COVID-19: Is Bangladesh heading towards herd immunity?

The number of coronavirus cases is escalating by the day, and yet Bangladesh has decided to relax the lockdown significantly. Readymade garment factories have been opened, along with many other industrial units. Now other business establishments, shopping malls and mosques have opened up too. While medical experts have opposed such a move from the very outset, ‘economy’ is being used as an excuse to lift the lockdown. Virologists, physicians and epidemiologists have said this is a ‘covert’ herd immunity policy of the government.
From 8 March, when the first coronavirus case was officially detected in Bangladesh, till date, a total of 13,770 persons have tested positive. Initially 2, 3, 4 or 5 cases emerged per day, but from 20 April onwards, the numbers have gone above 400 a day. By the time it was 25 April, the rate had gone up to 500 daily, then over the next few days to 600. On 5 May, 786 cased were confirmed and on 6 May, 790. And on May 10 the number of new cases went up to 887, a single-day highest. With this, the death toll from the virus rose to 228 and the number of total infections stood at 14,657 till date.
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Amidst this upward curve, readymade garment factories, jute mills, re-rolling mills, cement factories, cables, tannery, packaging, shoes factories, business establishments, shops, malls and mosques are all opening up.
Senior virologist of the country, Professor Nazrul Islam, sees this as grave danger. Speaking to South Asian Monitor, he said that 55 per cent of the confirmed cases are in the capital city Dhaka and 87 per cent are in Dhaka division. Most of the factories which have opened up are in and around Dhaka city and within Dhaka division.
Nazrul Islam went on to say, only after 12 May will it become evident just how dangerous it has been to relax the lockdown. He pointed out that the factories opened up on 28 April and 14 days from then the rate of increase in cases will be evident.
Health minister Zahid Maleque was blunt. He said, “The number of patients will increase if everything is opened up.” He was speaking to the media on 5 May after a meeting of the coronavirus national advisory committee at the health ministry’s conference room.
Professor Nazrul Islam is a member of the committee. On 19 April, the committee comprising 17 experts, was given responsibility to draw up recommendations regarding the pandemic. Nazrul Islam said that the decision to withdraw the lockdown was quite contrary to the recommendations. The committee has maintained that this would increase the risk factor manifold.
Another virologist, professor and official of the Institute of Epidemiology, Disease Control and Research (IEDCR) has said that this decision has been a suicidal one. She said the risks are high as it is. The virus has spread to the community and asymptomatic cases are increasing. All over the world they are emphasizing the need to maintain hygiene and social distancing, but we are opening everything up.
She said, it was important to have increased the scope of tests long ago and to study the behaviour of the virus. But the manner in which Bangladesh is proceeding means that many lives are to be lost.
Assistant professor of genetic engineering and biotechnology at Dhaka University, Mustak Ibn Ayub, has researched the virus contagion in Europe. He reached the conclusion that the number of cases and deaths was relatively lower in the countries where the altered form of the virus reached. Portugal was an example. But to reach any such conclusion, the genome sequence of the local variety of the virus must be determined. India has done this for 50 viruses but they have not been able to reach a conclusion as the results were mixed.
Sri Lanka has done four virus genome sequencing, Pakistan one and Nepal one. Bangladesh has not been able to do a single one. Yet it takes at least 100 genome sequences to reach a conclusion. Bangladesh could have been ahead in this game. There are technician who are have the expertise, there are at least 10 labs for the purpose, but it is not being done. It requires preparation and a decision. The decision should be to attach genome sequence to public health.
Mustak Ibn Ayub went on to say, that this would determine the behavioural patterns of the virus and we could also understand which vaccine being discovered around the world would be applicable for our country.
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The researcher blamed the policy makers for the lack of transparency in their decision making, saying that the countries which have been transparent in their strategies to tackle the virus, have displayed higher degrees of success. South Korea and New Zealand are examples.
He said, even if the decision for herd immunity is taken here, that should be made transparent. Sweden has done that. They said they would not lockdown, but each and everyone would have to maintain social distancing. Even so, Sweden is being criticised from within and outside of the country for this decision. It had a higher coronavirus-related death rate that its neighouring countries.
Coming back to the Bangladesh scenario, he said, first it was called a general holiday and now it is being called lockdown. Garment factories have been opened up but no transport was arranged for the workers. It was a hurdle for them to make their way back to their workplaces and the risks increased manifold. It would not have been very difficult to arrange transport for them, maintaining the health protocol.
Policy Research Institute’s executive director Ahsan H Mansur has referred to this disorder as unwarranted, He said that our economy is in a fragile state, but that does not justify increasing the risks by suddenly opening up the mills and factories. The decision should have been taken with 10 days’ preparation in hand. It was important to ensure the health rules for the workers.
He said, there is a draft health regulation prepared, but it has not been finalised. He said it was doubtful if the health rules could be maintained on a voluntary basis without imposing penalties. He said, the way things stand, we may lose many lives in the days to come.