100 DAYS OF COVID-19: How did we fail so miserably in handling it?

The Daily Star  June 17, 2020

“There are decades where nothing happens; and there are weeks where decades happen.” This comment by Vladimir Lenin, describing the Bolshevik revolution over 100 years ago, serves as an apt metaphor for the journey Bangladesh has had since March 8, when the country confirmed its first Covid-19 case. It’s been 100 days since that fateful spring day—and three months since the day its first Covid-19 death was reported. The official death toll so far from the pandemic has topped 1,200 and the number of infections has crossed 90,000. Bangladesh is now the eighteenth worst-affected country in the world, even ahead of China, where the pandemic began.

These figures help us understand our position in a world ravaged by the coronavirus. What the “curve” doesn’t tell you is the price paid in sufferings: the decades’ worth of pain, chaos and uncertainty, all endured in just months. For the ordinary folks, there seems to be no end to this Herculean test of endurance. For them, there is only the next turn in the road. The next batch of unaided, unrecognised victims. The next bureaucratic screw-up, leading to even bigger screw-ups.

Any analysis of how the crisis has evolved in the 100 days since the first case will illustrate how Bangladesh’s response, like that of most countries, has been shaped by a persisting conflict between opening up the economy and saving lives. As one of the most densely populated countries and simultaneously one of the poorest, it’s naturally getting the worst of both worlds: a higher infection rate than comparable countries and a more ravaged economy. With the country’s historically underdeveloped and underfunded healthcare system, no one, frankly, expected the government to be fully prepared for a crisis of this magnitude. We have seen stronger systems than that falling apart. But it was, at the least, expected to learn from its mistakes as it went along and judiciously use its limited capacity and resources for a better response. As it turned out, even a lowered expectation was one too many.

So how did a country otherwise used to frequent natural calamities fail so badly in dealing with this disaster? Let’s consider four key factors that might explain this.

Ossified bureaucratic/political institutions

After the March 8 disclosure, the government’s lukewarm response to the initial warnings about imported Covid-19 cases and a possible spread at the community level served as a sign of things to come. In the subsequent days, we began to see frequent shifts in strategy: a countrywide lockdown imposed; stimulus packages announced and food (and cash) relief distributed; factories allowed to reopen; lockdown withdrawn amid soaring cases. These decisions, suffice to say, were meant to merely ride the beast—not to tame or direct it. There was no carefully laid out plan, no vision for the future.

TTI and treatment debacles

On April 5, Bangladesh was ranked 117th in the list of countries with the highest cases in the world. Today, within two and a half months, it finds itself in the 18th position. In simple terms, this means those hundred countries that were above us in the ranking have done a better job of containing the spread of the virus. How much of this downward plunge for Bangladesh is an organic development, following the natural laws of viral transmission, and how much of it is because of our policy failures and execution blunders is anybody’s guess.

Experts say there is a two-stage optimal strategy for dealing with Covid-19: The first stage is a lockdown to stop the spread of the virus; the second involves ending the lockdown step by step. A number of conditions have to be met to graduate from stage one to stage two (and to remain there). Bangladesh has ticked both boxes, but without meeting any of the conditions. The stress is on “any”. For example, one of the conditions for lifting lockdown is building up a decent test, trace and isolate (TTI) infrastructure. Ours is not even remotely comparable. Our stubbornly low levels of testing mean that the actual numbers could be far worse (only around 15,000 samples are tested every day in around 60 labs across the country). Of the 18 countries at the top, only Mexico is conducting fewer tests than Bangladesh. How can we ever hope to check the virus with such a pathetic TTI regime? The healthcare system, meanwhile, is crumbling. After mounting reports of Covid-19 and general patients, and those with suspected Covid-19 symptoms, dying without treatment, the High Court, on June 15, ruled that denying treatment to patients would be considered a criminal offence. As well as these TTI and treatment debacles, the government has also drawn sharp criticism for its failure to provide adequate protective equipment for fmedical staff and other frontline workers.

Evasive communication

The other side of this dismal coin is the lack of communication. Communication is highly important in a pandemic situation. Information saves lives. But the government’s communications have been mostly evasive and shambolic. From day one, it has failed to provide a coherent account of its plans, policies and capacities. Contradictory numbers of infections and deaths were sometimes given. Then confusion reigned when the nationwide lockdown was imposed, which the government promoted as a “general holiday”. By doing so, it created a perception that emergency lockdown measures were not essentially enforceable. Many people were, and still are, in the dark about what to do when, for example, someone needs to get tested. Or think of the time when garments workers were given mixed messages about resuming work, taking them on a desperate trip through overcrowded ferries that both risked their safety and likely helped spread the virus in far-flung corners of the country. Even now, when the government has reportedly prepared a list of 55 virus hotspots to be categorised as “red zones” and placed under lockdown, there seems to be confusion all around.

Instead of establishing a channel of communication that inspires trust and dispels confusion, the authorities have rather taken regressive measures to curb the free flow of information. Activists, doctors, academics, and journalists are justifiably afraid to speak up, thanks in no small part to the recent spike in lawsuits and other harassment and scare tactics against critics. The cumulative effect of this climate of panic, confusion and distrust amidst a raging pandemic is deeply disconcerting. Free flow of information and clear, effective messaging from the government are vital to create public awareness, which has been key in battling Covid-19 with relative success in Southeast Asian countries like Thailand, Malaysia and Vietnam, as a recent report by Reuters has shown.

Lack of national unity

Could a united health response through public-private partnerships or collaborative policy efforts by major political parties produce a better result? It most certainly could. So far, there has been no sign of such a thing happening. Politicians, like in normal times, continue to bicker over petty issues. People, like in normal times, continue to be divided or disengaged. The administration, like in normal times, continues to cavalierly dismiss scientific solutions. Perhaps the biggest barrier to Bangladesh’s success is this business-as-usual approach to the pandemic. Even four months into the outbreak, the ruling Awami League and BNP have failed to find common ground for much-needed national unity. Until they do so, the very urgent need for the creation of a national council or committee on the Covid-19 emergency would remain unfulfilled. Such a bipartisan council could do a much better job of handling the crisis than the current bureaucracy-led response mechanism. A national unity that brings together citizens and political rivals to face this emergency head-on is an urgent need of the hour.

Endgame

Bangladesh, with its large population and grinding poverty, may seem like a perfect nursery setting for a new virus to take seed and spread uncontrollably. But this doesn’t have to be the case, as some cramped cities and relatively poor countries with a better TTI regime and better policies than ours have shown. A properly enforced lockdown, zonal or national, is still our best chance to fight the virus. As a study by a research team at the Imperial College London has recently shown, lockdowns have saved more than three million lives from the coronavirus in Europe. Whatever course Bangladesh takes going forward, one hopes that mistakes made in the first 100 days of Covid-19 will not be repeated in the second.

 

Badiuzzaman Bay is a member of the editorial team at The Daily Star.

Email: badiuzzaman.bd@gmail.com