— By Shama Obaed
“Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death,” said Tedros Adhanom, director general of the World Health Organization (WHO), in one of his briefings back in March.
That is a fact, indeed, but the WHO was compelled to declare the Covid-19 outbreak a pandemic once the virus has been detected in more than 200 countries and territories. What started as an epidemic mainly limited to China has now become a truly global pandemic. Unfortunately, the novel coronavirus has its clutch on Bangladesh as well.
After March 7, when the first cases were disclosed in Bangladesh, the number grew slowly for a period. But now, the country is experiencing an explosion of cases and a fluctuating number of deaths on a daily basis. Experts maintain that the actual number of infected people could be much higher.
There are cases where patients are dying with corona-like symptoms and these are not being taken in to account as Covid-19 deaths. Unless many more cases are detected through widespread testing, community transmission will continue and the situation will be out of hand. There is one basic confusion that still remains constant in our minds: Is there an official lockdown in Bangladesh or is the country still on holiday? If the lockdown is enforced, then why are transport workers and labourers on the streets demanding to open up modes of transport?
It seems, if we had utilized our armed forces fully to enforce health regulations and guidelines, and also to distribute food to the poor and the needy, then the situation might have been a little different.
We often sense a relief in the statements of the health minister and the other government officials, stating that developed countries like the US, UK, Italy, and Spain are experiencing the most widespread outbreak and large number of deaths, and compared to that, Bangladesh is not doing badly combating the Covid-19. When governments and public health experts around the globe are scrambling to understand, track, and contain this new virus, there are some countries that are able to manage and contain it much better than other developed countries. Vietnam is unquestionably one of them.
The case of Vietnam
Vietnam prepared for the epidemic as early as the very first case in China emerged, around middle of December 2019. Despite its border with China, with a relatively low income majority, and a population of 95 million, Vietnam is a definite success story in this pandemic.
It has 270 confirmed cases of the virus and no deaths. The country is beginning to lift the strict lockdown measures it began imposing in February, reopening restaurants and barber shops. There are arguments that Vietnam is an authoritarian one-party state, so its numbers can’t be trusted. However, Todd Pollack, a professor at Harvard Medical School, who directs the Partnership for Health Advancement in Vietnam in Hanoi, argued: “I see no reason to mistrust the information coming out of the government at this time. Vietnam’s response was swift and decisive. If the epidemic were much larger than is being officially reported, we would see the evidence in increased emergency room visits and hospital admissions -- and we’re not seeing it.”
Vietnam is cited by global media as having one of the best-organized epidemic control programs in the world, along with Taiwan, South Korea, and Singapore, all of which have had higher infection rates than the former. Despite relatively lesser economic and technological capacities, the country’s response to the outbreak has received acclaim for its immediacy, effectiveness, and transparency.
The most well-known case of a coronavirus epidemic was Severe Acute Respiratory Syndrome (Sars), which, after first being detected in southern China in 2002, went on to affect 26 countries and resulted in more than 8,000 cases and 774 deaths. At present, many are praising Vietnam’s response to Covid-19, comparing it to the success in 2003 when Vietnam became the first country to be cleared of the Sars outbreak.
In the case of Covid-19, Vietnam was also on higher alert than most other countries because of its land border with China and the large amount of travel between the two countries.
So, what are the vital reasons behind Vietnam’s coronavirus success? Experts have identified a few key tactics used widely by the government: Early detection and precautions, temperature screening and testing, targeted lockdowns, and constant communication. On January 11, with the first death in Wuhan, Vietnam tightened its border and airport controls.
Four days later, when there were still only 27 cases in China’s Hubei Province, Vietnamese officials met with the World Health Organization and counterparts from the Centers for Disease Control, and the WHO praised Vietnam for its rapid risk assessment and issuing of protective guidelines.
As early as on January 29, the Ministry of Health in Vietnam established 40 mobile emergency response teams, on stand-by to assist affected locations, for quarantine, disinfection, and transporting patients or suspecting patients. In the beginning of February, all educational institutions were suspended to avoid the spread of the virus.
There are around eight doctors to every 10,000 people in Vietnam, and with limited clinical resources at its disposal, Vietnam has seemingly managed to get the outbreak under control. Their Ministry of Health, as early as on January 2, issued an urgent dispatch to hospitals and clinics on prevention and control of the acute pneumonia disease outbreak from China.
