An Analysis of Covid-19 and Vaccination

Lt Col Muhammad Sanaullah

19 June, 2021 12:00 AM printer

An Analysis of Covid-19 and Vaccination

Bangladesh is currently experiencing the difficult period of the second wave of the Covid-19 pandemic. The second wave reached its peak in the first week of April but the situation is still unchanged as of Mid-June. The lockdown in the Rajshahi-Natore-Satkhira-Jashore belt is on for consecutive two weeks. Bangladesh saw a surge in coronavirus infections between mid-June and mid-July last year. By measuring the course of the current spike in Covid-19 cases, it could be said that the pandemic has now reached its peak. Cases have been increasing rapidly for the last couple of weeks, but the numbers will likely start to fall from the end of June. The World Health Organization considers a pandemic to be under control if the infection rate remains below 5% for two consecutive weeks. The infection rate in Bangladesh was lower than 5% for seven weeks from mid-January to last week of March 2021. On the other hand, 287 people died of Covid-19 in February, the lowest monthly death toll after May 2020. In the 55th week of the pandemic in the country, around 13% of people who had gone for Covid-19 test were found infected. Then for one week, over 23% of the tested samples were Covid-19 positive. The number of tests conducted every day during mid May has been a little lower for the last few days, but the infection rate is still high. The Directorate General of Health Services (DGHS) had formulated a core committee on Covid-19 management, comprising eight public health experts and scientists last year, which recently submitted a projection report on the resurgence of Covid-19.

Using a mathematical model called Susceptible Infectious Recovered or SIR, the committee found that if 35,000 samples were tested now, the number of daily cases and deaths would be around 10,000 and 100, respectively. The surge in infections will continue till mid-June or another week if the measures to contain the spread of coronavirus are enforced strictly. Otherwise, the number of cases will continue to mount, the projection report of the committee warns the government machinery. Again experts opined that the situation through following a mathematical model have some uncertainties. However, it is undeniable that without proper containment measures, infections rate cannot be kept in check in our country. People should follow the government’s instructions and stay home during the lockdown period. Experts have recommended continuing the lockdown until the 4th week of June or beyond. The country saw a fall in Covid-19 infections from 1st week of May as the government had been enforcing a hard lockdown.

Our government has taken firm steps to continue with the vaccination program. There are questions amongst the mass about the effectiveness of the vaccine: whether they are completely immune to the virus or partially immune. Here lies the paradox. Despite many ifs and buts, people are in favour of the government the vaccination. So far, we have seen the cases of infections after vaccination is very few. Now, where to stop with the debate of vaccination? The government is negotiating with China and Russia for getting the vaccine with the assurance of continued supply. Whatever may be the case, we need to curve the rise of infection, maintaining the Covid-19 protocols and vaccination.

Why is the infection rate still increasing? The answer probably is: we have become relaxed or exhausted or both. Unfortunately, 14 months of Covid-19 infection has gone by, yet we are not accustomed to using masks and hand washing. The question of social distancing is far away. More than 50% of people who have to go outside the home do not use a mask. Among them, more than 50% do not know how to use masks properly. Most of their noses are exposed. Inappropriate uses of mask do not give them any protection. Soap and water are available in our country, but we are reluctant to wash our hands. During social events, there is a large gathering of people. So the virus transmits easily. Another cause of the spread of infection probably is the novel coronavirus can remain in the air for a long period inside enclosed rooms. Washing hands with soap and water is one of the key hygiene rules to reduce the risk of infection, but people tend to avoid washing hands frequently. It may also facilitate the spread of viral infections. For Covid-19, experts suggest that 80% of infections are mild or asymptomatic, 15% are severe infections, requiring oxygen and 5% are critical infections, requiring ventilation. The cause of death due to Covid-19 is either lung damage or coagulopathy. Occasionally sepsis or septic shock is also responsible. The older population with co-morbidity succumb to death more frequently. Bangladesh is lucky enough to have a lower death rate in comparison to other countries, but the death rate of doctors, nurses and paramedics are, unfortunately, a little higher compared to other countries.

During June-July of 2020, Bangladesh witnessed a peak time of the coronavirus infection. Particularly the period between mid-June and mid-July saw two to three thousand infected patients every day. Afterward, the pandemic situation seemed under control for several months. However, a rising trend of infection has again shocked the country in early March 2021 after nine months of a steady situation. The number of daily-basis infected patients has been increasing for the last few days. Given the situation, experts have warned that the Covid-19 infection rate is going to reach its peak again. In response to this second wave, the government had to go for nationwide lockdown. Experts are suspecting the situation is likely to get worse than the peak season in 2020. The Covid-19 daily death rate has also been going up with the increased infection rate. Besides, a huge number of foreigners also got Covid-19 tested and found positive. Although the rate of infection and death stayed low in the beginning, the situation had gradually worsened from the end of May 2021. There were two fluctuations in the infection chart since August. From late December 2020 to mid-February this year, the contagion seemed under control. From then on, the number of new patients started to grow again from mid-March. Currently, the line is curving up steeply. If the situation remains uncontrolled, it would be worse in the coming July-August than the previous corresponding months. There are some precautionary measures after a rise in infection rate during November 2020 resulted in positive change. But effective measures through lockdown have been taken most successfully till now after the second wave hit the country. It is crucial to identify the infected persons and enforce quarantine for the people who came in touch with the patient. Besides ensuring health guidelines, all kinds of public gatherings inside four walls must be restricted. The kind of health guidelines enforcement at the recent National Parade Ground events set a good example.

