Corona :Unfailing public policy needed
As the coronavirus epidemic accelerates within its territories, Bangladesh must rapidly go on enhancing the preparedness of its health care system. However, this is not to say that very little was achieved to this end. From one testing centre only in March, there are about 60 now and whereas a few hundreds used to be tested many thousands are being tested every day for the virus. But looking ahead, we will need to handle the surge of corona related illnesses likely to swell demand for scarce hospital resources. Simultaneously, we will need to manage the normal flow of all other things that require high-level institutional care.
In January and February, China struggled to provide care for the burgeoning volume of severe coronavirus cases, especially in Wuhan and Hubei province overall, while also tragically squeezing out people who needed critical routine care (e.g., kidney dialysis or treatment for diabetes or cardiovascular disease). It is likely that many Chinese deaths resulted from these shortcomings. We must learn from this example and should be proactive to prevent an overwhelming of our health care system in like manner.
Effectively meeting likely health care needs is only partially the task of hospitals. Civil society, government, and the entire public health and health care system must, on the one hand, seek to limit demand on hospitals and, on the other, use limited medical resources efficiently. We all can contribute to slowing the spread of the virus, thus diminishing the numbers needing care at the peak of the epidemic and ultimately reducing the overall number of people infected. Public health, buttressed by civil society organizations, can support this by effectively educating people about the need for conscientious social distancing (e.g., limiting travel, exposure to crowds, and handshaking) and better hygiene (e.g., careful handwashing and using face masks). We all need to comply, both for our own welfare and for the common good.
To ensure that advanced care is available for those who need it most, the health care system must match patients with the level of care truly needed. Private practitioners and clinics must divert non-critical cases-the 80% of infected individuals who will have few or moderate symptoms-to home care with sufficient isolation to prevent transmission to family members. Hospitals, for their part, will have to limit elective procedures and discharge patients promptly to free space. That will reserve scarce hospital beds and intensive care facilities only for critically ill patients.
Caring for people in the home setting will require logistical support as well, and this also needs to be thought of as part of the healthcare system. To hold space in hospitals for the most critically ill, we will be outsourcing to home the care of the less-severely ill, but they and their families will need assistance in meeting both medical needs and daily living needs in that setting. Support can be mobilized from the public sector , the social sector associations and from community organizations ( mosques, Rotary Clubs, …), and from community volunteers-but this takes thought, organization, and management that is not self-executing.
Robust external support for the health care system is crucial. We need a vigorous logistics system to ensure adequate supplies of test kits for diagnosis, personal protective gear for clinicians and support staff (e.g., masks, gloves, and protective clothing), and necessary equipment such as respirators to care for patients. The procurement of the same from internal and external sources must be planned well in time to be able to receive and use them as and when needed avoiding sudden shortage. We need to exercise great care that critical facilities and clinical staff are not contaminated or infected and therefore forced out of operation, as several hospitals wereseen during the first outbreak of Covid-19. Finally, we must not only safeguard health care workers’ physical needs but also recognize the potential for psychological burnout from long hours of work and potential demoralization from persistent stress.
The likely challenges to health care from an accelerating coronavirus epidemic will be challenging. Many public health and health care entities are already hard at work getting ready. To minimize the dangers and produce the best results possible, we must even more energetically mobilize the whole system.
It is very important to enforce a unified and unchanging public policy. We have seen double-mindedness in enforcing an unwavering public policy against corona virus though such half hearted decisions generally could not be written off as entirely useless. For instance, halting countrywide movement of public and private transports used for mass transportation for two months but allowing their limited use nonetheless. This attitude showed mixed benefits arising, both positive and negatives.
But there should have been no confusion or dilly dallying in applying restrictions on travel or movement during the last Eid-ul-Fitr that aided large eruption and spread in the infection. The same sort of administrative failure was noted in irresponsibly and suddenly inviting garments workers to join work and forcing them to scramble to work places with no heed for maintaining social distancing while doing so. This led to a spike in the disease which could be much limited or prevented from happening with proactive preventive steps. Again another ill prospect for a spurt in the disease is seen as looming with the nearing of the sacrificial event of Eid-ul-Azha. People all over the country will likely again attempt a mass exodus from the cities causing breakdown of the social distancing requirement. Why can’t we have emergency legislation through ordinance to absolutely stop such suicidal journeys ?If people will not do on their highest interests what they need to save their lives, then the government will be fully justified in controlling their suicidal behaviour through declaring appropriate regulation and its strict enforcement. It seems that people in general are in no mood to listen to pleas from our leadership that they should observe the upcoming Eid-ul-Azha staying in their present locations.
It is also highly imperative to absolutely ensure that all activities associated with carrying sacrificial animals to selling grounds, their subsequent sale and slaughtering by customers, disposal of the related carcasses and garbage, etc., are conducted in the cleanest ways possible to stop the spreading of the pandemic. Anyone seen in a public place without wearing a mask must be challenged and fined to drive the message finally into their behavioral consciousness.