To open or not to open: Lockdown exit strategies can help

Medical experts across the world, including in Bangladesh, have cautioned against the risks of loosening restrictions too much and too soon, which according to them could spark the Covid-19 pandemic further.

Four local leading businesspersons and an economist have jointly written an article on what Bangladesh should do to have an effective exit plan. They have talked about an exit strategy, which can help the country sustain its hard-won gains so far.

The Discourse  on Life vs Livelihoods

Life or livelihood? That is the question facing millions and millions of people around the world today in an entirely unprecedented scenario for the modern, globalized world. But are the two truly mutually exclusive in the time of Covid 19? Or, can an accommodation be made to keep the search for livelihood as safe as possible from the point of view of health. Luckily, perhaps due to divine grace, Bangladesh has so far seen figures of infection and mortality which are far lower than might have been expected.

As economies across the globe continue to face the brunt of COVID 19, the question regarding when and how countries resume economic activities is generating much debate everywhere. With almost half of the world's population currently in confinement or under reduced mobility, and economic activities at a virtual standstill,  reopening is indeed a critical issue to ponder upon where the livelihood of millions is under threat. Responses by countries  have had few things in common, but much divergence is also inevitable as reopening decisions are very much determined by the stage of the pandemic in each country. Given that the extent of the problem is asymmetrically distributed across regions and countries, the responses  of governments vary significantly.

European countries such Italy, Spain, and Germany that have seen the curve flatten, with a lowering of the number of new cases and deaths, have embraced limited opening of businesses and activities for the general public. The United Kingdom (UK),  on the other hand, continues to maintain lockdown out of an abundance of caution despite recent decreases in the number of new cases and deaths. To many, the British position appears to be appropriate. Hastening to a full re-opening of the economy before the curve has truly flattened or enough evidence regarding  the spread and possible containment of the virus is established could lead to a resurgence in cases and spread with possibly devastating consequences. There are examples of countries such as Singapore which did well initially  and remained without any lockdown, only to find cases soaring by 50 times within four weeks since mid March, requiring a late but strict lockdown. 

There is little doubt that such wide-ranging restrictions are hard to bear,  but both science and wisdom suggest that they not be lifted prematurely, at least not without a strategy which takes into account public health science and data, emergency management tools, and a structured, safe-guards based approach to any opening up of the economy. 

The Bangladesh Context 

Bangladesh, having been under a form of partial lockdown for over four weeks to save lives, is taking heavy economic losses of about Taka 33 billion a day to GDP, and with more than 10 million marginalized families missing out on the daily-waged income they rely on. Business membership organizations with considerable clout such as the ones representing the garments and textile sectors have successfully pursued the policy makers to allow re-opening of factories.  The Government, having been left with difficult choice of weighing lives against livelihoods, has finally decided to allow gradual opening, a decision which, according to many experts, may have come ahead of time or without adequate preparations. Under the current arrangements, companies operating in pharmaceutical  and export sectors have been allowed limited operation from 26 April, although they had had a similar dispensation from the beginning, following Covid related health and safety requirements. Partial banking services had been operating and have now been asked to expand further; and goods-transport have also been given a go-ahead. However, since factories have opened up fully in several sectors without paying much attention to the "gradual" part of the decision, the ancillary economic activities such as food shops and accommodation in those areas have also opened up. Additionally, a limited opening for iftar has been permitted. There are concerns though, that the limits will be observed more in being breached than followed. A large proportion of the general population, having complied with the lockdown orders, are somewhat unhappy at the current dispensation. 

How Are Other Countries Responding 

There is little doubt that countries, developing and industrial economies alike, cannot afford to remain under complete lockdown for an indefinite, and unknown period of time. Return to normalcy is not plausible until  some sort of vaccine is found, and it makes sense to get back to restoration, gradually. But one would have to also note that countries and regions with significant ongoing virus transmission should expect that restarting economic activity will only lead to more transmission. Hence,  countries which have allowed some form of resumption of work and business operations, have done so following a systematic approach that  builds on science, data, risk categorization of businesses, geography, and segment of population. These economies have  put in place clear, structured Lockdown Exit Strategies which provide the outline for gradual opening of the economy starting with essential and low-risk parts of the economic activities. The Strategies are also flexible to allow for modifications in light of newly available information, and must be targeted for granular level localities 

Countries which have now laid out clear, timebound exit plans to withdraw gradually include nations which have been severely hit by the pandemic such as the USA, Spain, and Italy to the ones who have contained it really well such as Australia, New Zealand and the Czech Republic. India laid out a plan  to start from April 20 the process of restoring livelihoods by permitting economic activity in key sectors, such as agriculture, pharmaceuticals, packaging, exports, e-commerce, construction and self-contained industrial clusters. South Korea has shown that strong intervention and effective planning can keep the virus in check and help resumption of economic activity. Federal countries and unitary nations have different political and constitutional requirements which also need to be accommodated.