Oxford –AustraZeneca vaccine was the only Covid-19 vaccine that was used for emergencies from January to April 2021. Bangladesh ordered the vaccine from the Serum Institute of India (SII). India is not in a position to deliver even half of the doses. After the vaccine shortage, Bangladesh approved Russian Sputnik V and Chinese BBIBP-CorV vaccines for emergency use in late April 2021. It was reported that the Bangladesh government planned to give permission to Bangladesh made "Bangavax" to conduct the first clinical trial. As of May 2021, Bangladesh is observing for full approval of any Covid-19 vaccine. All the above three vaccines got emergency authorization only. On 27 April 2021, Bangladesh drug regulator has authorized the emergency use of Russian Sputnik Vaccine. Russia has proposed to produce their vaccine in Bangladesh with joint collaboration with a local pharmaceutical company and Bangladesh has already given a policy approval in this regard. Russia also agrees to sell 4 million doses of Sputnik vaccines to Bangladesh to be delivered in May 2021. On 29 April 2021, Bangladesh drug regulator has authorized the emergency use of Chinas Sinopharm BBIBP-CorV. Like the Russian vaccine, Bangladesh also wants to produce the vaccine locally. The situation becomes complicated when the second dose of 1.3 million citizens is uncertain as India already halted exports. They are worried about whether they will get the second dose of the Oxford-AstraZeneca vaccine as a second dose. According to experts, it would not be wise to inoculate one person with different brands. If we do not get the second dose at the right time, it is likely to hamper the vaccination program. Health experts indicated going for multiple sources for a smooth vaccination process.

Again, there are issues of eradicating the coronavirus completely. UK’s top scientist has warned that it is unlikely to eradicate coronavirus completely. The Covid-19 vaccine is not also full proof to stop the infections. The coronavirus infection may turn into endemic which means that it will constantly remain present in the population, much like seasonal flu. The vaccination will decrease the chance of infection and the severity of the disease. The scientists of the UK suggest that the Covid-19 vaccine is unlikely to provide long-term protection against the virus. The softening of the virus may require annual isolations (Arab News, 20 October 2021).

One of the reasons for the uptrend in Covid-19 mortality is people are coming to hospitals very late. Many people having mild symptoms are receiving treatment at home but they don’t check the oxygen-saturation level, which can cause an abrupt fall in its level along with breathing problems and lung infections. The wrong treatment and abuse of medicine is another reason behind the growing mortality rate. Everyone now knows the coronavirus treatment protocol and takes medicine as per their whims. There are also rumours that people can recover fast by taking some particular medicine or herbals and many people are taking those. Some people also take advice from doctors over the phone and stay at home. But all the coronavirus-infected people don’t have the same type of symptoms and immune system. It is wrong practice to take medicine without proper examinations, diagnosis and doctors’ advice.

Just before the vacation of Eid-ul-Fitr, amid nationwide lockdown, at least 10 million people left the capital. They have ignored the Covid-19 health rules. There was no social distancing and wearing of mask properly. The concerned minister said that about 10.6 million mobile SIM users have left Dhaka between 4 and 12 May 2021. Except few intercity services, all sorts of public transports have been barred under the lockdown. Our Honourable Prime Minister Sheikh Hasina also urged people not to leave stations during Eid-ul-Fitr to stem the proliferation of the coronavirus. Here we also found the dichotomy of enjoying leave and containing the virus. Presently the bordering districts are in danger of uprising the corona situation. After Chapai Nawabganj, Natore, Jashore and Satkhira are facing the challenges to fight back the corona situation. Again the Eid-Ul-Azha is also getting nearer. This time the government should enforce strict lockdown and restricting people to move from one place to another. This will certainly help to minimize the rate of infections.

The coronavirus is resurging in the countries where it eased earlier. So, we must remain alert. We will have to make people aware of maintaining health-hygiene and safety rules. We must encourage people to undergo tests and come to hospitals at the right time. Otherwise, we have to pay a heavy price in the days to come. Since there is a paradox of completely immunised by taking vaccines, people are less worried about vaccination. Again, there are fewer cases of infections amongst the vaccinated people. So, to be true, we should be vaccinated as per the planned program of the government. We need to remain safe maintaining proper Covid-19 protocol till it is completely eradicated from the community. The recent rise in infections and death toll in Chapai Nawabganj remind us to enforce lockdown as per districts. As per the updated news, Bangladesh has booked with Chine for one and a half crore vaccines. Again our government has asked for 20 lacs AustraZeneca vaccines from the USA and hopefully, we will receive those soon. The government has extended lockdown till 15 July as coronavirus cases and deaths flare up in many parts of the country. Whatever may be the dichotomy and paradox, we need to abide by the rules and steps taken by the government.

 

The writer is an army officer


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