COVID-19: Our success in Bangladesh

Many people try to judge COVID-19 disease on the same scale as other infectious diseases. That’s not right.  Such diseases or health disasters have not occurred in the world in the past. All countries have never faced such a terrible problem at the same time. All countries were struggling.

In Bangladesh, we started taking all-out measures to prevent and deal with the coronavirus in the country soon after the case of corona virus infection was reported in China in December last year (2019). A National Preparedness and Response Plan for COVID-19, Bangladesh was developed. The plan set three price targets: (a) to control the arrival of the coronavirus from abroad; (b) control of the spread of coronavirus in the country; and (c) identifying the infected and isolating them and treating them.

The implementation of these programs started from the beginning of January (2020). They are summarized below:

1. On 31 December 2019, the People’s Republic of China published information on the outbreak of the novel coronavirus infection in the city of Wuhan. On 4 January 2020, the World Health Organization announced an outbreak of the virus in  China.
2. We, form the Ministry of Health of Bangladesh, also started screening of all passengers coming from abroad at all land and naval ports, including airports of the country, from January 4, Arrangements were made to monitor the suspected passengers by keeping them in temporary quarantine at the airport. The health declaration form and passenger locator form distribution were started among the passengers through the crew inside the aircraft which is still operational. A total of 8,83,600 passengers have been screened till September 2, 2020.
3. The disease control wing of the IEDCR and the Directorate General of Health Services (DGHS) continued to procure PPEs and laboratory testing equipment with the help of the World Health Organization. The stock of PPE supplied in the past due to the fear of various disasters across the country was also reviewed.
4. The Directorate General of Health Services (DGHS) was monitoring the movement of the virus in China every day and I as the Director General of the Directorate General of Health Services briefed the Honorable Health Minister and the Secretary of Health Services about the situation and what to do. On January 21, 2020, the hon’ble Health minister apprised the Hon’ble Prime Minister of the situation. From the very beginning, at every moment, Hon’ble Prime Minister Sheikh Hasina saw everything like a watchwoman and took the right national decision and action at the right time.
5. On January 22, 2020, the DGHS gave a briefing to the media. On January 26, 2020, the first corona control room was opened at IEDCR.
6. On January 30, 2020, the World Health Organization declared corona a public health emergency of international concern.
7. Meanwhile, worried Bangladeshis, especially Bangladeshi students stranded in Wuhan, China, started making fervent appeals to return to Bangladesh. The Hon’ble Prime Minister Sheikh Hasina took the initiative to bring them back to the country. On February 2, 2020, 312 Bangladeshis were brought back home from Wuhan via Biman Bangladesh at full cost. They were kept in a 14-day quarantine at the Ashkona Hajj Camp near Hazrat Shahjalal International Airport. Gratitude is due to the Ministry of Religion and the Ministry of Disaster and Relief for their cooperation in this regard.
8. The Ministry of Health formed inter-ministerial, district and upazila COVID-19 prevention committees on March 1, 2020. Instructions were given to open isolation units at a rate proportional to the number of beds in all public and private hospitals.
9. In the light of the deteriorating global situation of Corona, the first integrated corona control room of the DGHS was opened at IEDCR on March 4, 2020. It was shifted to the Directorate General of Health Services (DGHS) on March 16, 2020, as an integrated COVID control room for 24 hours/7 days on a large scale. On March 17, 2020, the birthday of Father of the Nation Bangabandhu Sheikh Mujibur Rahman and the beginning of Mujib Borsho, the integrated COVID Control Room was formally inaugurated.
10. To raise public awareness about the coronavirus, information and advertisements were started in the national media and the campaign on disease prevention. Posters and leaflets are printed and distributed.
11. The first COVID-19 infected person in our country was identified on March 8, 2020. We met Hon’ble prime minister Sheikh Hasina on an emergency basis and informed her about the matter. She ordered to announce it in the media She decided to hold the opening ceremony of Mujib Borsho digitally by avoiding public gatherings. The government regretted the postponement of the event to the foreign high-profile guests.
12. The infection spread rapidly in Narayanganj, Shibchar in Madaripur and Mirpur in Dhaka. Local lockdowns were imposed in all these places. In this context, committees were expanded up to divisional, city corporation, municipality, and union levels (15-18 March 2020) to prevent the spread of community transmission and strengthen local initiatives to control and combat COVID-19. On March 18, 2020, the country’s first corona-related death occurred.
13. Images of daily corona infections and thousands of corona-related deaths in Europe and America were coming in the media. Anxiety-panic among the common people increased manifold. Initial observations by public health experts said that since Bangladesh is a very densely populated country with a population of 170 million, the number of infected people in this country could exceed millions if effective measures were not taken very quickly. Death could also exceed a million. The projection of Imperial College, London in the UK in this regard was very worrying. It feared that more than 90 million people would be infected even if maximum social distancing was ensured in the entire nation, about 360,000 people would die; 22 lakh 16 thousand people will be admitted to the hospital; and of these, the number of severely sick patients would be 4 lakh 77 thousand.