Building an Effective, Clear Exit Strategy 

An intrinsic feature of the approach adopted by these countries is a structured, and phased  exit plan which, most importantly, remains informed by science and data.  Evaluating a country's readiness to restart activities will essentially depend on the health system's level of strength combined with  an assessment of the intensity of virus transmission. Thus, effective exit strategies  build on 

• An increased capacity to test 

• Contact tracing lifted to a mass level to find and isolate all of the contacts of a known source of infection 

• Dissemination/disclosure of adequate information regarding cases and mortalities on a regular basis 

• Strengthened local response capabilities – essentially the ability to effectively lock down hotspots where outbreaks occur. 

Reflecting upon best and safe practices identified so far from around the globe, it is critical that Bangladesh ensures holistic planning and solutions which are implemented towards control of the spread of the pandemic while the policy makers strive towards effective lifting of the lockdown. Planning and solutions must clearly outline :

• 1. Criteria: conditions based on health and medical data that sectors and localities should satisfy before initiating phased opening.

  2. Preparedness : what the country and local administration should do to meet challenges in the coming days, including potential of resurgence of the virus.

  3. Guidelines: Responsibilities of individuals and employers and relevant government agencies especially in the locality  during all phases, and in each specific phase of the opening.

While it is understood that this is an unprecedented situation in modern times, where no country has managed to find a fool-proof method of either preventing, containing or curing the disease, key considerations Bangladesh must bear in mind while developing a Lockdown Exit Strategy includes i) geographical vulnerabilities managed at the local level, ii) timebound phasing based on the capacity of the central and local administration, iii) scenario planning with regard to the strength and other particular characteristics of each part of the society and economy, and iv) specific impact on the vulnerable parts of the society. Finally, the strategy must be pragmatic and robust enough to respond to clear objectives such prioritizing the health and safety of all stakeholders, especially workers and others in vulnerable positions; ensuring healthcare management, putting in place the necessary governance measures for effective planning, implementation, and monitoring;  generating livelihood, ensuring mobility, and, in a slightly longer term, enabling a robust recovery of economy . 

All this can be done with the judicious use of expert advice, particularly in the spheres of public health management, medical service management, social behavioral science, and economics. Effective coordination, an important  but often missing feature in the way Bangladesh handles crises, will be critical to attain success, and can be significantly strengthened by putting in place an institutional coordination mechanism. Such a platform, ideally headed by an empowered, competent, high-level  policy-maker, will be key to bring the relevant stakeholders together  for appropriate decision and regular monitoring. There will have to be behavioral changes which will last beyond the immediate contagion, general health and safety protocols to be observed by all at home and in public places, and specifically designed protocols for different industries. These will have to be incorporated into daily behavior.

Let's Wrestle The Enemy to Floor Before Taking Victory Laps

As Prime Minister Boris Johnson of UK said upon his return to work this week, ' do not let go as you begin to wrestle the enemy to floor'. Bangladesh must not let down the guard without an evidence-based assessment to determine the time to re-open its economy fully,  and it must take a systematic, science and data driven phased approach before easing restrictions even more. Having avoided wide-spread outbreak in the initial few weeks through judicious policy decisions, we as a nation must avoid resurgence resulting from pre-mature opening which will lead to a collapse of the already struggling health system, and a second wave of lockdown which will have the potential to grievously harm the society in the long term. Restriction must be eased out in a manner that can help get maximum economic gain with minimum loss of lives through the pandemic, and at the appropriate time. 

We believe, therefore, that life and livelihood are not an either/or choice. Both can be safeguarded through pragmatic yet cautious and courageous policies. We have the advantage yet of relatively low infection and mortality numbers, which we do not want to squander. Our policymakers may take advantage of the experiences of many of the countries which are several weeks ahead of us, set up committees of experts in public health management and economic recovery management, designing interventions and actions suited to our specific circumstances, thereby charting the shortest course to a viable and safe re-opening and recovery.

Asif Ibrahim, Chairman, Chittagong Stock Exchange
Nihad Kabir, Barrister, President MCCI, Dhaka
Abul Kasem Khan, Chairman, Business Initiative Leading Development (BUILD)
Syed Nasim Manzur, Leather Footwear and Good Manufacturers and Exporters Association
Dr. M. Masrur Reaz, Chairman, Policy Exchange