A member of the national advisory committee formed to tackle the Covid-19 pandemic in Bangladesh, Prof ABM Abdullah is also the personal doctor of Prime Minister Sheikh Hasina. In an interview with Dhaka Tribune's Mehedi Al Amin, he shares his views on the crisis and what one can do to fight it better
The number of Covid-19 patients was slowly increasing in the first four weeks of the outbreak. Now almost 600 to 800 people are infected on a daily basis and it is increasing by the day. We have seen the same process of increasing numbers in the USA, the UK, and Italy. Where is Bangladesh heading
March 8 was the first day when three patients were declared positive. Now diagnosis has increased which is why patients have also increased. But this is not the real picture. Figures come based on tests. The number of infected people is more than the figures we have. If testing increases, the numbers will also increase. Only then we can predict the real picture.
The good thing is that the death rate is lower in Bangladesh.
Earlier I said the numbers may reduce in mid-May considering that lockdown will continue. But we are at risk now. Now that the lockdown has been relaxed. It will be clear within several days how much more positive cases increase due to the relaxed lockdown.
Opening of RMG and shopping malls will increase human movement, is this the right decision?
If a lockdown is maintained strictly, that would have been better. But the government is considering economic issues which are also important. The number of day labourers is huge in the country. They fear starving more, not coronavirus. They need to earn to feed their family.
RMG and agriculture are two major sectors of our economy. Opening these two sectors is an administrative decision.
Farmers can not harvest paddy without labourers. Farmers cultivating vegetables do not get fair prices. Dairy farmers dispose of milk failing to sell. Poultry farmers are killing off one-day-aged chicks due to lack of customers.
On the other hand, we are paying more in the capital to buy those products.
As lockdown is relaxed already, now everyone has to obey health regulations and maintain distance as much as possible.
From the very beginning, elderly people and those who have comorbidity (history of multiple lifelong diseases) died more. Now people of all ages are dying. Why is that?
From the very beginning of the outbreak, elderly people faced death all over the world. Now children and youth are being infected, and dying too.
Younger generations do not obey lockdowns and they have the urge to go out and perhaps sometimes out of necessity. Thus they risk their own lives all by themselves. It is difficult to say why young people are dying nowadays.
Those who smoke, drink alcohol, and who go for outings are at higher risk. If infected, one could easily die. Till now the mortality rate is high among the elderly. But why young people are dying now, it is difficult to say.
From the beginning of Covid-19 outbreak, developed countries said elderly people are dying. We also said that. Now we are observing that people of all ages are dying.
The virus attacks the lungs, destroying them. It affects blood, heart, kidneys, and brain as well, due to lack of oxygen supply. Till now research is going on. We still have to wait to know the nature of the disease and the way the infection is caused.
But till now it is true that elderly people and those who have comorbidities are dying more.
Government has predicted that 100,000 may be infected. If so, do the hospitals have the ability to accommodate all the patients, if not, what is the alternative?
No one can say how many people will be infected. The USA is struggling to treat and to accommodate patients. Health professionals from the USA told me that they are also not getting enough PPEs.
On the other hand, we are a poor country. We do not have much ability. But a good thing is that 80% of the patients do not need hospital care. Less than 5% may need ICU or ventilators. We have to continue our fight by the manpower, mental strength, and the technology we have.
Media reported that doctors and nurses are not going to patients and touching them. If this situation continues, then how will patients get proper treatment in hospitals?
Treatment means infrastructure, care, and medicine.
We have a shortage of ICUs. Setting up ICUs need several pieces of machinery. It is not possible overnight to arrange those. Many developed countries also have a shortage of ICUs. We should not worry about ICUs as only a few patients need ICU care.
Many patients are complaining that they do not get food, oxygen, medicine in hospitals. Or that doctors and nurses do not visit a patient to look after them. Many patients said this to me.
I heard that a patient died and was kept several hours in front of the bathroom of a hospital. No one went to him. Another patient died and was in his bed at the hospital for eight hours, no one went to him. I have this kind of report. It is inhuman. Authorities should look after these matters seriously.
Medicines are in the research phase. No vaccines are invented so far. They are all in the initial stages. We need a huge amount of vaccines, but we cannot say when we will get them. If developed countries invent a vaccine, we can get those at a much later date as developed countries themselves need more vaccines.
Some medicines were named as ‘effective’ to treat coronavirus patients. How effective are those, if at all?
Effective drugs are yet at the experimental stages. Hydroxychloroquine is a medicine to treat malaria patients. Azithromycin is an antibiotic. The USA and the UK used these two medicines to treat Covid-19 patients. It cannot be firmly said that these two medicines will work on Covid-19 patients, thus far. More trials are needed before these two medicines are used for treating Covid-19 patients.
Avigan was used for Japanese patients. They are saying they got good results. Despite that, it cannot be said that it will work on Covid-19 patients, until now.
Remdesivir is a medicine from the USA. The US says it can be used only on critical patients. Based on those countries' experiences, some of our companies want to produce those medicines. I think permission should be given. We have to provide at least some medicines to the patients. It may be so that those are sometimes effective.
Doctors are facing action when they say that they are receiving poor quality PPEs, is it okay?
Over 700 doctors got infected. Personal protection is important. Without quality PPE, how will they provide care to a patient? Those who complained over poor quality PPE and masks faced punishment. It is not okay, it is unacceptable, it is injustice. Appropriate action has to be taken against those who supply poor quality PPE.
I think the administration should stop harassing doctors. I asked for separate hotels and food accommodation for health professionals first. We need those to keep them safe. House owners are behaving roughly towards doctors. It is irrational. Everyone should show humanity.
There is a discussion going on over poor quality PPE. If there is no corruption then why and how poor quality PPE became available in hospitals?
Disclosing a probe report over poor quality PPE is an administrative duty. I cannot say anything as I am not from the administration.
Will tobacco ban help fight Covid-19?
I support banning tobacco. Directives are needed to take action. Users also should stop consuming tobacco.
There have been some controversies in testing samples, management, monitoring, and speed of tests. What do you have to say about it?
DGHS or IEDCR who will play what role is also an administrative question. The number of tests should increase. Sample collection booths and testing labs should be increased in different places to increase the number of tests so as to get the real picture of Covid-19 transmission in the country.
Last of all everybody should remain patient.