenge to design a cheap but rapidly deployable mechanical ventilator device. All non-essential surgeries and hospital admissions should be canceled immediately to make sure the hospitals are not unnecessarily occupied. Hospitals can become a source of COVID-19 transmission, and it is advisable to decentralize healthcare services and, whenever possible, to provide care at home. Government rest houses and private hotels can be turned into emergency response healthcare facilities. Moreover, as a riverine country, Bangladesh has a huge water transport system. Large water vehicles, including steamers and launches, can be used as mobile healthcare facilities for the people who live in remote areas.
Together, the media personalities and political and religious leaders could help spread basic knowledge on COVID-19-related issues to the mass populace, especially the marginalized communities. Given the high level of illiteracy among the slum and village population, the dissemination of COVID-19-related basic knowledge would be the key to controlling the spread of the virus.
Above all, Bangladesh must source a decent emergency support fund to help its workers, employers, parents, marginal people, and hosted refugees. It has already received fast-track support of USD 100 million from the World Bank; however, this is far from the actual amount needed for this country of 180 million people . Additionally, the country has recently unveiled an economic stimulus package of 8 billion USD to counter the adverse effects of the pandemic . The country may temporally postpone all non-essential developmental works and gather a modest amount of money to support its people in fighting this crisis. Also, top business organizations and international funders should come forward to help Bangladesh fight the COVID-19 challenge. Only a supportive and empathic collaborative effort can help the world, especially the low and lower-middle-income countries like Bangladesh, overcome this crisis.
