Surviving through the second lockdown

After about a year, since March 2020, Bangladesh has now gone into a second lockdown in view of the worsening Covid-19 situation. Just as the vaccines have been rolled out, the world is observing yet another wave of the pandemic. Countries have higher numbers of infected people and more casualties. The emergency situation has forced several countries to opt for lockdowns and to announce strict measures.

The severity of the coronavirus pandemic once again reminds us just how uncertain the recovery from this illness has become. New strains of the virus have spread fast within and across countries. The initiation of vaccination had brought hope for humanity to be done with the pandemic gradually. But it seems the virus is still here to stay for some time more. Many experts have of course cautioned time and again that we may not expect the strength of the coronavirus to decline before 2022. Some have also warned that the coronavirus may not be wiped out fully and could continue to prevail and affect people, but that the variant may become weaker over time and the fatality rate may decline. Only time can tell what awaits us. But the new health crisis and the subsequent lockdown will have implications for both human lives and the economy, nationally and globally.

In 2020, the Bangladesh government had announced general holidays for 66 days during March-May. Measures like country-wide shutdowns, use of masks, and maintaining physical distance have helped reduce the spread of the virus. However, there has been a lack of seriousness among the common people in following health protocols of late. The decline in affected cases and initiation of the vaccination programme had made some people too confident. A large section also seems to think they are immune to the virus, terming it "a disease of the wealthy". So, reluctance in observing health protocols has been observed. In fact, a large number of people—including those who are educated—never wear masks in public places, or wear them incorrectly. This reiterates the need for constant efforts for awareness-building through social campaigns and the media.

With the announcement of the lockdown, the concerns of losing livelihoods of people have also resurfaced. Though the lockdown period is said to only last a week, it is apprehended it may be extended further since the situation will probably not improve dramatically within such a short time. The experience of last year's lockdown tells us that the income of the poor, low-paid, and informal sector workers were affected severely. Many of them are yet to regain their jobs. There had been a reverse migration from the cities to the villages as these workers had lost their income. But they could not find jobs in the villages either, as there are fewer job opportunities there, compared to the cities. Now that a second lockdown has been announced, people have again started their homebound journeys outside Dhaka. Risking their lives by exposing themselves to the virus in crowded transports, they want to avoid economic hardship in the city as they would have to bear certain basic expenses such as house rent and utility bills if they stay, even if they do not have an income.

Last year, the government had announced a number of stimulus packages for the people and businesses affected by the virus. An amount of Tk 1,258 crore was allocated for 50 thousand poor households, who are unemployed and are not covered under any social safety net programmes. This was a welcome move, but many remained outside the support bubble as the portion of the population that is needy is much higher than just 50,000 households. Also, the list of the support recipients is not inclusive. It also includes people who do not need support under the social safety net. And even those who are listed do not get their due stimulus packages if they do not have connections with influential people.

One year into the pandemic in Bangladesh, this is also a time to reflect on how we have prepared ourselves in terms of healthcare facilities in hospitals. The health sector has been perennially underfinanced by the government. With an allocation of around one percent of the gross domestic product (GDP) of the country, the sector suffers from inadequate human resources, facilities, and innovation. Despite various limitations, our doctors, nurses, and other health professionals have provided excellent healthcare to Covid-19 patients, risking their own lives in the process. Many of them have been affected or have lost their lives, but this sector never stopped serving its patients.

However, the capacity of the whole health system compared to the severity of the pandemic is far too low. Since last year, some capacity in tackling the pandemic has been developed, but essential facilities such as ventilators, hospital beds, and intensive care units in hospitals are terribly inadequate. There is a need for a higher allocation of resources for the health sector. But the quality of the healthcare services and the inherent weaknesses in the health system cannot be improved with higher allocation of resources alone. So, the whole sector has to be revamped through reform since much of the problem is also linked to the governance of the sector. In the health sector, how government funds are used, who gets contracts, who oversees procurements, and what is the quality of the supplies are some of the issues which need to be scrutinised and streamlined. Equally important is the need to increase the number of healthcare professionals. New doctors and nurses were recruited by the government following the pandemic, but the requirement is much too high to be fulfilled quickly enough.

While higher investment is needed by the government to ensure affordable healthcare for the majority of the people, the private sector also has to invest more. In view of the high demand, healthcare services by the private sector are on the rise. However, not all can meet the quality in terms of services and prices. The government's regulation and monitoring of these hospitals are essential to ensure the maintenance of their standard. Besides, reputed international hospital chains may be encouraged to come to Bangladesh and operate in collaboration with local private investors, since there is a demand in the country. There are certainly people in Bangladesh who can afford such health services. In normal times, these high standard hospitals can also attract patients from abroad.

Coming back to the issues of lockdown and pandemic control, we have to bear in mind that, while a lockdown is one of the major ways of controlling the spread of the pandemic, the livelihood concern of the poor cannot be overlooked. There has been a rise in inflation in recent months. Disruption in movement of goods could accentuate the level of inflation. The supply chain system will need to be kept uninterrupted under special arrangements so that the prices remain stable and affordable for the poor and fixed income earners. Besides, the government will need to provide cash support to the poor and low-income groups, who are without jobs due to the pandemic. Food support should also be provided to the poor. People should be protected both from the health impacts of the pandemic, from economic suffering, and should also be prevented from falling into poverty. Since it has now been more than a year of us being in this crisis, our experiences during this period should be taken into account while taking any initiative. The policymakers should reflect on what worked well and what did not, and take measures accordingly.

Dr Fahmida Khatun is the Executive Director at the Centre for Policy Dialogue.

Views expressed in this article are those of the author and do not necessarily reflect the position of her organisation.