Dr ABM Abdullah is a doctor with numerous titles under his belt. He is the Personal Physician to Prime Minister Sheikh Hasina. He is also a University Grant Commission Professor, Ekushey Padak recipient and honorary fellow of Bangla Academy. He recently spoke about the current state of Covid-19 in Bangladesh with The Business Standard.
The Business Standard (TBS): How critical is the current state of Covid-19 in Bangladesh?
Dr ABM Abdullah (ABMA): The week ahead is crucial for Bangladesh. The country has entered the risk period. However, if those infected with the novel coronavirus and the returnees from abroad follow proper social distancing and quarantine, the situation can be kept under control.
The government has extended the shutdown period and law enforcement is on the streets to impose social distancing. The returnees from abroad have almost passed the risk time. So, their quarantine is more important. The outbreak occurred when they defied the government-imposed home quarantine and spread the virus across the country. Now, if their quarantine can be ensured, I hope the situation will not worsen.
TBS: The number of Covid-19 patients was slowly increasing in the beginning of the outbreak. Three cases, two cases. Then, no cases for a few weeks. All of a sudden it jumped to five and then nine. It was 117 till April 6. Is this not alarming?
ABMA: The number is rising as detection is growing. Lakhs of people, in flocks, came from abroad – especially from Italy. They did not maintain social distancing and roamed around freely. Some of them spread the virus. Yet, if we compare the epidemic outbreak to that of first world countries – for instance the US, Italy or Spain – the number of infected patients has not increased to an alarming level in Bangladesh yet.
Again, I am saying if social distancing can be ensured and those infected and who came from abroad maintain quarantine, our situation will not worsen.
Moreover, for the time being, if people from abroad – especially the countries hit with Covid-19 do not come to Bangladesh – we can be optimistic about the fact that the outbreak will not take on the form of an epidemic in the country. We are already in the risk period, we need to be careful.
TBS: If we compare the situation of ours with that of the US or Italy, the number was rising slowly in those countries in the beginning. Suddenly, it jumped to lakhs after one or two months. Is there a chance of that kind of outbreak in Bangladesh?
ABMA: We are at high risk, no doubt. However, we should not be very worried because our government is very cautious about the situation. Our Prime Minister Sheikh Hasina has taken the right decision by imposing countrywide social distancing through declaring a public holiday, at the beginning of the outbreak, for quite a long period. Though not everyone, the majority of the people are following WHO guidelines on hygiene. Schools, colleges, offices, and the other institutions are already closed. So, community transmission is under control.
TBS: People are afraid because the virus came from Italy, not China's Wuhan. And the virus changed its characteristics when it hit Italy. Is this a reason to be worried and afraid?
ABMA: Yes. The virus turned deadly in Italy. The death toll in Italy has surpassed the number of deaths in China. Of course, it is a worrying fact that a lot of people have flown back to Bangladesh from Italy, and many of the carriers of the virus were asymptomatic. However, not all of them were carriers. A few of them were. But, as the virus is highly contagious and transmits from human to human, it is a worrying fact. Ensuring their quarantine and restricting entry from abroad can stabilise the situation.
TBS: Are the numbers in Bangladesh low because of inadequate testing and underreporting?
ABMA: No country was prepared for the outbreak. In the beginning, there was a shortage of testing kits. The shortage was not because Bangladesh was unprepared but the exporting countries were under lockdown. We could not import them.
Another reason is that the testing and detection process is technology-based. As testing is a technical job, it requires a large amount of manpower. Suddenly, understanding how to operate the machine was difficult. We could not take the risk of wasting kits. We had to do the tests very carefully.
Now, we have a sufficient number of testing kits and trained technicians. I hope we can have a better testing situation now.
TBS: Can lakhs of people die in Bangladesh?
ABMA: We cannot predict the future. However, if we look at the fatality rate globally, the majority of the deaths were reported among elderly people and patients with complicated medical conditions like diabetes and hypertension. Even in Bangladesh, elderly patients and those with complications died. We have a lot of elderly people and patients with co-morbidity in Bangladesh. So, the risk is of course high. We advise the elderly population to stay home and stay safe. Their caregivers, family and relatives should also be careful about them. They should also stay home as much as possible.
TBS: Can Bangladesh's climate, weather, and unhygienic lifestyle help?
ABMA: The connections between climate, weather, living conditions and Covid-19 are not scientifically proven yet. The climate factor is controversial. Some accept it and some reject it.
But, data shows the number of affected people is relatively low in hot and humid countries compared to cold countries.
And about unhygienic living conditions, it is not scientifically proven either. There are some hypotheses that the people of Southeast Asia have a better immune system. We eat adulterated food, we are exposed to air pollution, all these might develop immunity in us. This is just a hypothesis – nothing proven.
TBS: People have complained that they were refused treatment at hospitals. Many people are dying untreated. What is your advice for doctors?
ABMA: A doctor's job is a humanitarian job. But, they are also human beings. They have families. So, it is normal that they are afraid. They had a demand for personal protective equipment (PPE). Now, the PPE crisis is over. We have a sufficient amount of PPE.
Now, every health professional who comes in direct contact with patients must wear PPE and – after ensuring their safety – they should provide treatment.
Not every patient has the coronavirus. If they do not receive treatment, it will be a disastrous situation for the public.
For flu and Covid-19-related complications, there should be a separate room, or corner, where doctors with special protection treat those patients.
It should not affect other patients. So, I would request that the doctors show sympathy towards all patients – of course after protecting themselves.
TBS: The number of ventilators is very low in Bangladesh. If the number of patients rises, what will happen?
ABMA: The number of ventilators is low in other countries as well. Some people in Bangladesh are trying to produce ventilators. We need to import them, too. Since temporary hospitals are being made for treating Covid-19, we hope they will make them, ensuring the availability of a sufficient number of ventilators.