Herd Immunity by choice or accident?

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Rasiqh Wadud

When majority of the population develop immunity to a disease either naturally or through immunization by vaccination and it indirectly provides protection by inhibiting spread to susceptible individuals in the community, it is known as “herd immunity”, “herd protection” or “community immunity”. Polio is a prime example, which was once very prevalent in our country but now occurs very rarely because the vaccine helped establish herd immunity.
Initially, in response to Covid-19, UK and Sweden were the only two countries who opted for natural herd immunity. However, “R0” value is the sole reason for which the UK took a complete U-turn from herd immunity to favouring complete lockdown. R0 value is the basic reproduction number, which is a way of rating the ability of the disease to spread. It counts the number of people that one infected person will pass the virus onto on average. With the results from the initial moderate coronavirus testing, scientists from Imperial College London (ICL) in UK used a mathematical model and found the R0 value to be between 2-3. The UK government realised if the spread in reality is even remotely near to that value, then their National Health Service (NHS) will not be able to bear the burden and the death toll will reach half a million in a few months. Currently the R0 in some places in the UK has come down to 0.5-0.7, for which they are now planning to exit lockdown, although experts are still strongly against it.
Now coming back to Bangladesh, what was our plan? It seems likely that our policy makers have not figured out an effective strategy yet. Bangladesh effectively entered the lockdown on 24th March 2020. While Sri Lanka imposed a curfew nationwide at a similar time, Bangladesh on the contrary decided to officially term the lockdown as a “general holiday”; such is the radical difference in interpreting the gravity of the crisis. Although, the general holiday was extended five times, towards the end of April, the Health Minister Mr. Zahid Malik proposed to end the lockdown soon. Why? To quote him, “The US, Italy, France and many other European countries have relaxed lockdowns. New Zealand has even returned to normal life. We will also get normal life back soon if everything goes alright.” Though we did not adhere to the level of guidelines, methodology, steps and actions taken by New Zealand to protect its citizens, nevertheless, we are giving hope to our nation that we will reach their level soon.
Moreover, on 30th April 2020 it was reported that Bangladesh had the lowest recovery rate of coronavirus cases in South Asia in the first 53 days. Fast-forwarding few days our recovery rate improved to 11.2% in a single day. Why? Because Bangladesh Clinical Management Committee formulated a new guideline, according to which a patient will be released if he or she does not have the following symptoms: cough, fever and breathing problems. This is drastically opposite to the previous guideline provided by WHO in which after the first positive test, the patient needs to be tested for the second time within 14-21 days and if the test result is negative, then the patient needs to be tested further for a third time within 24 hrs. The patient will only be released if the third test is negative. This change in guideline is extremely dangerous, because it allows a potentially infected patient to go back into the community and spread the virus. Furthermore, our data appears to be manipulated, so now it cannot be trusted and we do not have a proper picture of the true spread of the virus, which further hinders our plan to tackle the crisis.
Nonetheless, Bangladesh eased lockdown on 31st May 2020 after several extensions, while the country reported highest number of infected patients on the previous day. Perhaps our experts utilized data from New Zealand, which led to the ease of lockdown. Although, the government imposed a hefty fine on failing to wear a mask, however, the social and digital news media are flooded with pictures of how social distancing is ignored in public transport. If this was the case, why did we ever enter a lockdown? Our experts leading the crisis should have opted for herd immunity from the beginning like Sweden and planned accordingly. It is worth mentioning though that the architect of Sweden’s Covid-19 strategy Dr. Tegnell recently admitted that if he had encountered the same disease again, knowing exactly what we know about it today, he would have opted for something in between herd immunity and what the rest of the world has done, which is lockdown. Acknowledging, that completely relying on natural herd immunity was a mistake based on the high mortality rate currently in Sweden.
The whole world is facing these truly unprecedented events. However, Bangladesh had a very simple advantage and that was ‘time’. Bangladesh at least had one and a half month to prepare for damage control. We could have managed enough PPEs (Personal Protective Equipment) for our key workers such as healthcare professionals, police officers, government officials, etc. There should have been more coordination with private hospitals on testing, arranging isolation units, stocking on ventilators, etc. In addition, there could have been setting out of emergency awareness program, researching on treatment methods by other countries and preparing a lockdown plan.
We, including the government have taken immense pleasure in how we are one of the fastest growing economy in the world. Karan Thapar, one of the leading journalists of India, mentioned how we have outperformed our neighbouring country India in terms of economy. Has this economy really helped us during this crisis? We are so drunk on success and growth of our economy that we have no clue on how to utilize it for our own wellbeing. The pandemic has not only revealed the frailty of our health system and infrastructure, it has also exposed the staggering level of incompetency and rampant corruption.

Rasiqh Wadud, currently doing PhD in Biological Sciences from University of Cambridge, UK with IDB and Cambridge Trust Scholarship. He also works as a Lecturer in North South University (NSU).




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