To tackle the ongoing second wave of COVID-19 in Bangladesh, a week-long lockdown had been announced with the possibility of extension recently. Hopefully, if the lockdown is properly maintained, its purpose will be served. Experts from the Initiative for Health and Development (IHD) have suggested the following guidelines to make the lockdown more effective, control COVID-19 transmission and improve patient management.
What to do until COVID-19 is controlled
• Make sure that people use masks everywhere. Take firm action if necessary. Places like bazars, bus and rail stations, launch terminals where there are gatherings of people – wearing masks be enforced strictly.
• To increase awareness regarding health safety rules, comprehensive communication programmes should be undertaken. Proper communication materials should be prepared and a befitting campaign should be carried out.
• COVID-19 vaccination registration should be simplified and on-spot registration services should be set up.
• A mass campaign should be undertaken to encourage people to vaccinate for COVID-19 with support from local administration and social workers.
• Regularising the study of genome sequencing and seroprevalence to understand the real situation can be understood. Especially, the situation of hospital bed occupancy should be shown with help of real-time updates on dashboards.
Things to do in the lockdown period
• Collection centres for COVID-19 sample testing should be established at the union level and efforts should be given to bring them closer to the urban population.
• The government determined COVID-19 test fees should be eliminated.
• Limited level mass transport should function under government control so that doctors and other health workers, emergency service givers and patients can commute with ease.
• Normalise the banking schedule to avoid crowding created by the limited bank transaction hours.
• Along with treatment for COVID-19, all other health services including maternity services should be kept functioning. Triage should be conducted in hospitals to better manage patients.
Things to be done after the lockdown
• All kinds of public gatherings, assemblies and meetings should be completely banned until COVID-19 is under control.
• All tourist places and entertainment centres should remain closed until it is deemed safe to open.
• People should be barred from leaving severely infected areas like Dhaka, Chattogram, Gazipur and Narayanganj during Eid and/or other festivals.
COVID-19 patient management
• High-flow nasal cannula or rebreather masks must be made available in all district, general, government and private medical college hospitals. Treatment for COVID-19 should be ensured in district and division levels to avoid unnecessary referrals to Dhaka.
• An effective oxygen supply system should be established within the next three months in all district, general, government and private medical college hospitals.
• Less serious and non COVID-19 patients should be encouraged to be at home care, get their treatment and advice from local doctors.
By proper implementation of these suggestions, Bangladesh can achieve notable success controlling COVID-19 and patient management.
Dr Syed Abdul Hamid is a Professor at the Institute of Health Economics, University of Dhaka; Dr Abu Jamil Faisel is a Public Health Expert; Dr Nasrin Sultana is a Professor and Director at the Institute of Health Economics, University of Dhaka; Dr Shafiun Nahin Shimul is an Assistant Professor at the Institute of Health Economics, University of Dhaka; Dr Mofakhar Hossain is an Adjunct Lecturer at the University of Toronto, Canada; Jamal Uddin is a Development Worker; and Muhammad Ihsan-Ul-Kabir is a Research Assistant at the Initiative for Health and Development (IHD).