Too early a retreat from lockdown?

There is no doubt lockdowns cannot continue for an indefinite period; but is Bangladesh making a hasty retreat that is premature and risky?

Sometimes data speak louder than words if we care to hear. 

The graphs below suggest we might be taking a hasty decision to end the lockdown early.

The graphs show the path of destruction of the pandemic in some of the worst hit countries where infection and deaths were high.

As afflictions and deaths rattled their economies and societies, all of them had imposed lockdowns.

The infection curves lifted dramatically during the lockdowns and then they flattened, serving the purpose of such a shelter-in-home approach. It was only then the restrictions were withdrawn followed by massive testing and contact tracing.

On average, these countries took about 60 days to make the decision to step out of the extraordinary restrictions.

But Bangladesh imposed lockdown for only 30 days, from March 26 to April 25 when it allowed garment factories to open in phases. In reality, the floodgate was thrown open and hundreds of thousands of workers have streamed into the cities and factories.

And during the time frame of the lackluster lockdown, the infection curve has just started lifting and is likely to reach a peak very soon.

The health ministry itself fears May would be quite nervy as infections and death would rise sharply.

In lifting the lockdown, the study of two Oxford University researchers who gave two models of lockdown for effective control of infection was also ignored.

In one model, they suggested a continuous lockdown of 49 days, during which the curve would rise and then fall close to the base line. This means every day about 20 cases would be detected.

It is then the lockdown can be withdrawn because low infection rate would minimize the risk of the disease spreading.

In another model, they suggested a three-phase lockdown, each paused by a five-days restriction withdrawal. The first phase would last for 21 days after which the infection would again raise its head. As the 28-day second phase would come into force after 18 days, infection would again slow down.

As the second phase would end there may come a third wave when the last lockdown phase of 18 days would begin which would beat back the curve closer to the baseline.

But we did not follow any of the methods.

So lifting restrictions without flattening the curve makes fighting the coronavirus a daunting task, putting enormous pressure on the country's very shaky health system.

Some of the signs of such impetuous acts are becoming clear now. Only Wednesday, the number of infectious patients reached a new high, although much of it can be attributed to a sudden rise in testing too.  But that shows the trend – the pandemic is very much at its heightened virulence.

More worrying was the finding that in some places, such as Narayanganj and Kushtia, up to 90 percent of the people tested were found positive on some days. Garment workers who have returned to work are also being infected.

For the countries represented in our graphs, one of the key elements in restriction withdrawal is maintaining physical distancing.

In Bangladesh, it did not happen despite the garment owners' promise. In reality, as reports filed from the fields show, the factory floors are as crammed as ever. The workers have been given no training in virus safety.

Probably Bangladesh is caught in its own unfortunate economic structure where the informal sector is vast and mostly labour intensive.

A labour cannot work from home to maintain the luxury of physical distancing. And a day's loss of work is an absolute erosion in income.

Health experts strongly denounced the decision of allowing factories and restaurants reopening without the curve being flattened.

According to media reports, the national advisory committee to fight coronavirus was not consulted about the factories reopening.

In view of Professor Ridwanur Rahman, the head of the Research Centre at Universal Medical College, allowing the factories to reopen runs counter to the health safety rules. "We may have to pay heavily for this unscientific decision." 

Prof Be Nazir Ahmed, former director, communicable disease control, DGHS, echoed the same view and feared the new cases may jump after reopening of the garment factories.

A look at what they did

Outside of China, Italy was the first worst hit country. The first case was detected in Italy on January 31. The number of cases remained below 100 until February 27. 

But from the beginning of March, the cases started jumping almost every single day and the curve reached a peak on March 21 recording more than 6000 new cases. The death toll also rose. 

 After March 21, the curve started to flatten. Italy recorded 2091 cases on April 28. 

 The government initially was hesitant to enforce a lockdown. But as the situation worsened, it enforced strict lockdown on March 9 and later extended the restrictions.

On April, 26, the Italian government promised that it would gradually ease the restriction from May 4. 

The same pattern regarding the increase in numbers in infection cases, death toll and imposing of the lockdown was followed in Spain and France to fight the spread of the coronavirus.

The governments of Spain and France have recently promised to ease the lockdown measures from next month.

France, which enforced the lockdown on March 17, has now planned to ease the restrictions from May 11.

The Spanish government that enforced the lockdown on March 14 has allowed children under 14 years of age to go outside for an hour each day from April 26, although parks and playgrounds remain closed.

The government announced that the gradual lifting of other restrictions would begin in the second half of May, assuming the rates of infection continue to decline.

Denmark, Germany, Switzerland and Austria are the other European countries taking steps to end the lockdown restrictions.

The European Commission's roadmap for lifting lockdowns underpins the necessity to flatten the infection curve, a sufficiently robust health system and monitoring capacity.

Each of the European countries took three months to reopen since detection of the first infection case. 

We took only one and a half months from detection of the first case on March 8 to reopening factories on April 25. So we are different from others.