Enforcing social distancing: NOW!

March 23, 2020

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Our planet is being ravaged by the Coronavirus – Covid 19. The situation is getting worse every minute of every hour. At the time of writing this piece (March 23, 10am), there have been over 340,000 cases worldwide. Hardly any country is spared. There are over 14,000 confirmed deaths already. The 1918 Spanish Flu pandemic is only a grim reminder of what might happen, where 18 million people from our own subcontinent alone perished. Since the first Covid 19 case was detected in Wuhan, China, in December 2019, our knowledge of the virus and its transmission has expanded. Scientists are working hard to find its treatment and a vaccine to prevent it. The good news is – we know how not to get it. But are we doing enough to protect ourselves?

Every epidemic has its own life cycle. Typically, the curve rises until a peak is reached and then it flattens. China has flattened its curve and has not reported any new domestic transmission for the past week. In the other parts of the world, we are yet to see a break in the exponential rise. The coronavirus is too aggressive and no measure short of some draconian steps is enough to contain it. China has achieved it with a price. The challenge is how to stop the transmission in our part of the world.  The so called ‘developed countries’ have been skittish and indecisive in following the China-like policies, leading to the loss of precious time. Now, much of Europe and a third of the US population are under ‘lockdown’ conditions. Even our neighbours are not far behind. After a trial run yesterday, India is on the way to enforce a complete nationwide lockdown now.

In this totem pole of varied reactions, where does Bangladesh stand?  The virus is very much here and has started to take its toll. Official statistics based on the IEDCR reports indicate that we are probably in the early part of the epidemic curve in the sense that there are a few cases and fewer deaths. Unfortunately, all indications and projections are pointing to a grim future. If the experience in other countries is any guide, one hardly finds any panic mongering in these. If true, then the flattening of the curve won’t happen until, perhaps, before May. By the time it does flatten, what would be the price that the nation would pay?  How many of us would cease to exist? How many would suffer?  How many would slip into deep poverty?

We are aware of the capacity, or lack thereof, of our health systems to withstand such a potentially catastrophic situation. We cannot expect overnight improvements. For example, we cannot produce or procure enough testing kits should the worst case scenario materialise. What we can do is to decentralize whatever testing capacity we possess. We also need to do a better job of communicating to the masses that for more than 80 percent of the cases, a test is not necessary. It will cure itself automatically, like any other flu. For us to prevent such a devastating situation occurring, the only way open is to enforce a strict regime of protective measures. Irrespective of how draconian the measures may appear, they must be enforced ruthlessly and immediately to prevent a catastrophe.

Over the last few weeks, we are being told about ‘hand washing’, ‘social distancing’, and ‘self-quarantine’. Barring hand-washing, popularised over the past years by the government and NGOs, the other two measures are socially and culturally ‘foreign’ to us. The social media is galore with stories of how these terms are being misunderstood and misinterpreted, leading to consequent malpractice by the concerned people. Unfortunately, we haven’t clarified these to the people, particularly the hundreds of thousands of returning expatriates. The government, NGOs and other stakeholders must take the blame for this potentially fatal failure. It is frustrating to see how poorly even the so called educated elites of Dhaka are practicing these. They are regularly meeting for business or adda in large groups, despite repeated advice otherwise. Are we losing all senses? When Saudi Arabia has closed its mosques and the European countries their churches, our mosques are still attracting huge number of devotees! Sanjay Gupta, the celebrated public health communicator, said, “We all have to behave like we have the disease and stay at home”.

Granted, behaviour change does not happen overnight. The only option remaining at this cross-roads is enforced measures. The government must learn from their European counterparts that the time for timidity and indecision has passed and the inevitable measures have to be taken immediately. NOW!


Dr Mushtaque Chowdhury is professor of population and family health, Columbia University, and formerly vice chair of BRAC.

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