What Bangladesh should learn from the recent C-19 spike in India?
Enamul Hafiz Latifee and TanziaIslam Latifi
India is in a very critical situation at this moment due to COVID-19 havoc. Let our prayers be with India, and let us take learnings from there-- at what grounds Bangladesh needs to get prepared immediately to fight Coronavirus if it starts striking Bangladesh in a similar way with the deadliest double and triple mutant strains of COVID-19 that hammered India in tandem with severe Medical-grade Oxygen supply shocks and Vaccines shortages.
Meanwhile,following a farsighted plan, the USA has been reportedly secured more than 550 million excess doses that could be used to help end the global pandemic faster. In accordance with the global wants,the Biden administration announced on 26 April 2021 that the USA will release 60 million AstraZeneca doses to other countries as they become availableto the countries pleading for help.
In this situation, when the next-door neighbour of Bangladesh is struggling against COVID-19 at this moment, Bangladesh should redress the status quo and get ready accordingly as mentioned below.
Ensuring the availability of Medical-grade Oxygen by forecasting the increasing demand
Health Minister Zahid Maleque on 27 April 2021 had been quoted saying, that, "There is no shortage of gaseous oxygen in the country. We needed to import the liquid oxygen during the COVID-19 upsurge," however, his remarks came at a time when India has abruptly halted its oxygen export to Bangladesh as it is struggling with the latest wave of the COVID-19 pandemic and hospitals in several states are reeling under a shortage of medical oxygen.
But, it has to be kept in mind that, the present demand for Oxygen in Bangladesh is around 200 tonnes in a day for medical treatment purposes, which has a significant possibility to elevate at an exponential rate everyday with the upsurge of COVID-19 cases and we never know if it crosses 1,000 tonnes a day, then what crises it may create if we do not have any contingency plan. So, to meet up the potential needs, Bangladesh is required to ready itself, firstly, by establishing a demand forecasting model for Medical-grade Oxygen at the earliest with the coordinated efforts of Department of Public Health Engineering (DPHE); and Institute of Epidemiology, Disease Control and Research (IEDCR).
Secondly, Directorate General of Health Services (DGHS), should say "Yes" rapidly to the pending domestic applications of producing Oxygen. Thirdly, should start searching for immediate alternative sourcing countries apart from India, and the National Board of Revenue and Ministry of Shipping of Bangladesh should instruct all custom stations and land ports, seaports as well as internal ports to release the "Oxygen imports in any form" at the quickest possible time, should give a timebound approach allowing them not more than 24 hours. Bangladesh must not fail to ensure Medical-grade Oxygen supply, should do everything that it takes, either by producing here or by importing from alternative sources.
Negotiating over the timely collection of the COVID-19 shots : We have been seeing that some developments are going on by the Ministry of Foreign Affairs, Bangladesh to ensure sourcing of vaccines from China and Russia, also thinking of going for co-production with Russia to make 'Sputnik V' COVID-19 shots here in Bangladesh, but, it all seems to be very time-taking initiatives as of now. We should also explore the scope of co-producing AstraZeneca here either with the UK or India. We should establish our proposition by recalling that AstraZeneca signed a deal with South Korea's SK Bioscience to manufacture its vaccine products for local and global markets. Japan is also making AstraZeneca jabs, a long-standing and time-tested friend of Bangladesh, hence, we should not do late in approaching Japan for that to have.
We know that Bangladesh decided in January 2021 to buy COVID-19 shots developed by Pfizer-BioNTech through COVAX, a platform by the US and German pharmaceuticals to ensure coronavirus shots reach those in greatest need, but, as it is required to store this vaccine at minus (-) 70 degrees Celsius, it may not sound realistic for Bangladesh to ensure a total end-to-end cooling chain maintaining this temperature.
Meanwhile, the Special US Presidential Envoy for Climate John Kerry on 09 April 2021 had been quoted saying, "And I can assure you when we reach the level of the critical mass vaccinated and we have surplus, we will absolutely make vaccines available in whatever different ways the President decides.That's up to him.But I know that he believes very deeply that we have a responsibility, moral and practical, to make sure we're bringing the whole world back from this brink". We believe, Bangladesh is also maintaining deep correspondence with the USA to procure vaccines from there.