The hospitals were instructed to set up measures for early detection and prevention to the disease, and set up rapid reaction teams to confront the high risk of the disease spreading. Moreover, their Finance Ministry declared that people would not be charged for medical fees when they undergo mandatory quarantine at health care centres and other isolation facilities. They would also be transported to isolation wards for free, and receive free drinking water, towels, face masks, hand sanitizers, mouthwash, and other daily necessities.
If people were confirmed to have caught the virus and needed extra treatment, their treatment and test fees would be covered by the state budget. These kinds of decisions definitely provided the people of Vietnam with hope to fight the virus with courage.
What is significant is the ratio of tests to confirmed cases, and that ratio in Vietnam is almost five times greater than in any other country. Testing was followed by strict contact tracing (including secondary contacts) for anyone known to be infected, immediate isolation followed by quarantining, and the prompt creation of a real-time database and two mobile apps by which people could record their health status and symptoms.
All this was backed up by the mass mobilization of the country’s military, public security forces, the health care system, and public employees, and an energetic and creative public education campaign that included TV cartoons, social media, and posters that drew on the traditional iconography of official propaganda and heroic doctors with appropriate protection.
But, what are we experiencing in our homes? If we take a glance back at the events that took place in Bangladesh in the last few months, educational institutes were still open till March 17. In the months of February and March, international flights were still coming to Dhaka in full swing from China, Italy, and other European countries with minimal or no screening at the airport.
On March 15, 142 passengers returned from Italy, who were also taken to the Ashkona Hajj camp but after they complained about the unsanitary conditions there, many of them were allowed to go home with advice to self-isolate.
Health experts have expressed serious reservations about the action. One cannot help but wonder if this decision has actually contributed to the spread of the virus rather than controlling it.
The Institute of Epidemiology, Disease Control, and Research (IEDCR) has recently been stripped of its task to coordinate Covid-19 tests and sample collections, and from now on, the Directorate General of Health Services (DGHS) will coordinate the Covid-19 tests and sample collections.
According to different public health experts, the matter of shifting the task of testing from the IEDCR amidst the ongoing coronavirus menace exemplified the government’s poor planning and mismanagement. Again, opening up shopping malls and businesses at the time when the death toll is going up is another detrimental decision. In this case, maintaining the health regulations and social distancing will be next to impossible. These kinds of decisions only create panic, confusion, and distrust among the people.
As coronavirus cases mount in Bangladesh, the government struggles to keep its front line health care workers free from getting infected, which has further strained the country’s medical facilities. At least 419 doctors, 243 nurses, and 324 other health workers had tested positive for coronavirus as of Thursday, according to the Bangladesh Doctors Foundation (BDF), as the group blamed a lack of personal protective equipment (PPE) and infections from patients for the outbreak among the doctors.
In addition to that, so far, many members of the police force have tested positive. All this paints a grim picture indeed.
Countries like Vietnam, Hong Kong, Singapore, Germany, New Zealand, and South Korea have been using the process of strict contact tracing aggressively to reduce the outbreak. Contact tracing is used to slow down the spread of infectious outbreaks. When someone gets coronavirus, anyone they have been in prolonged contact with will be tracked down and potentially asked to self-isolate. Phoning or emailing the friends and family of coronavirus patients is one way of contact tracing.
This can be combined with a location-tracking mobile app, to pick up on others who have been in contact. Why not use this method to save the lives of our countrymen?
The grim reality is that Covid-19 patients and suspects are facing hurdles and barriers on a regular basis. A good number of people are not being able to do the test because of a lack of planning and strategy on part of the health ministry and the health department.
There are still not enough testing facilities in the country. We are witnessing, every day, a huge number of people queuing up in front of the BSMMU Hospital with no hope or sign of when they will get their tests done.
There is also doubt on the quality or authenticity of the test kits being used. A banker passed away recently in spite of his first two test results being negative.
The only way the government of Bangladesh will be able to gain and maintain public confidence is by being transparent and pro-active in communicating with the public. In a Dalia Research survey of 45 countries asking about public opinion of government responses to the Covid-19 pandemic, 62% of Vietnamese participants said the government was doing the “right amount.” One can’t help but wonder what the response of the Bangladeshi people be if the same question was posed before them.
Citizens of this country have the right to analyze things and hold the government of the day accountable for all its decisions, so that mistakes can be avoided in the future.
— The writer is an organizing secretary of Bangladesh Nationalist Party—BNP and also a member of the party’s Foreign relations committee. The opinion was first published on Dhaka Tribune, can be accessed on https://bit.ly/3dGOOm3
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