Prime Minister Sheikh Hasina on Thursday rang the alarm bell as she warned that everything could come under restrictions again as it happened last year as coronavirus infection has taken a dangerous turn in Bangladesh.
Her warning comes as Bangladesh recorded its highest ever daily cases on Thursday, nearly 6,500 – from only 3 cases on the first detection of 8 March last year – and the highest single day deaths, 59, in months.
A day before, the health minister voiced his concern and termed the situation a "red signal for us".
Zahid Maleque, the health minister, looked even more concerned on Thursday as more cases were detected than the previous day. "If 500-1,000 patients come every day to take urgent admission to the hospitals, the whole Dhaka city won't be enough to accommodate the patients," he said.
The man, who is leading the government pharmaceutical measures to fight the deadly virus, now wants immediate enforcement of restrictive measures to prevent the hospitals from being overwhelmed by patients.
In fact, his ministry raised the red flag two weeks back, sending a set of emergency proposals, including reducing work hours in factories and shutting shops by 6pm.
Of late, some restrictions have been imposed, but in a haphazard way, raising doubts about their efficacy.
One such measure is restriction on travel. Buses were asked to keep half of their seats empty, while offices and businesses remain open, causing immense suffering to commuters and chaos on the roads, exposing them to further danger.
With hospitals running out of ICU beds, coming weeks seem more dangerous. Epidemiologists warned that the virus is in incubation period and may spread fast infecting more people in the next two weeks.
Finding a bed in the coronavirus unit has been a Herculean task for the family of a patient. Of nearly 3,500 beds in Covid units, less than 1,000 beds were occupied in early March. on Thursday, 2876 beds were full. Although some beds were shown vacant, when contacted hospital authorities said those were occupied.
The most worrisome matter for doctors to treat the patients is that the infection is more severe than before and previous treatments were not found functioning effectively, leading to fast deterioration of the patients' health condition.
So non-pharmaceutical measures have now become the immediate weapon to use in the battle against Covid-19 as many countries enforced months-long lockdown last year. Bangladesh has also enforced its own brand of lockdown in the guise of shutdown by announcing general holidays for more than two months since 25 March last year.
Some restrictions are already put in place this week – public transports, gatherings, but – what the premier hints is something bigger. Whether or not the country is going into another shutdown has already been in talks, now the prime minister's hint and health minister's alarm bell make some more lockdown measures more likely.
And what is required as the health minister spoke for – a draconian restriction on people to prevent them from gathering together as it is the best non-pharmaceutical measure to contain the spread of the virus.
Some steps have already been taken, and more are to come.
Bangladesh has already imposed a ban on entry of passengers from European nations, except the UK, and 12 other countries as the coronavirus situation is worsening here. The restriction will remain effective from 3 to 18 April.
Public gatherings have been restricted in Chattogram till 14 April. The authorities asked all tourist spots, entertainment and community centres to stay closed.
The national technical advisory committee on Thursday recommended that the Ekushey Book Fair at the Suhrawardy Udyan should be shut to avoid public gathering.
Schools are closed and the possible date of reopening has been deferred.
The PMO from a video conference on Wednesday asked the district administration to enforce health guidelines. Secretaries might be given responsibility to oversee relief management of districts as was done during the first wave of outbreak last year.
Farhad Hossain, the state minister for Public Administration, said district administrations have been asked to stay alert. They have been asked to follow the 28 March guidelines for two weeks.
"No new guidelines have been planned yet," the state minister told TBS on Thursday.
Additional Deputy Commissioner (Media) of Dhaka Metropolitan Police Iftekharul Islam said the police started enforcing the 18-point instructions issued by the government. Steps have been taken for public awareness about safety, he added.
No decision has been taken to restrict factory operation and businesses.
Most of the businesses were caught off-guard in the latest surge in infections and deaths from coronavirus.
"We were not prepared for the second wave. After the start of vaccination, we thought the virus spread would reduce and we have set production contracts accordingly," said Engineer Abu Noman Howlader, chairman of BBS Cables Ltd and president of the Steel Building Manufacturers Association of Bangladesh.
"As the infection rate keeps rising, we have decided to continue production, maintaining health safety," he told TBS on Thursday, urging the government to find ways to support businesses in this tough time.
Shams Mahmud, managing director of Shasha Denims Ltd and former president of the Dhaka Chamber of Commerce and Industry, said buyers started coming back with fresh orders, but the surge in infection would put the industry into crisis again.
Apparel factories, which have the largest concentration of manufacturing workforce, are concerned and focusing more on health safety measures enforced during the first outbreak last year. "By now, we have gained some experience to fight against the pandemic through trials and errors," said Fazlee Shamim Ehsan, a director of the Bangladesh Knitwear Manufacturers and Exporters Association.
