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8 April, 2021 07:08:23 PM
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Fresh hike in Covid-19 infection: Causes and remedies

In financial organizations like banks or other service providers, where a large number of customers congregate, reducing the transaction time would rather increase the crowding of people. This can create an environment of Covid-19 proliferation rather than control.
Dr Mohammad Didare Alam Muhsin
Fresh hike in Covid-19 infection: Causes and remedies

Covid-19 infection is on the rise again in the country. Infection and death tolls are increasing very fast. Why is that? What is the reason behind this? Was it expected? If so, how much is our preparation to deal with it? When the danger is already in our midst, are we moving forward with the right action plan? To overcome the crisis, alleviate the suffering of the people and keep the number of deaths to a minimum, the issues need to be closely monitored and reviewed.

Covid-19 was diagnosed for first time in the country on 8th March last year and the first death from the disease occurred on the 18th of the same month. When the disease arrived here and began to spread while it had already traversed through Europe, America and the Middle East after its first appearance in Wuhan, China in December 2019, it became clear soon that our preparations to combat the disease were pretty inadequate. We could not take the advantage of the two and a half months of time, that we got in between the first ever emergence of the disease and it's appearance here in Bangladesh, to understand the nature of the disease and to formulate a proper action plan for identifying the disease, managing it and preventing its spread. As a result, at the beginning there arose a chaotic situation in the health system throughout the country. As if a great storm has blown over everyone, regardless of the patient and the doctor.

People have learned a lot about this disease in the last one year. Two to four months after the initial confused situation, the primary panic was gone. In the meantime, everyone has gained more or less an idea about what should be done at the individual and collective level to prevent and deal with this disease. It became clear from the examples of other countries in the world that the basic policy to deal with this disease is to prevent its spread, so that the number of patients to be admitted to hospitals and treated in general beds or ICUs could be kept limited within the capacity of the country's hospitals. The steps taken to this end in almost all the countries affected by Covid-19 included among others such measures as patient identification, isolation / quarantine, hand-washing in soapy water / hand sanitization, wearing of masks, restrictions on international flights, and limited or all-inclusive lock-down internally. Measures such as lock-downs appeared to be a major setback for the country's industries, businesses and low-income earners, forcing the government to phase out the lockdown after a couple of months, despite the corona infection not being brought under control.

Luckily for us, even after the lockdown was lifted, experts' fears were disproved and, after the level of infection reached a peak as per the usual course of an epidemic, it began to decline at a certain point and by the end of the year it was more or less under control. However, scientists have repeatedly warned that the pandemic could come back again in a more devastating form. For example, they were talking about the Spanish flu a hundred years ago, the second wave of which was much more terrible than the first. In addition, in many countries around the world after the infection rate came under control, it was increasing again. So, it was pretty much expected that another wave of the pandemic can hit the country at a certain point. As the Covid-19 infection affects primarily the respiratory tract, it was apprehended that this second wave might come in the winter. For this reason, even though the government opened everything, it did not dare to open educational institutions. For good reason, not only the scientists, but also the Prime Minister herself was warning the public about a possible second wave of Covid-19. God willing, the winter has passed well. Meanwhile, the people of the country were praying fervently, if the Covid-19 vaccine also came. Fortunately, the country also received a shipment of vaccine earlier this year, which was an important milestone in our ongoing war against Covid-19. On the other hand, some scientists were coming up with the idea that, by the end of the last year, the prevalence of infection in the general population could reach the level of producing herd immunity among people.

When this had been the overall situation, a large section of the public was left feeling fluffy. In January-February this year, the infection rate dropped to its all-time low. Some people started thinking, maybe this evil of Covid-19 is gone. Many began to care less about issues such as wearing masks and social distancing. There were socio-political and religious gatherings, wedding ceremonies, etc. all around. Tourist spots found a huge turnout. As a result, the wave that did not come in the winter finally came, but at the beginning of the summer. Infections began to increase from the beginning of March, and soon the acceleration took a high momentum. This second wave is more severe than the first, not only in the rate of infection, but also in its morbidity. According to a doctor, this time as many as 40 to 50 percent of the patients need oxygen.

According to the latest statistics, the daily infection rate in the country has already crossed 7,000, breaking all past records. According to experts, the negligence of people to health rules in recent days has undoubtedly played a major role in increasing the rate of infection. However, the exact cause of the sudden increase in the rate of infection is a matter of research. In addition to the neglect of health rules, many other factors might have played a role here. Mutations might have made the virus more powerful. In addition, genome sequencing of patient samples has also confirmed the presence of UK variants and South African variants of the virus in the country, which are capable of transmitting much faster. There is also the opinion that when many people stay in a closed room with AC / fan running during hot weather, it becomes an ideal environment for the spread of Covid-19 infection.  (COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020 - Volume 26, Number 7—July 2020 - Emerging Infectious Diseases journal - CDC)

It is a matter of concern that almost all the beds available for Covid-19 patients in the country's hospitals, including general and ICU beds, are now almost fully filled. The health system of the country might collapse if the rate at which Covid-19 infections are increasing could not be stopped. Although a shipment of vaccines has already arrived in the country, it is a matter of time to get the required number of vaccines to bring a significant proportion of people in the country under vaccination and complete the implementation of this programme. Apart from that, the vaccines that have been developed so far may not be equally effective against all the new variants of the coronavirus that are emerging through mutations. So, the expectation that the level of Covid-19 infection can be brought under control very soon through vaccination is far from over.

Against this backdrop, the government has announced a 'lockdown' for a week, subject to certain restrictions, to curb the rapid spread of the infection. However, there were two immediate problems. First, a large number of people dependent on daily income are running towards the village. In many cases, people are traveling without paying heed to health rules and thus playing a role in spreading the infection on the way. Moreover, many feel that this village-bound flow of people is spreading the infection from urban to remote areas of the country. Second, with the sudden announcement of a 'lockdown' without proper alternative arrangements, the office-going people are suffering to get to the institutions or factories that are open. Many believe that this measure would have been more effective if it had been taken in early March when there was a clear trend of increasing infection.

Although announced for a week, many believe that the 'lockdown' could be extended. In the light of past experience, it can be said that it is very difficult to impose and implement a complete lockdown due to the socio-economic reality of our country. The question remains as to how effective a partial lockdown can be. Good results may be expected if the offices and factories are run in multiple schedules a day with not more than 50 per cent of the officers and employees by rotation. This on the one hand will control the presence of many people in the office / factory and, at the same time, on the other hand will also reduce the transportation problems. In financial organizations like banks or other service providers, where a large number of customers congregate, reducing the transaction time would rather increase the crowding of people. This can create an environment of Covid-19 proliferation rather than control.

Since it is not easy to successfully implement extreme measures like ‘lockdown’ in a country like ours, we should place more emphasis on ensuring measures like mask wearing and social distancing. These tactics do not involve any financial tug-of-war like a lockdown. The reason for our limited success in the past in this regard is that we have not been able to motivate the people properly. This is not possible only through policing. Moreover, the manpower of the police is also limited. If necessary, the army can also be involved for a limited time. However, it seems that the best results can come if the local people could effectively be involved. If volunteer teams consisting of local political/ social activists and students/ teachers, irrespective of party affiliation, could be mobilized in every locality in collaboration with the law enforcement agencies, it can certainly be expected to motivate the public. The results, that may come this way, may not be achieved by the law enforcement alone.

The writer is a professor of pharmacy, Jahangirnagar University.

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Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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