14. In this terrible fear, the government had no choice but to take the prevention of infection and the protection of people’s lives as the only vow. I jump with what I have. Day and night I work at rocket speed. Colleagues of the ministry and the Directorate General of Health Services (DGHS) realized that people’s lives could not be saved if they worked in the traditional administrative system. So, everyone jumped with all their might.
15. Earlier, it was thought that PPEs and masks would be needed only by the medical workers directly engaged in the treatment of corona patients. But it was found that the possibility of corona cannot be ruled out if someone has respiratory problems. Many patients were coming to the doctor hiding their symptoms. Therefore, there was a need to provide PPEs, masks, and other disinfection products at all levels of all hospitals. As a result, the demand for these items skyrocketed overnight.
16. There was same problem in every country. As a result, it was difficult to bring the logistics and supplies from abroad. Initially, there were concerns about the supply situation, but the situation was handled quickly. At the local level, arrangements were made to produce and supply PPEs with the help of various garment industries. A task force committee was formed from the Directorate General of Health Services (DGHS) to ensure the quality of PPEs, N95 masks and protective gears. The Task Force Committee met in a series of meetings and analyzed the Guidelines and Scientific Methods of the World Health Organization and formulated recommendations and wrote to the Directorate General of Drug Administration and Central Procurement Department to implement them. Subsequently, the Directorate General of Drug Administration (DGDA) took appropriate effective initiatives. The DGDA issued a notice to the companies, which manufactured personal protective equipment (PPE) and accessories and gears (gowns, masks) to get testing and surveillance done from five ISO17025 accredited laboratories.

14. On the website of the DGHS, www.dghs.gov.bd, the Corona dashboard was created, and the new Corona Web Portal was launchedcorona.gov.bd to disseminate daily updated information and public awareness advice. It showed updated supply and stock situation of safety equipment, test kits, etc.;  the number of laboratory tests; number of infected patients, hospitalizations, deaths, recovered patients; hospital beds; on the hotline, the number of calls to the center, the number of telemedicine services, etc.  were updated.  Numerous video clips have been created and circulated through social media and web portals.
15. The system of providing media briefings on electronic platforms for journalists and public of print and electronic media every day and publishing COVID-19 health bulletins every day was introduced.

14. Apart from the IEDCR, there was no RT-PCR laboratory anywhere else in the country for corona testing. Soon, the capacity of the laboratories had to be created by searching for RT-PCR machines at all levels, public and private. Now this test is being done in about 100 centers, 50 government. Among them were government institutions that were not under the Ministry of Health and Family Welfare. There were 43 RT-PCR laboratories at the private level. Of the total laboratories, 54 were in Dhaka city and 39 outside Dhaka. Later, COVID antigen testing was allowed.
15. As of September 2, 2020, there were 14,474 dedicated corona hospital beds and 550 dedicated ICU beds across the country. According to the daily health bulletin of the Directorate General of Health Services (DGHS), of the dedicated corona beds, 6,266 were in Dhaka city, 782 in Chattogram city and 7,426 in other places. There were 310 dedicated ICU beds in Dhaka city, 39 in Chattogram and 201 in other places. Apart from this, many isolation hospitals and quarantine centers were opened in different parts of the country. The ministry and the DGHS had to hold many view-exchange meetings so that private hospitals admitted COVID patients, and the doctors opened private chambers, which they kept closed out of fear in the initial days of COVID-19 outbreak.

Dedicated Covid hospital beds and ICU beds across the country (2 September 2020)

