Pathogen-control lesson for Bangladesh

Has the coronavirus epidemic peaked already or yet to peak? By the middle or end of the month at the latest, the answer to this question is most likely to be known. If local health and epidemiology experts' projections are to be any guide, the pandemic might continue to peak throughout June. If the death tolls and infection cases over the past week are taken into account, there are reasons to believe that the process has already begun. 

Whether the projections about the pandemic will be on target or not may be known gradually. But does the country have a second thought about further reopening of manufacturing units, businesses and services apart from offices or the matter should be left to chances even if the disease start taking nightmarishly heavier tolls? With physical and social distancing outrageously compromised in many cases of public life such as on water transport and lately on road transports, the deterrent to infection has all but gone.

The majority of the people have started behaving as if the threat of scourge has gone following the government's relaxation of the lockdown. In the United States of America, the protesters threw caution into the wind during staging their protest rallies against killing of George Floyd. Here in Bangladesh also some desperate groups such as workers had to come to the street to make their grievances known. They also could not care less about physical distancing. However, generally people demonstrate the attitude that they have waited much too long and come what may, they will get out of home confinement.

Unfortunately, the pandemic is not over yet; rather it has started stalking this land and a few other countries including India more relentlessly. The numbers of deaths and cases since the reopening of the economy speak for a steep deterioration of the situation. How worse it can get is quite unpredictable. Can Bangladesh learn any lesson at this stage to salvage something from the worsening situation due mainly to delayed action programmes?

Even India has extended the lockdown period for the fifth time in containment zones up to June 30, allowing religious shrines, some of the productive sectors and services to operate. In Bangladesh, the messages of staying home are on paper only. It is now up to people here to maintain physical and social distancing.

Here is a virus that countries across the world ignored primarily. But there is one exception ---Vietnam. The West calls its government authoritarian but hats off to the leadership that readied its defence against the virus's attack well in advance. Vietnam's success story in containing the disease is exemplary. There has been no death and only 328 cases. For about one and a half months, no new case has been reported and the country is gradually opening up.

Vietnam achieved this extraordinary feat without ever enforcing a nationwide lockdown. When there were just two deaths from Covid-19 in Wuhan, China and the World Health Organisation was yet to recognise that the virus spread from human contact, the country of 97 million population activated its health apparatus to deal with the 'common enemy'-a war cry during Vietnam war. The country successfully managed in the past outbreaks like SARS in 2003, avian influenza in 2010 and measles and dengue. Those experiences proved precious. People responded appreciably. Vietnam has a long border with China and without delay got into action ---it closed its border and subjected all subsequent returnees from China or any other country to mandatory quarantine. In contact tracing and cluster testing, Vietnam has no equal in the entire world.

Well aware of its limitation in hospital and medical facilities, the country stepped a few paces ahead of the virus. Its sole mantra was prevention. In February when seven cases were reported from a rural area north of Hanoi, the entire surrounding area with a population of 10,000 were put under lockdown and everyone was tested. The same was done with a commune near the capital where 11,000 people live in. Thus it could avoid a large-scale outbreak and death. All because the authorities knew that the country's not-so-advanced medical system would be overwhelmed if they failed to contain its spread.  

Vietnam's past experience in dealing with large outbreaks helped trigger its preventive mechanism instead of waiting for reactive measures. Bangladesh or any other country cannot apply any such strategy now but in the future this should be 'the lesson' to deal with pathogen onslaughts or pandemics.  Vietnam's contact tracing was full and total and this yielded result because 40 per cent of cases were found asymptomatic. Cluster lockdown and tests free of cost of everyone there irrespective of symptoms could identify those cases. Had it not been done, the patients without symptom would roam freely infecting others coming in contact with them. This is how Vietnam controlled the disease.

Perhaps the system of cluster quarantine and test can still be applied in what is known as hotspots in Bangladesh. Marking of zones with red, yellow and green colours like that of America will hardly be of any help except for those people who want to avoid the risky zones. Also, healthcare interventions can be intensified there as well. No other lesson will be of use except keeping the fingers crossed and hoping for the best.

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