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What Bangladesh can do to fight the coronavirus
We did not know about this invisible enemy even a few months ago. Yet, in this short period of time, it has affected 210 countries and territories around the world, infected over 2.5 million people and killed over 180,000 globally. According to the official estimate, the number of Covid-19 cases in Bangladesh is 3,772 (as of April 22). Even if we take this number to be true, there are probably at least five times more untested cases. This, hypothetically, puts the number of local infection cases around 18,000-19,000.
This still may sound like a small number but this enemy is not an equal-opportunity killer. It does not prefer survival of the fittest or the wealthiest. Only the most adaptive will survive (recall, dinosaurs did not survive; humans did).
So how can Bangladesh be adaptive? Is it possible for the country to minimise the impact?
Yes, it is still possible, but time is running out.
We must keep one thing in mind: this is not the time to argue what could have been done or who did not do what or who should be blamed. Everyone needs to work together—governmental, non-governmental and private institutions as well as citizens. This is the time to learn from other nations. But make this learning adaptive with what Bangladesh has as resources: physical, economic and cultural.
Working with an interdisciplinary group with multiple expertise: It’s unfortunate if leaders have to make decisions based on incomplete and uncertain information. Our leaders and policymakers must plan to work with a diverse group of scientists, engineers, business leaders, opinion makers, and citizens. They must listen carefully to multiple perspectives and decide based on situation-specific information. There is no single solution. We must be adaptive as new information comes in.
Dividing the population into risk groups for treatment and survival support: This virus does not care about socio-economic conditions, religion or prejudices. Older people with pre-existing medical conditions are more vulnerable. Daily workers with “hand to mouth provision” are at high risk of starvation and malnutrition. It is, therefore, important to create risk groups—for treatment and survival support—and make actionable plans with advice from the experts.
Diagnostic tests must be made simpler and accessible: Assuming that everyone is a carrier is the best protection as seen in Japan. So we must act accordingly to minimise exposure and spread. Testing can be reserved for the more vulnerable people. It is unlikely that Bangladesh will have sufficient testing kits available anytime soon. Thus, using simpler screening through temperature and oxygen saturation level measurement will be more practical. People with high temperature and low oxygen level can be isolated and then treated.
Supporting healthcare professionals: We must prepare for a possible surge in the number of severely ill patients. So we must collect as many Personal Protective Equipment (PPEs) as possible for healthcare professionals and first responders. Deploy resources to manufacture ventilators and create more intensive care units (ICUs). Repurpose some of the schools, university halls, hostels and other spaces as quarantine and make-shift hospitals for the less severe patients.
Engaging the NGOs: Use their network, infrastructure and experience to execute situation-specific responses. NGOs can come up with Covid-19 survival manuals and protocols of what to do or not do. They can do rapid surveys to find out what interventions are working (or not working) and adapt quickly.
Deploy Army, BDR and police judiciously: From India to Rwanda to South Africa, countries have deployed security forces to enforce quarantine and lockdown. Bangladesh has also deployed the Army to carry out these operations and take part in relief efforts. Military-enforced lockdown is not without problems, as observed in South Africa, Kenya or Uganda. Yet, at times like these, deployment of troops, when done carefully and compassionately, can build confidence. The security forces can be repurposed by integrating with a public healthcare approach that puts community engagement at the centre. The Army with their excellent organisational and logistical skills can work with the youth volunteers to execute many essential services for citizens with different risks.
Inspire the public, engage the youth and create a volunteer force: This is the time for the public—particularly youth—to actively engage with their energy and creativity. Students and young professionals can organise online hackathon and crowdsourcing to learn tips and tricks from other countries that are actionable (for example, making ventilators and masks with local resources) in Bangladesh.
Organisational and logistical experiences of the armed forces can help mobilise the youth to execute many labour-intensive activities—driving recovered patients home, checking with elderly neighbours, delivering food to vulnerable groups, etc.—as appropriate. This will help build trust between the enforcers and the citizens. This will also lessen the burden from healthcare workers.
Be a model Covid-19 fighter: Follow the safety guidelines.Create “community self-policing” units to encourage and enforce preventive measures. Encourage local leaders, village elders, imams and priests to be the early adopters of wearing masks, washing hands and isolating oneself when needed. Like the virus, modelling virus fighting behaviour can also be contagious. It has started happening in Boston, Nairobi, Tehran, etc. In Tehran, it is considered cool and responsible to wear a mask while, in Boston, people consider wearing a mask heroic!
We need to minimise the impacts of secondary effects like hunger, isolation and mental depression. We must mobilise resources from governmental, non-governmental, private sector and donor agencies to create safety nets for the most vulnerable groups facing shortage of survival essentials including nutrition, daily medicine needs and other supplies.
Aggressive and personalised social messaging: Assume what you hear (rumours and misinformation without verification) may be more viral and deadly in killing trust and confidence. Do not spread unverified information. This is not the time to criticise. Be critical of action, not of individuals or institutions. And continuously look for what works (and why) and how to be adaptive to changing situations.
We must emphasise the importance of personalised and context-specific messages. For example, convince the imams to tell people that they don’t need to come to the mosque; they can stay home and pray. Use Saudi Arabia’s action to close the mosques as an example, if necessary. Avoid mass funeral rituals, and encourage alternative and safe forms of grieving and burial.
Avoid fake Covid-19 news and misinformation. Seek reliable sources of information. Create trusted information networks to make actionable information, empathy and resilience go viral.
Reasons for optimism and decisive action : Covid-19 is affecting the population over 65 years disproportionately (over 80 percent of fatalities involve over 65-year-olds with pre-existing health conditions); the youth (less than 30 percent) shows mild symptoms with very low fatality. But the youth still need to be careful because they may infect other people. Over 94 percent of Bangladeshis are less than 65 years old and this may make the country seem less vulnerable. But this is not the time to celebrate this optimistic (yet highly uncertain) projection. If we do not act quickly and decisively, it may turn into a nightmare.
Despite its many dysfunctional institutions, poverty and widespread corruption, Bangladesh has achieved remarkable progress in many development indicators. Now is the time to promote and accelerate this Bangladeshi Brand of Ingenuity. If Bangladesh takes a concerted and determined approach of adaptive learning, it can minimise the impacts of the coronavirus disaster. Bangladesh can forge an actionable and adaptive plan to defeat this virus and show the world that it is a model of adaptive survival, resilience and ingenuity.
Professor Shafiqul Islam is Director, Water Diplomacy Program, Civil and Environmental Engineering, Fletcher School of Law and Diplomacy at Tufts University, USA.
This is not the time to argue what could have been done or who did not do what or who should be blamed. Everyone needs to work together—governmental, non-governmental and private institutions as well as citizens. This is the time to learn from other nations.