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Bangladesh’s ‘Reactionary’ COVID-19 Response Is Working, But For How Long?

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Bangladesh’s ‘Reactionary’ COVID-19 Response Is Working, But For How Long?

As the country battles hard to stop an ongoing surge of infections in the border districts, structural difficulties and public indifference about the pandemic are fueling the fire.

Bangladesh’s ‘Reactionary’ COVID-19 Response Is Working, But For How Long?
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In January, Bangladesh seemed to be doing well in terms of curbing the transmission of COVID-19. The infection rate was recorded at lower than 5 percent for seven weeks straight in mid-January, indicating a good response to the crisis according to World Health Organization guidelines, which consider the pandemic under control if infection rate remains below 5 percent for two consecutive weeks. The cases were dropping consistently, with February 26 seeing the lowest monthly recorded death toll of five.

The Second Wave: The Beta Variant

The onslaught of the second wave started in mid-March when the number of daily recorded cases and deaths started rising sharply. According to Bangladesh’s leading health research institute, ICDDRB, between March 18-24, the Beta variant, originally detected in South Africa, was found in more than 80 percent of the samples tested. The Beta variant was first detected in Bangladesh on January 24.

By the beginning of April, however, pandemic fatigue had already set in among people. With Ramadan approaching, markets and public transportation were operating in full capacity with minimal compliance with social distancing and health guidance. By the time a strict lockdown was imposed on April 14 to curb the second wave, the country was already seeing around 6,000 to 7,000 daily cases, dramatically rising from daily recorded cases of about 500 the month prior. April 7 saw the highest daily recorded cases of 7,626 and April 19 marked 112 recorded deaths, the highest since March 2020, when the pandemic first hit the country.

In the middle of all this, a massive infrastructure gap in the country’s COVID-19 preparedness became apparent. Although a second wave had been anticipated since November 2020, Bangladesh government shut down dedicated COVID-19 hospitals around the country, citing a “lack of patients.” The country’s biggest makeshift COVID-19 hospital in International Convention Center Bashundhara (ICCB), with 2,000-beds, was shut down in September 2020 by the health ministry because of its high maintenance cost and “poor turnout of patients.” Eleven other dedicated COVID-19 facilities around the country were also shut down by the Directorate General of Health Services due to a decline in the number of patients. The DNCC COVID-19 hospital, which the government rushed to set up amid the second wave, was supposed to become fully operational by April 29, 2021. It is still incomplete, although some 800 beds have been operating.

The privately run hospitals were not equipped to address the crisis either. Most hospitals either did not have adequate ICU beds or enough ventilators to accommodate a rising number of patients. For instance, Kurmitola General Hospital in Dhaka had 10 ICU beds and an average queue of 30-32 patients for each in April. Better Life Hospital had 12 ventilators and only two high flow nasal cannulas against 24 ICU beds. This disparity consistently became the picture in most private hospitals across the country.

After a dramatic spike in April, May has seen a steep decline so far in the number of daily infections and death tolls. As of May 31, the daily infections stand at 1,710 while the daily death toll stands at 36. While Bangladesh is recovering from its second wave of COVID-19 infections triggered by the Beta variant, the highly infectious Delta variant – first detected in India – was spreading fast. Experts fear a severe COVID-19 surge by the end of June as a consequence of the highly infectious new variant spreading across India. Health Minister Zahid Maleque clearly outlined that the country will not be able to tackle another wave of infections.

Preventing a Third Wave: The New Delta Variant

Since April 3, India has been logging more than 100,000+ daily infections consistently. Myriad pictures, videos, and reports have been beaming out from India, projecting the lethal potency of the virus. The emerging new Delta variant, poised to become dominant in the world, spread across borders to neighboring countries. Notably, Nepal recorded 337 new daily infections on April 10 but jumped to 1,667 daily infections in just 10 days, challenging the medical infrastructure of the South Asian region, which was already battered with scarcity and inefficiencies.

In late April, India began surpassing 300,000 daily cases consistently. In light of the grim development, health experts all over Bangladesh urged the government to close all borders with India. “We have suggested that the government seal off the borders with India right away as the situation there is grim,” Professor Nazrul Islam, a member of the National Technical Advisory Committee, told The Daily Star. On April 26, Bangladesh decided to close all borders with its biggest neighbor for the first time in its history.

The border closure applied to all passenger movements to and from India, including suspension of flights on any route toward India. Trucks and vehicles transporting goods were allowed to transit through the borders. Bangladeshi nationals were only allowed to repatriate through Akhaura, Benapole, and Burimari crossings, and then only after receiving a No Objection Certificate from the Bangladesh High Commission in India and a COVID-negative certificate.

Upon arrival, all returnees have to go through a health screening, which included a COVID-19 test, and sit a 14-day mandatory institutional quarantine in hotels and guest houses commissioned by the government for the purpose. However, ensuring proper quarantine and smooth compliance with protocols had not been easy. For instance, on April 26, eight returnees who had tested positive for COVID-19 at the border fled the quarantine facility at Jashore General Hospital. They were apprehended on the same day.

Since the border closure, hundreds of authorized Bangladeshis have entered the country through designated entry points and have been sent to institutional quarantine centers. However, health officials have suggested that illegal border crossings in Satkhira, Jashore, Jhenaidah, Kushtia, Meherpur, and Chuadanga are still ongoing. According to sources at The Daily Star, individuals have been crossing the border with assistance of illegal rackets. Since the borders are not fenced, many people frequently travel to India to see their relatives, and often illegally without a visa.

As of May 25, the bordering districts of Chapainawabganj, Satkhira, and Rajshahi have seen positivity rates soar to 55 percent, 42 percent, and 33 percent respectively. Some of these border districts have been put under strict lockdown to disrupt the transmission, and it is reported that hospitals have started to face an acute shortage of medical oxygen. While it has yet to be confirmed officially, experts are saying the spike in infections is likely caused by the Delta variant first detected in India.

Bangladesh first detected the new variant on May 8 in two patients – both male, aged 41 and 23 – who recently returned to Dhaka from a visit to India. According to official figures so far, only 20 COVID-19 patients have been identified with the Delta variant of the virus, but in the border districts, COVID-19 infections have been consistently on the rise. As per the latest, health officials countrywide are preparing for a spike in infections since the new variant has been found to be locally transmitted among seven people who do not have a history of visiting India. This is a developing story.