As the second wave of 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 118 now and whereas a fewhundreds used to be tested in the past many thousands ( between 12 to 18 thousands) are being tested every day nowadays for the virus. But looking ahead, we will need to handle the surge of corona cases 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. 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 should plan 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, etc), 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 of 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 were seen 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 two Eids 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.
Why couldn’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 regulations and their strict enforcement. It seemed that people in general were in no mood to listen to pleas from our leadership that they should observe Eids staying in their present locations.
All highest levels consultants or advisers to the government have been repeatedly recommending stepped up activism to create a greater sense of caution among people to observe personal safety measures with increased dedication. It is not that the administration has been too uncaring about obliging people to heed these suggestions. Police have started fining in some different parts of Dhaka city for not wearing masks. This activism is appreciated. But to cause any significant effect on the Corona scene, such fining activities need to be carried out regularly or every day in many more points of the city. Let us not forget that this is a city of over 16 million people. Therefore, many more places need to be covered on daily basis for a truly beneficial effect.
A much greater impact can be achieved by enhancing public awareness of the danger afresh. The danger has become so much worse from people turning too complacent about Corona. People in far greater number seemed sensitized during the first wave of Corona from March. They seemed to be more careful in that period to wear masks, gloves, etc. to ward off the disease. But the same people grew complacent and presently totally unconcerned in many cases about the lingering cases of the disease not to speak of its fresh resurgence. Thus, these people need to be sensitized again with large scale intense daily publicities in the mass media and other forums. Apart from the government controlled mass media, the privately controlled media’s cooperation must be ensured to this end.
