What will it take for Bangladesh to win its battle against Covid-19?

India’s devastating second wave of the coronavirus pandemic poses a threat to neighbouring Bangladesh. Many believe that the failure of the Indian government to tackle the outbreak is the result of the Bharatiya Janata Party and its parent organisation, the Rashtriya Swayamsevak Sangh, emphasising the communal politics of division rather than prioritising human development, building a robust healthcare infrastructure and taking Covid-19 seriously.

The Indian surge places Bangladesh in an extremely precarious situation in its own battle against Covid-19.

In early 2021, many in Bangladesh had started believing that their country was finally getting the virus under control. Deaths and new cases had fallen significantly. The vaccination process started smoothly after 10 million of 30 million doses of Covishield were delivered by India. In April, however, the situation suddenly declined in the face of a second wave, resulting in 2,404 government-reported deaths – the most in a single month since the pandemic began in March of last year. Although experts initially feared that this second wave might get out of control, infections subsequently declined, for reasons that are not yet understood.

On Tuesday, Bangladesh recorded 2,322 new cases, the first time since May 1 that the number breached 2,000. Forty four more deaths were recorded, the highest daily figure since May 10.

Although Bangladesh has been able to develop its health sector significantly in recent decades, it is still not at the robust level of Western standards. Experts in the West were apprehensive about the potentially catastrophic consequences of the pandemic in the Global South, especially in sub-Saharan Africa and South Asia. Nonetheless, the Bangladesh ministry of health failed to take the coronavirus outbreak seriously enough.

The Chinese experience

The first coronavirus case was spotted in Wuhan, China, in December 2019. Though there was no prior model for handling the Covid-19 outbreak, China nonetheless quickly contained the disease long before a vaccine was developed. Public health experts in China swiftly understood that it would be almost impossible to contain the virus if it were to spread all over the country. To isolate the outbreak where it originated, Chinese state authorities imposed a strict lockdown in Wuhan and adjacent areas. They also ensured the provision of food and the continued job security of the inhabitants during the lockdown period.

China was able to implement lockdowns successfully by imposing them only in smaller areas, rather than throughout entire country. This gave them the ability to move doctors and nurses from other parts of the country into Wuhan to tackle the epidemic. A clear set of measures helped China swiftly contain the outbreak, including setting up makeshift hospitals, repeated mandatory Covid-19 tests for all city dwellers, institutional quarantines, successful contact tracing, strict screening in different ports of entry, enforced social distancing, and a policy of obligatory mask-wearing.

Some countries in the Global South, including Vietnam and Taiwan, applied China’s model. As a result, despite having weaker healthcare infrastructures, they kept the death and infection rates much lower than in the West.

The Western dilemma

The leaders of many Western countries – notably the United States – often adopted disdainful attitudes toward anything related to China’s handling of the outbreak. Rather than grounding their decisions in scientific rationality, they viewed the situation through a political lens, criticising China’s draconian measures as anathema to civil liberties and personal freedom. They failed to realise that to beat an epidemic, some rights might need to be curtailed for a short period of time, a step that would eventually protect the lives, liberties and livelihoods of citizens. But instead of engaging the entire community, the West, especially the United States, try to tackle the outbreak through an individual approach (centred primarily on treating the sick).

The initial refusal of Western countries to impose stringent lockdown measures, strict screening at ports of entry, or an institutional quarantine policy took a devastating toll on human life. The West took longer to realise that containing the outbreak requires not only treating each patient but on mobilising communities for preventive measures. States that did that were able to keep the outbreak in check, while those that took the individual-centred approach suffered severe consequences.

Bangladesh’s battle

Bangladesh, too, took the individual-treatment approach to combatting the pandemic after it officially reported its first case in the second week of March 2020. It also, at the beginning, downplayed the danger of the epidemic. The ministry of health ignored all of the projection models and dismissed Facebook posts about the spread in local areas as politically-motivated disinformation.

Despite taking some initiatives, the authorities were unable to successfully screen Bangladeshi ports of entry and failed to impose mandatory quarantines for persons coming from abroad. This failure led to outbreaks in small areas in Dhaka. Like the West, Bangladesh could not arrest the virus in particular localities and it eventually spread throughout the country, resulting in nearly 13,000 reported deaths.

Bangladesh was highly unprepared initially, with only 39 PCR (polymerase chain reaction) labs available for Covid-19 testing, concentrated mainly in Dhaka. Through trial and error, however, the ministry of health shook off its initial torpor and set up more than one hundred PCR labs and makeshift hospitals. By successfully coordinating public and private hospitals and involving NGOs in the containment effort, the government was able to keep infection and death rates in check.

Dhaka’s response was tarnished, however, by press allegations of massive corruption involving the ministry of health and the health sector regarding misuse and appropriation of funds allocated for Covid-19 mitigation. Public speculation is that Bangladesh’s initial decision to procure vaccines solely from India was connected to the ministry of health’s decision to steer business to a particular corporation. Now, after India stopped exporting vaccines, Bangladesh is desperately trying to procure them from China and Russia.

Two challenges now face the country: the first is to protect Bangladeshi citizens from the imminent risk of spreading a highly contagious delta variant with its origins in India that has already been detected in several places. The second is to flatten the infection rate to zero. Unfortunately, the health authorities have been unable to produce any hypothetical projections or models for the suppression of the contagion, nor any road map for forward progress. The nation thus remains uncertain as to when and how the epidemic will end.

The pandemic has taught us two lessons. First, the importance of a robust healthcare system, and second, the significance of making the right decisions. If the government can make correct decisions and intervene quickly, it can halt the outbreak even with a relatively weak healthcare system.

On the other hand, if the government is unable – or unwilling – to intervene quickly, the outbreak can get out of control, as it has in the West, regardless of the strength of its healthcare facilities. If Bangladesh can learn from its experiences, it can overcome the challenges of blocking the delta variant and flattening the curve.

Sayeed Iftekhar Ahmed is a faculty member of the School of Security and Global Studies at the American Public University System. He is the author of Water for Poor Women: Quest for an Alternative Paradigm.