'Perceived insusceptibility' is the opposite of 'perceived susceptibility' towards any disease in public health. Perceived susceptibility refers to the personal risk assessment regarding any disease or illness.
When people think that they are vulnerable to certain diseases they are prone to take anti-contagion measures so that they do not get sick. On the other hand, perceived insusceptibility refers to the attitudes and beliefs of individuals in response to any disease believing that they are not at the risk of being infected by any definite condition.
At the moment, Bangladesh seems to be experiencing perceived insusceptibility among its population towards the Covid-19 virus.
After 12 months of the pandemic, we are passing the second wave of Covid-19 infections in Bangladesh. Since March 8, 2020, we have been going through continuous rises and falls in the infection rate.
Initially, during the peak of the Covid-19 outbreak, the infection rate was 24 to 25 percent until it later skewed down to 10 percent in October 2020.
Afterwards, the infection rate was 12.57 percent at the end of December 2020 . After showing a brief downward trend in February 2021, the number of Covid-19 cases has once again started rising from March 6, 2021 alarming us all while our vaccination coverage is still going on.
At the time of writing this article, the WHO reported that the total number of Covid-19 patients in Bangladesh was around 600,000 with a total of 8,624 deaths on March 19, 2021. The health experts are worried that the number of infected will rise sharply in the near future.
However, it is observed that over time people's perceptions, attitude and responses towards Covid-19 have changed for the worse in our country.
It is worth noting that in the beginning when the number of infected patients was high, people took the necessary precautions and were careful around the world despite not knowing much about the virus.
We saw the government take action through a countrywide lockdown and the shut down of institutions and offices except for emergency services.
Moreover, relevant information about taking safety precautions against the virus was widely shared across social and mainstream media and was well-received.
Primarily, these practices might have helped us check the rapid spreading of the virus, as reflected by the fall in the number of cases in the months of July and September in 2020.
However, during the second wave of Covid-19, the infection rate is escalating worldwide, including in Bangladesh. While many countries are undergoing a second lockdown, our people have become bolder and more careless about taking the necessary health and safety precautions to prevent the spread of Covid-19.
A study from the Bangladesh Medical Research Council bulletin in June 2020 on measuring knowledge, attitude and practice of 1,549 people towards Covid-19 found that 73.5 percent of people had a negative attitude towards wearing face masks even though most of them knew how the virus was transmitted.
It is evident that despite the rising number of cases and deaths from the second wave of the virus in the country, people have chosen to remain oblivious about the level of danger they are in by downplaying their odds of getting infected by Covid-19.
An article from the Daily Star on December 6, 2020, remarked that 50 percent of people of Bangladesh who go outside do not wear a mask and out of this, more than 50 percent do not have the proper knowledge about how to wear a mask (most people's noses remain uncovered while wearing a mask).
Also, most people were reluctant to wash their hands frequently even though soap and water are not so difficult to manage.
When the pandemic began, on social media and the news we heard many incidents of people abandoning their sick loved ones in the fear of being infected. People were so desperate to protect themselves that they even resorted to unscientific practices based on rumours like going to the kabiraj or other unscrupulous practitioners, and followed whatever guidelines they were given.
Now that the infections have started rising again, it is worth exploring why people remain callous and reckless about Covid-19 safety despite knowing better and having the necessary information about the transmission of the virus.
In this article, we try to identify the factors that are responsible for the perceived insusceptibility toward Covid-19 among the people in Bangladesh. Experts say that the structural impediments are mostly responsible for this perceived insusceptibility and they include: 1. The absence of social protection mechanisms; 2. Absence of established social security; 3. Absence of sufficient government allowances; 4. Absence of alternative livelihoods; 5. Misinformation that corona is a foreign disease (and thus not transferable to locals); 6. Distrust in expert knowledge; 7. Illiteracy; 8. Limited access to proper scientific information; 9. Low perceived threat; 10. Fewer tests and positive cases, less susceptibility; 11. Over-population with high unemployment rates; 12. Living in dissident enclaves that makes them idiosyncratic; and 13. Fatalistic beliefs that infection and potential death are all predetermined by supernatural forces and thus not preventable through safety measures.
Additionally, living conditions, geographical locations (urban or rural), social status, occupation, age, and gender are also responsible for propelling people towards being indifferent or reckless towards the Covid-19 pandemic and personal safety measures.
Scientists and experts expect Covid-19 to be a long-term worldwide phenomenon. Considering this, effective and timely measures should be taken by the government with the collaboration of non-governmental organisations to eliminate such insusceptibility among people before it is too late.
During the nationwide lockdown, we saw thousands of peoples lose their jobs or income sources. They were forced to live on their meagre savings and rely on whatever handouts they could find.
Even after the lockdown was lifted, many did not get back to their earlier occupations and became burdened with loans. Although some people got relief and ration assistance under government and non-governmental initiatives, the assistance covered only a handful of people in comparison to the actual number.
Under such circumstances, maintaining health and safety protocols and social distancing become a luxury for those who had to go out to earn a living. In that regard, designing programs, food and hygiene rationing systems for the poor, ultra-poor and unemployed is an essential step.
Spreading proper knowledge and encouraging healthy practices in response to Covid-19 through mainstream media is still necessary as a time-to-time remainder. Although the Bangladesh government has started the 'No Mask, No Service' slogan to tackle the second wave, which is praiseworthy, solely encouraging the wearing of masks is not going to prevent the spread of the virus.
The teaching and enforcement of proper mask-wearing techniques are also necessary.
The handwashing program in urban areas which was started at the first phase of the Covid-19 pandemic ended as soon as it began. It is easily seen that most of the previously installed water taps and handwashing points are now useless, broken or stolen. The program demands re-initiation with proper monitoring systems.
The authority could take the Knowledge, Attitude and Practice (KAP) technique to remove misinformation, misconceptions and rumours with strict policy, laws and surveillance that will rationally prevent malpractices towards coronavirus safety. This could be made possible by mobilising volunteers, community leaders, and law enforcement agencies.
The number of Covid-19 testing facilities and testing kits could be increased on a large scale while reducing the price for all (it should be made free for the poor if possible) to address this problem.
Non-government hospitals could be compelled by the government to reduce the testing fees significantly in that regard. These could encourage people to test more and develop a Covid-19-aware mindset. However, the present free vaccination coverage in Bangladesh is also appreciable.
To prevent insusceptibility to health and safety protocols from developing in future crises, measures should be taken to increase literacy rates along with the provision of a minimum level of science education among people, in the long run.
Professor ASM Amanullah is a public health expert and academician in the Department of Sociology, University of Dhaka.
Laboni Khatun, M.Phil., is a researcher at the Department of Sociology, University of Dhaka and a development worker.