He said apparel factories invested a lot to maintain health safety, and as a result death rate was zero in the apparel industry. Factories are already running at 70% to 75 % capacity, he added.
Health ministry's 22 points
On 15 March, the Covid-19 management group of the health ministry had proposed that presence in government and private offices should be restricted to 25-30% except for essential services. It recommended that shops should be closed by 6pm and garment and other factories should reduce working hours and introduce shifting duty.
It also urged for withdrawing the test fee and increasing the number of Covid-19 tests. The 22-point recommendations, which also included limiting guests at social gatherings to 50-100, were sent to the Prime Minister's Office. The infection rate would double in two weeks if those measures were not taken immediately.
The group's concerns came true.
And state machinery has started responding.
As the situation has turned grave, some previous initiatives seemed to have gathered pace.
The World Bank-aided initiative to install ICU beds and ventilators and setting up a 1,500-bed isolation centre at the Mohakhali DNCC Market was stalled amid allegations of irregularities. Now it will proceed on an emergency basis – the isolation centre will be operated under the Armed Forces Division.
Work is underway to build a 50-bed ICU and 200-bed HDO within seven days at the North City Corporation market hospital, which will be ready in 15 days with 1,200 isolation beds, the health minister told a programme on Wednesday. Government hospitals will have 2,500 more beds, he also informed.
on Thursday he virtually inaugurated 10 new ICU beds at the Dhaka Medical College Hospital (DMCH).
After the Covid-19 outbreak in March last year, the government had planned to install central oxygen plants in 36 government hospitals. The designated agency could equip 14 hospitals so far. The work on oxygen plants in six more hospitals is in progress.
Though no income support scheme has yet been planned, the government has decided to spread the Open Market Sale of rice during Ramadan. "We will add 30 tonnes of rice daily in Dhaka in addition to 120 dealers, each selling 1 tonne every day. Similar programmes will be taken in other city corporations as well," Food Secretary Dr Nazmanara Khanum told The Business Standard on Thursday.
Kurmitola General Hospital has 275 beds dedicated for Covid-19 patients. The hospital had 422 Covid patients admitted on Thursday, 66% more than its capacity. All its 10 ICU beds were occupied.
The situation is more or less the same in all Covid-dedicated hospitals in Dhaka, where admission in general beds surged by 51% in the last two weeks. The number of ICU patients also rose 20%.
Covid hospitals in Dhaka had the highest patients in June-July last year. Of 7,053 beds, on an average 2,100 patients were admitted.
But the situation seems alarming now as 2,876 patients were admitted on Thursday in 19 government and private hospitals that have 3,457 beds. Of the 285 ICUs, 51 were reported vacant.
The infection rate had dropped to less than 3% but shot close to 23% on Thursday, putting the hospitals on the brink of their capacity.
Bangladesh Thursday reported a record 6,469 new cases and 59 deaths – highest in a single day since 30 June last year.
Dr Khalilur Rahman, director of Shaheed Suhrawardy Medical College Hospital, told TBS that admissions to their Covid ward more than doubled to 140. They will add 50 more beds and 10 ICUs from tomorrow.
"Patients are now requiring oxygen more. They are staying admitted for a longer time. So, vacant beds are rare," he said, fearing that the situation might turn even worse for them if the trend of patient growth continues.
Dr Asim Kumar Nath, director of Mugda Medical College Hospital, said they did not have any scope to have more beds. "Our 29 ICUs are always occupied. We cannot accept requests from external patients," he added.
Bri Gen Nazmul Haque, director of Dhaka Medical College Hospital, hoped that additional 10 ICUs would mitigate some crisis, but the demand for ICUs will always be there since critical patients are referred to DMCH from all over the country.
Private hospitals are no different.
Dr Shagufa Anwar, director of Communication and Business Development at United Hospital Ltd, said no ICU bed was empty there. "We are keeping patients waiting. We are sending home those who are not in need for oxygen," she told TBS on Thursday.
However, the oxygen crisis this year is not as severe as was seen last year in hospitals. This year 90 hospitals have central oxygen lines, while large government hospitals are equipped with high-flow nasal cannulas and more are coming, hospital authorities informed TBS.
Dr M Mushtuq Husain, consultant of the Covid-19 Pandemic Control at the Institute of Epidemiology Disease Control and Research, felt that hospitals now need more beds with high-flow nasal cannulas to reduce pressure on ICU beds. But the situation "may spiral out of control" if infection cannot be checked through strict measures for detection, isolation and quarantine, he warned.