21. There are 13,011 COVID-related oxygen cylinders, 482 high flow nasal cannulas and 180 oxygen concentrators across the country.
22. Arrangements were made to provide proper medicines and medicines for Covid patients in government-run COVID hospitals.  Arrangements were made for training, lodging, eating, transportation, quarantine, isolation, etc. of doctors, nurses, and health workers.
23. Efforts were made to know the updated situation at the local level through regular video conference with health managers and doctors across the country and they were given regular advice. Zoom meetings have been held with various groups almost every day and effective decisions have been taken in them.
24. Four special hotlines were opened to assist in hospitalization and receive complaints: 01313791130, 01313791138, 01313791139 and 01313791140. Apart from this, arrangements were made to receive people’s complaints using the link “Send corona complaints” link or http://app.dghs.gov.bd/covid19-complaint link in the corona corner of the website www.dghs.gov.bd of the DGHS. Complaints were looked and remedies were made.
25. The hotlines 16263 and 10655 operated by the Directorate General of Health Services (DGHS) and IEDCR have been strengthened manifold to answer various questions of the public regarding COVID-19 and to provide them necessary consultation support. The National Teleservice Hotline 333, operated by the ICT Division, was added to the COVID service. As of September 2, 2020, a total of 19,847,818 calls received and provided to the people necessary support.
26. Follow-up and telemedicine services were provided to 2,84,047 COVID-19 infected people treated from home. Volunteer doctors were appointed to provide this service. Thousands of doctors provided this telemedicine service by obtaining certificates with prescribed training on an online platform called Muktapath run by A2I.

21. Analyzing the medical protocols of the World Health Organization, China and other countries, our experts prepared COVID treatment guidelines. More than 36 different types of guidelines/ protocols were prepared and distributed.

28. In addition to the inter-ministerial, district and sub-district COVID prevention committees were formed by the Ministry of Health on March 1, 2020. Several committees were formed at the level of the Ministry of Health and the Directorate General of Health Services (DGHS). These were: (a) The National Technical Advisory Committee; (b) Committee on Public Health; (c) coordination committee of COVID-19 core committees; clinical guidelines and medical management committee; (d) expansion, quality and pricing and monitoring committee of COVID-19 laboratory testing at public and private levels;  (e) Information Management, Mass Communication and Community Mobilization Committee;  (f) The Committee on Maternal and Child Health;  (g) Essential and Regular Health Care Committee;  (h) Committee on COVID-19 and Mental Health;  (i) Committee on Medical Capacity Building of Public and Private Hospitals;  (j) Hospital, Laboratory and Environmental Infection Prevention and Control Committee; and (e) Group on Zoning Systems.
29. Ten projections were prepared by public health experts to get an idea about the future course of the corona situation in Bangladesh.
30. All kinds of communication and preparations were made to protect the people of Bangladesh with COVID vaccines.  Hon’ble Prime Minister agreed to the cooperation initiative of the World Health Organization and GAVI. An initiative was taken to procure the Oxford vaccine for Bangladeshis through a partnership with neighboring India. Russia was also in contact with Russia regarding the receipt of a vaccine made by Russia.    the work of microplanning done to start vaccination as soon as the vaccine would arrive.
31. Many works such as providing briefing information for the video conferences of the Hon’ble Prime Minister, coordination with the ministries, inter-ministerial, policymakers, media, World Health Organization, and donors, managing integrated COVID control rooms, etc. were done in a very short time, speed, and efficiency.
32. The government was quite successful in COVID-19 management in Bangladesh through the huge activities mentioned above in the urgent need of the situation. By end of 2020, COVID-19 related economic activities in the country returned to almost normal level. Beds of COVID hospitals found vacant. There was no fuss about oxygen supply or ICU. Private hospitals were admitting COVID patients. Doctors’ private chambers were opened.
33. The situation in Bangladesh, a densely populated country of 170 million people, was under control, whereas in many developed countries, including in neighboring India, where the number of infections and deaths was worrisome.
34. According to the World Bank’s observations, the world’s GDP has declined by an average of -7.7 percentage points due to COVID-19. But the situation in Bangladesh was different. The people of Bangladesh were participating almost fully in social and economic activities. Public transports were allowed to fill passenger seats in full swing. People were traveling on long distances without being afraid. Flight operations started. Hat bazaars, supermarkets, factories, and businesses went on in full swing.
35. The main reason for this change in the situation is that the fear of COVID among the common people decreased. People’s knowledge and awareness increased. People were as alert as they needed to. Another reason for the place of confidence of the people was that people knew that there were enough laboratories and testing facilities for diagnosis in the   There were enough COVID hospital beds across the country.  There were enough ICU beds.  There was no shortage of oxygen supply in the hospital.
36. We also feel some satisfaction that the Ministry of  Health and the Directorate General of Health Services (DGHS) and our other agencies were able to create this positive situation by performing the right leadership and responsibilities in time from their respective positions. We worked day and night with all our energy and received cooperation from all the ministries, agencies, and donors of the government.  We pray for the salvation of the souls of the health workers, the police and the COVID-19 warriors who had to sacrifice their lives and extend deepest condolences to the families who lost their loved ones due to COVID-19.