By Farzana Misha

Photo: Wameq Raza

When Prometheus stole fire from heaven, Zeus, the king of the gods, took vengeance by presenting Pandora to Prometheus’ brother Epimetheus. Curiosity got the better of her and the fabled box was open — letting loose sickness, death and unforetold evil on the world. Though she did her utmost to shut the box close as soon as it was opened, everything but one remained.

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In the wake of the CoVID-19 outbreak, optimism has taken a back seat while the sense of an impending doom takes control with the sixth death reported[1]. The impulse to hoard is begging to take hold as we see prices of essentials creeping up. Educational institutes have been closed off along with many offices. In the middle of all the chaos and uncertainty, we sit at home under the shroud of impending doom. We are trying to get some work done — we are after all working from home — but it remains a challenge with the stress of the virus in the background coupled with our two girls, six and three years old, bounce off the walls with unbridled pent-up energy.

So, what is fueling this unease? Could it be the non-stop push updates, all suggestive of the same general conclusion that we are done for? Maybe! Bangladesh has been complacent and therefore left wanting. We have shut our eyes, ears and senses as the COVID 19 slowly but surely made its way towards us. The current situation is by no means a surprise to all concerned — we saw it coming, from really far away. The COVID- 19 gave us plenty of examples of how fast and how bad things can really get to contemplate, on its way here. We also saw plenty of examples of how best to deal with it given our limitations. But alas, we buried our head somewhere and fell for the age old “oh, that’ll never happen to us!”.

Well, it’s happening. The question then becomes, how are we responding? Here are some of my personal suggestions below:

First, we need to take actions to exponentially increase awareness as much as possible. One good example of this is the implementation of public services messages by the telephone companies, text messages can be delivered. We need to make sure that all public gathering (including religious ones) are strictly discontinued.

Second, our screening system is in desperate need of a complete revamp, as the WHO Director General suggests — ‘Test, test and test’. However, in a country of 160 million people, this is difficult with one government run IEDCR and only four public hospitals are caring for those infected. But is this enough to combat what will coming in the next few weeks? Even months? Certainly, a step in the right direction is the ‘go-ahead’ with a test kit developed by the Gonoshastho Kendra. If proved effective as claimed, this will go a long way in addressing the bottleneck and giving us a more representative picture of the situation.

As the official numbers finally start to come in of the confirmed cases, we gradually switch from being concerned to panicked.

Our screening system at the airports were underwhelming at best. This was one of the first lines of defense that we let slip. Any half-decent projections would have suggested that once the outbreak started in Europe and the middle East, a large number of our expats would start to make their way back — potentially carrying the virus back with them. What did we do? We set up a “quarantine” zone in the Hajj camp that does not boast any remotely adequate medical facilities required for such an occasion. We lock them up, not taking into account their conditions, without adequate facilities, food and water and then call them names when they react. We began to get a gleam of hope as the Government suggested setting up another quarantine zone in Diyabari. The plan was scrapped as soon as it was announced — we are eagerly awaiting more development on this front. We need to set up these zones away from residential and heavily populated areas. The hospitals, granted, will not have enough ICU facilities, but now is the time to think ahead and set up isolation units much like Gaza is doing, using shipping containers. Honestly, this probably won’t be enough, but we need to think outside of the box and consider places quarantine camps such as indoor stadiums and other comparable spaces.

Third, the healthcare delivery mechanisms need to be upscaled with considerable urgency. Given the recent reactions by some of our front-line workers and doctors, it’s evident they need assurances that the we have their backs. Declaration by public hospitals that they are unable to support their staff with protective gear (such as Personal Protection Equipment — PPE) is worrying. Government really needs to provide full support to them and explore how to scale these initiatives very fast. Also, a crash course (or even a briefing) should be provided to the health workers along with support staff on how to handle such a situation protecting themselves and others, from getting infected. Should they start to retreat due to fear or absence of support, the whole health system will collapse. At the moment, there are only 3.05 certified physicians and 1.07 nurses for every 10,000 people. The Government needs to set up a stronger support mechanism for the precious few front-line workers because believe me, we are going to need them more than ever.

Fourth, we are yet to receive any clear guidance on how to lay to rest a victim of COVID-19. A dedicated body needs to be set up to deal with the deceased victim’s remains. The Government needs to designate areas in the graveyards and crematoriums. Teams should be trained to handle such cases, so that the families of the victims do not feel helpless or abandoned by the system.

Bangladesh does not have an officially recognized pandemic, or even an epidemic yet. More thought needs to be directed at facing reality with adequate measures put in place to deal with what is inevitable. Citizens should be informed of what to expect, so that there is no surprise. As the world is dealing with this on a full scale, expecting external assistance will be a waste of time or might come too late. The policy makers need to work with relevant experts and facts to come up with realistic coping mechanisms.

Once the country inevitably goes into the “lockdown” mode, the consequences can be far reaching, resulting is mass unemployment, possible unrest and spike in crime rates to name a few. Now the big question is, are we prepared for all this? By ‘us’ I mean not only the government, the authorities, the NGOs, communities but also all of us who are responsible for the country we call Bangladesh. Because together, we make ‘us’. While everyone came together to monitor breeding grounds of mosquitoes during the dengue outbreak, we need to once again come together to stay away from each other.

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When Pandora hastened to close the container, only one thing was left behind — ‘hope’. At this point, we can only ‘hope’ that we are fast enough to close the box, before all that we are afraid of, escapes into the country we hold dear. If we are not, we may just be left with the kind of ‘hope’ that might turn out to be nothing but ‘deceiving expectations.’

[1] IEDCR (25–03–2020)

Farzana Misha is a Research Coordinator at James P Grant School of Public Health, Brac University

BRAC JPG School of Public Health, Bangladesh tackles global health challenges affecting disadvantaged communities through Education Training Research & Advocacy