Progressing rapidly to observe the applicability of BANGAVAX: It has been learned that on 17 January 2021, Researchers of Clinical Research Organization (CRO) applied to Bangladesh Medical Research Council (BMRC) seeking approval for the clinical trial of BANGAVAX, a DNA plasmid-based COVID-19 vaccine developed by a Bangladeshi company, Globe Biotech Ltd. after conducting preliminary animal trials successfully which led BANGAVAX to be listed in the 'Draft landscape and tracker of COVID-19 candidate vaccines' on 15 October 2020 by the World Health Organization (WHO).
But, just after that, the nation is seeing a total stagnation in the approval and clinical trial processes through which only it can obtain final approval to be used in a mass. If we fail to recognize our home-grown innovation, it will just not demoralize the makers but may lead the nation astray by causing insufficiency of COVID-19 jabs supply to tackle this lethal virus.
Creating a national dashboard to monitor real-time production of COVID-19 related medicines :Already, we are seeing piling-up posts in social media that many infected people are not getting certain medicines in the pharmacies or anywhere else. As we already know what medicines are suggested to recover from mild COVID-19, time should not be wasted to place a Special Order/Circular immediately by the Ministry of Health and Family Welfare instructing private pharma companies to make these medicines more. An online dashboard should also be created with the assistance of the ICT Division, Bangladesh to collect and monitor the daily production of those medicines in real-time.
Putting an immediate total flight ban with the countries where Double Mutant COVID-19 has been found :The WHO said on 27 April 2021 that the Indian COVID-19 B.1.617 variant has been found at least in 17 countries, listed as 'variant of interest', that has two significant genetic alterations on a surface protein-- E484Q which is similar to E484K, which has already appeared in the British, South African and Brazilian variants and L452R can be found in the Californian variant CAL.20C. In India, however, these two mutations appeared together for the first time, which is why it has been termed as "double mutant."
Surprisingly enough, when the Bangladesh government has decided to close its border with India for the next 14 days to control the spread starting from 25 April 2021 allowing movement of cargo only, then the Civil Aviation Authority of Bangladesh (CAAB) said on 28 April 2021 that passengers fromeight countries-- Saudi Arabia, Kuwait, Oman, Qatar, Bahrain, Singapore, China, and theUAEunder special flights will be allowed to enter the country till 05 May, but, the double mutant virus is also existing in Bahrain, and Singapore, so, it is a dire need to put a strict ban on the passenger flights from and to Bahrain, Singapore as well, otherwise, partial steps will not benefit Bangladesh in tackling the spread of this deadly strain.
Needless to mention that, we urgently need to set up dedicated wards, ICU's, HDU's and ready the required health frontliners to be deployed for COVID-19 treatment up to Upazilla level, as Bangladesh is one of the most densely populated countries and everything cannot be managed from the capital city, Dhaka efficiently. Besides, during quarantine, 2 testings should be done, one before entering the quarantine and the other one just before leaving the quarantine place. The country also should focus on increasing total COVID-19 testing up to 1 lac a day, and simultaneously, should concentrate on conducting sequencing tests on a daily basis to recognise vaccine-resistant COVID-19 strain.
Nevertheless, the total system of the government connecting the private sector should act fast and immediately in ensuring all that we need to fight COVID-19, now.
Let us hope for the best that we may be able to skip and survive this critical situation with ease under the leadership of Prime Minister Sheikh Hasina, but, it should not make us-the commoners,neglecting to follow health guidelines as prescribed by the government, and we must not just try to tag everything with the regime's political objectives-- certainly, it is not. It is high time, that we stand together, stand firm and united to protect our nation.
Enamul Hafiz Latifee is the Deputy Executive Secretary, Research and Development, Dhaka Chamber of Commerce and Industry (DCCI).
Dr.TanziaIslam Latifi(MBBS, MSc) is the PhD Student in the University of
Salford, United Kingdom.