The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease Covid-19 caused by the virus is very likely going to be with us for the rest of the year and beyond.
Normalcy will only return when a viable treatment (similar to what was found for HIV/AIDS) or a vaccine is developed.
As a society, we have a conundrum at hand:
1. How do you save lives, or at least, keep the loss at a minimum in the absence of a viable treatment or an effective vaccine? A complete lockdown and extreme social isolation may succeed, but that takes us to a potential problem, namely economic collapse;
2. How do you avoid an economic meltdown while curbing the pandemic, or at least take steps to bring back the economy to lessen the hardship?
No definitive test has been found (with close to 100% certainty) that will tell us that a person is not infected with Covid-19. There are tests currently available which, when administered properly in conjunction with knowing the individual’s medical history and recent social movement, may detect the virus in a person.
With a positive result from those tests we can be fairly certain that the person is infected. But the corollary is not true. In other words, to date, we can’t be sure if the person is completely free of the virus even if he/she tests negative with the tests available today, ie a false negative.
Testing, of course, should continue at the maximum extent possible to isolate or quarantine these individuals. However, testing alone will not allow us to separate the “completely free” from the rest of the population.
What does that mean in terms of opening up the economy?
In the context of Bangladesh, I propose the following actions for the next two months, after which they can be revisited or modified. The actions need to be implemented with social distancing as a top and necessary priority.
To varying degrees, all these actions will either flatten the curve or improve the economy, or do both.
Actions largely intended to flatten the curve
- Expand testing on a massive scale. Hire and train pharma and other technical graduates to conduct the tests. Encourage private companies and even invite foreign entities to open testing and treatment center; in effect makeshift field hospitals and clinics to quarantine, test, and treat Covid-19 patients
- Contact trace, test, and quarantine if necessary, all 600,000 to 700,000 workers/labourers and others who returned to the country this year from high incidence countries at the time of their departure
Use the immigration database, manpower companies, foreign companies that hired these people, and local district authorities to identify and locate them. Test, including antibody tests, each and every one of them, their families, and all those they came in contact with. If any of them is found infected, socially isolate them - Enforce social distancing in food and medicine outlets and other essential businesses much more than is currently practiced
- Engage foreign development agencies like UNDP, World Bank, ADB, GTZ, DFID, USAID, etc, and large national NGOs like Brac and Sajida Foundation to finance procurement of medical items such as masks, gloves, PPEs, and sanitizers for hospitals and clinics, both private and public.
Engage locally active NGOs all over the country to distribute the medical items. Fund and compel the local NGOs to hire local people in the distribution - Ramadan is upon us and Bangladesh, being a Muslim-majority country, would like to observe the month as the faith dictates. An important part of that ritual is to pray in a congregation in mosques
Rather than shutting them down completely, the government should partner with religious leaders and implement strict social distancing policies in houses of worship during prayer times, including tarabi. - All social functions such as weddings, parties, funerals, and large gatherings of all sorts should be disallowed.
- The elderly and people with compromised immune systems should continue to stay indoors. Definitions of such individuals should be determined by appropriate medical professionals
- Even after a vaccine or a cocktail of effective treatment drugs are developed, which is likely to be in the developed world or China, Bangladesh may have to wait its turn.
Therefore, work early with WHO and renowned CDCs to ensure Bangladesh has an adequate supply of such cures soon after it is available. Align the big pharma companies in the country to prepare to manufacture the vaccine and drugs here.
Actions largely intended to improve the economy
- Geographically identify all areas of the country where labour is needed to harvest rice crops and other agricultural products. Employ all willing low-income young people and move them to these locations. Either build temporary shelters or use closed government buildings/schools on location for these people
- Engage foreign development agencies like UNDP, World Bank, ADB, World Food Program, GTZ, DFID, USAID, etc, and large national NGOs like Brac and Sajida Foundation to finance and prepare food packages that the poor and the unemployed urgently need for their survival
Engage locally active NGOs all over the country to distribute the food aid. Fund and compel the local NGOs to hire local people in the distribution - Use the bully pulpit of the prime minister and her office to initiate a worldwide campaign for wealthy Bangladeshis to “adopt a village.” Many of these families have maintained a connection to their home villages.
Ask them to work with their relatives, no matter how distant, and send them cash to buy and distribute food and low-tech medical supplies for the very poor in their villages - Open up public transportation with strict social distancing while keeping clean. Use paid volunteers and police to enforce the social distancing, including at bus stops, train stations, launch ghats, and of course, the sitting areas of buses, trains, and boats. Install hand-cleaning stations at every stop and enforce their usage for every passenger
- Gradually allow most retail businesses to open, again with strict social distancing enforced by paid volunteers and police. Some businesses like beauty parlours, barber shops, and restaurants should remain closed but take-out should be allowed
- Office workers should largely continue to work from home. If a company wishes to open, then they should obtain special permission from the authorities to do so and, if possible, manage with half the number of employees coming in on alternate days. Accelerate existing infrastructure works such as the Metro Rail and Padma Bridge construction projects. Undertake other infrastructure projects on a massive scale (road expansions, repairing and enforcing of bridges, rail expansion, dredging, airport construction, etc)
- Ask the ICT Ministry to accelerate digitalization (Digital Bangladesh). Train office employees and those who can work remotely to use tools like Zoom effectively and productively. All educational establishments should be equipped and students and teachers trained to implement online classes
- Open up schools, colleges, and universities but initially use remote, online classes. Vocational schools and colleges may hold physical classes but only under strict social distancing rules
- Garment factories (and other factories) that are willing to open if they have demand: Test and isolate workers who are found positive and open up factories with those found negative (even if false negative) but mandate social distancing and hold the factories’ owners responsible for it. Such distancing could be accomplished by keeping some workstations empty and employees working on alternate days. Provide incentives to factories to accommodate workers to live next to the factories to avoid commuting
- Give incentives to factory owners to repurpose their businesses to make Covid-related items such as masks, gloves, PPEs, and sanitizers.
- Open up spectator sports stadiums for popular games like football and cricket, but without spectators. Broadcast on TV. Participatory contact sports, gyms, and entertainment centers should remain restricted
- Mandate zero import taxes, VAT, and any other tax or fees on any product imported to treat Covid patients such as ventilators and products such as PPEs that ensure safety and curb the spread of the virus
Ishtiaq A Chisti is a retired engineer from California, currently residing in Bangladesh to work on renewable energy. He can be reached at [email protected].
