How do we tackle this new onslaught of the coronavirus?
The infection rate and deaths from the coronavirus have been increasing after the Eid-ul-Fitr holidays. On June 26 the infection rate was 22.50 percent (with 4,334 cases) and there were 77 Covid-related deaths, fuelled by the Indian Delta variety, which is a lot more infectious and deadly.
Although the Delta variant was first detected in some bordering districts of Bangladesh in the second week of May, its community transmission has already taken place—and it has now spread throughout the country. According to the ICDDRB, 68 percent of the cases in Dhaka are of the Delta variant (based on the analysis of the genome sequence of 60 samples taken from Covid-19 patients, between May 25 and June 7). Samples collected earlier from different districts showed that 80 percent of the patients have this variety (Prothom Alo, June 18, 2021), indicating that the epicentre of the current wave is villages, not the big cities. Learning from our past experiences should be useful in confronting the onslaught of this current wave.
We have gained significant experiences in the last 15 months since the first detection of the coronavirus in Bangladesh in March 2020. When this deadly virus was causing havoc in Wuhan, we largely ignored it thinking that Wuhan is too far away, and we would be safe. However, the whole country became panic-stricken when the first wave of the virus hit Bangladesh. Some people at that time even abandoned their infected loved ones. We also saw patients dying because of the non-availability of ventilators or while going from one hospital to another looking for beds.
When the second wave of the coronavirus hit us earlier this year, we again saw serious panic due to a lack of hospital beds, especially ICU beds, and uninterrupted supply of oxygen. These experiences caused us to think that the way to survive this deadly virus is through treatment, for which we needed adequate hospital beds, expensive equipment, and ultimately vaccines—that is, clinical solution and investment of big money.
However, reflecting on the experiences of the past makes it clear that treatment and spending big money are not the real solutions. Even the rich countries, which have more developed health infrastructure and more money to spend, could not cope with the onslaught of the virus. For example, the United States, with an enviable healthcare system and wealth, had to pay a high price—the lives of more than 600,000 of its citizens. Investment of huge amounts of money by the western countries also did not always lead to discovery of effective vaccines.
The experiences of the past 15 months have taught us that mitigation attempts in terms of treatment of coronavirus patients will definitely have to be a high priority, although we still do not have an acceptable treatment—scientists are still experimenting and learning. Investments in vaccines are also necessary. We have also learned that coronavirus will not go away quickly, and we must become resilient to it. More importantly, it is urgent for everyone to take the necessary steps to prevent the spread of the virus so that the number of patients do not increase, because every patient, even the asymptomatic ones, is a spreader of the virus. Thus, the key to most effective protection against the virus is its prevention. In fact, those countries that could keep the infection rate under control during the past 15 months had fewer patients and fewer deaths from the virus.
Preventing the spread the coronavirus involves taking some important steps: contact tracing; motivating people to abide by health regulations and changing their behaviour; adequate testing for identifying patients, isolating them and giving them treatment; putting the suspected patients in quarantine; supplying food, medicines and other essential supplies to the people to limit their movement and so on. Another important preventive step is to vaccinate at least 70 percent of the people to create herd immunity, if vaccines are available. Lockdowns are effective only if they are accompanied by other preventive measures.
The cost of preventive measures, other than vaccination, is quite reasonable. People's adherence to the health regulations and their behavioural change, which normally takes intensive efforts over a length of time. Washing hands can prevent diarrhoea. Similarly, wearing masks can prevent air pollution related diseases and protect from airborne pathogens.
The WHO has a technical guideline entitled "Risk Communication and Community Engagement" to prevent the spread of the coronavirus, which The Hunger Project has been using to create "Coronavirus Resilient Villages" in 1,200 villages around the country since April 2020. The guideline incorporating four distinct steps—community engagement, risk communication, patient management and mitigating economic impacts—includes among others a "3W campaign" focusing on washing hands, wearing masks, and watching distances. As a result of this volunteer-driven, community-led initiative, the rate of wearing masks nearly doubled, and the infection rate and deaths also declined in our working areas relative to other areas, earning accolades from experts.
A similar community engagement initiative on a wider scale was recently launched in Chapainawabganj by Dr Samiluddin Ahmed Shimul MP. He initiated a social movement against the coronavirus in his constituency, Shibganj, by mobilising the local administration, local government representatives, businessmen and the people, which has now spread to other Upazilas of the district. As part of this initiative, 70 hospital beds with high flow nasal canula were set up for corona patients. He and his associates delivered food, medicines, and other essential supplies to people's homes and he himself provided treatment. As a result of such praiseworthy effort, the infection rate in Shibganj came down from 66 percent to about 10 percent in just three weeks.
The reason for such success is Dr Shimul leading from the front and earning the trust, support and cooperation of others through his honesty and sincerity. If other Members of Parliament take similar initiatives by mobilising their communities, we are confident that we will be able to bring this new wave under control in a few weeks. Fortunately, the government appears to have become seriously interested in engaging the community to contain the onslaught of this deadly Delta variant.
Dr Badiul Alam Majumdar, Global Vice President & Country Director, The Hunger Project.