Recently the government announced the first death in Bangladesh caused by the Covid-19 (coronavirus) infection. It is worth noting that most hospitals in Bangladesh do not have any test kits to diagnose the Covid-19 infection; doctors have said (off the record) that over the last month they have treated many patients with “atypical pneumonia,” which may have been caused by Covid-19 infections. So the actual numbers of Covid-19 cases and deaths are probably much higher than the official figures.
Over the last month, many Bangladeshis have returned from countries (like Italy) which have experienced high numbers of Covid-19 infections; these returnees were told to quarantine themselves at home, but news reports make it obvious that many of them did not do so.
It is very likely that some infected returnees have spread the virus, and that we will soon see a much higher number of cases. Some of the recent confirmed Covid-19 infections were family members of returnees, making it is obvious that quarantine at home has put the family members of the quarantined persons at risk.
It is now necessary to follow up with all those returnees who are currently or were recently in quarantine at home. The returnees and family members living with them should be tested for Covid-19 infection; anyone who tests positive should be moved to a secure quarantine facility.
It is also necessary to test the patients who were treated for atypical pneumonia over the past month, along with family members living with them; anyone who tests positive should be moved to a secure quarantine facility.
We should not underestimate the potential seriousness of Covid-19. In other countries it has been seen that the mortality rate from this infection is only 2% in healthy people, but it is much higher in people who already have other illnesses (complicating factors which push up the expected mortality rate).
Roughly 5 million people live in crowded Dhaka slums. Social distancing probably cannot be implemented in such crowded conditions; unless we can identify all the individuals who are positive, and move them to quarantine facilities, all slum residents will probably become infected.
It is reasonable to expect a 5% mortality in the slum-dwelling population as many of them already have diseases like diarrhoea and typhoid (common illnesses caused by lack of clean drinking water).
The calculation is simple: 5 million expected cases times 5% expected mortality means we should expect 250,000 dead in Dhaka slums, unless the right measures are taken (on an emergency basis).
It would be ideal if we had a large number of Covid-19 test kits so that we could test all possible Covid-19 patients residing in Dhaka slums. If they test positive they must be moved to a quarantine facility. The problem, though, is that people with a mild illness will not go to hospital to be tested; in fact they should not, as by going to a hospital they might become infected (if they were not infected before).
As people with a mild illness can still spread the virus, we probably will be able to slow, but not stop, the spread of the virus.
Recently it has been reported that the army has been tasked with managing two quarantine camps. This is a welcome development; quarantine facilities are needed, as “quarantine at home” has not worked; indeed it probably can’t work in Bangladeshi society, where large extended families often share a small space.
In China, hotels were converted into quarantine facilities; this was an excellent solution, as quarantine facilities must be clean, and must be able to feed quarantined residents. Many hotels are now empty; the government should negotiate with the owners to convert them into quarantine facilities.
It is absolutely essential to enable all hospitals to test for coronavirus, and to ensure that doctors and nurses treating patients showing symptoms of Covid-19 should have the right PPE (personal protective equipment). The situation will be much worse if large numbers of doctors and nurses become sick.
If we want to stop the spread of coronavirus in Dhaka slums, we will certainly have to quarantine thousands of people, probably tens of thousands. Many cities around the world have been “locked down” in an attempt to quarantine each family in their homes.
Lockdown has usually involved banning all gatherings in public places, and shutting down educational institutions, restaurants, most retail shops, and most offices; everything except pharmacies, hospitals, clinics, and supermarkets.
Locking down Dhaka would cause immense suffering; millions of working class people will not be able to buy food if their workplaces are shut down. The government will probably not be able to enforce a lockdown unless it is willing to deliver food to millions of people; such an operation would resemble a wartime food rationing operation.
Kazi Zahin Hasan is a businessman and an avid reader.
