by Be-Nazir Ahmed
The overall scenario of the country's healthcare system and the numbers of coronavirus cases and fatalities from it make it evident that we have not been successful in tacking the pandemic.
What we are seeing today is a reflection of gaps in all the measures undertaken to prevent the spread of the contagion – be it social distancing, identification of the positive cases, isolation of them, quarantine of those who have come into contact with them, and steps to ensure safety of healthcare providers.
When it comes to social distancing, the move would have brought better results had we managed it well and motivated people to comply with the prescribed guidelines for it.
Secondly, coronavirus positive cases should have been identified at a faster pace. To make it better understand, I would like to say that the risk of spreading the infection is less when one is identified on the first day of infection.
Isolation is less effective for delayed tests. And those who have not been identified keep on transmitting the virus to their friends and relatives. Strict quarantine could break the chain of transmission.
Thirdly, healthcare providers should have been provided with what they need for their safety.
Moreover, other precautionary measures such as hand washing and proper use of personal protective equipment (PPE) should be in rigorous practice. If someone follows the procedures completely, the risk of transmission from him can come down to zero.
Doctors, nurses, cleaners – everyone should be trained to ensure proper safety practices because they work as a team. The procedure has to be monitored by infection control supervisors who would fix the flaws, for example, helping a nurse wear a mask properly.
And the supervisors would also alert when masks are of substandard qualities. Had all these measures in place, so many doctors and other healthcare providers would not have contracted the virus.
To flatten the curve quickly, every positive case has to be investigated in order to find out the persons he has come into contact with, the places he travelled to, and the mode of transport he has used. The goal is to check if his contacts have become infected, and to disinfect the places he has visited to contain further transmission.
Teams should be set up from the upazila-level to cities to ensure strict quarantine. In hotspots, additional numbers of teams should remain vigilant to rein in the exponential growth of transmission. Then we can see the peak of the curve earlier and bring it to the bottom quickly.
Besides, highest efforts should be made to reduce the infection rate among doctors and other health workers. Another thing that needs to be made mandatory is wearing a facemask while stepping one step out of the home.
We have to decide immediately if we should strictly enforce social distancing and for how long. The last day of the ongoing shutdown, April 25, is approaching us. If we allow people to travel after the shutdown ends, the present localised transmission will reach every corner of the country.
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Be-Nazir Ahmed is the country lead at ASCEND Bangladesh and head of Parasitology at the National Institute of Preventive and Social Medicine (NIPSOM)