The outbreak of coronavirus disease 2019 (COVID-19) has created a huge global health crisis and the story of Bangladesh is not different from that. Since Bangladesh is a developing country which is one of the most densely populated countries in the world even before the COVID-19 crisis, Bangladesh’s healthcare system has been struggling with the increasing number of COVID-19 cases, experiencing low quality of healthcare coverage and an inadequate national budget for health.
Due to this outbreak of COVID-19, many countries have been forced to adopt certain measures, such as flight bans, mandatory lockdown and social distancing, to prevent the recent pandemic from spreading further. Like other countries, Bangladesh has also been implementing steps like banning flights, placing restrictions on public transportations, announcing general holiday nationwide, etc. In Bangladesh, most of the measures has been taken as per Infectious Disease (Prevention, Control and Elimination) Act, 2018 (“2018 Act”).
If we review the ongoing lockdown situation against the 2018 Act, it appears that, had the 2018 Act been effectively enforced, combating the spread of the COVID-19 in Bangladesh could have been much more efficient.
As per section 5 of this Act, to prevent the outbreak of infectious diseases, the Ministry (Health) may declare any market, mass congregation, station, airport and any port to remain closed for a brief period. Again arrival, departure or movements through aeroplane, ship, bus, train or any other vehicles can be obstructed temporarily. It has been observed that during the Covid-19 crisis, Bangladesh Government has been using this section to maintain lockdown throughout the country. The terms used to address the lockdown have been “general holiday”. In many instances, the lockdown was not effective due to the lack of enforcement of the measures. One such example is the incident that occurred in Brahamanbaria district where thousands of Muslims defied government restrictions and attended the funeral of a religious leader during lockdown period. General people from different parts of Bangladesh traveled to Brahmanbaria to attend the funeral, whereas this massive gathering has raised fears of a potential spike in Covid19 transmission throughout the country. The concerned authority should have taken a proactive approach in order to prevent the mass gathering. However, they completely failed to prevent it. It appears that due to the lack of effective enforcement of section 5 of the 2018 Act, the authority entirely failed to take necessary steps to avoid such incident from occurring, thereby posing grave risks to the public health nationwide.
Section 10 provides the direction for the doctor, treating any infected patient, to notify the concerned civil surgeon if such patient dies, so that people remain on the alert for the existence of the disease in such premises or area. In addition, if a boarding, residential or temporary residence owner or person in charge has reason to believe that a person living in the place has been infected, he shall promptly notify the concerned Civil Surgeon and the Deputy Commissioner. Despite the existence of this section, there are many cases where people with the symptoms are being reluctant to test for COVID-19. Moreover, there are a few people who suspect they might be COVID-19 patients but remain at home without informing the appropriate authorities. Being ignorant and irresponsible, some go out and spread the virus to others. To prevent such situations, 2018 Act has prescribed a provision for punishment. As per section 24, a person, who has knowledge about the virus but is not following any prescribed measures, doing activities which might added to the risk of infection spreading more, that person could be guilty under this section. Furthermore, this section of the 2018 Act explained that, if any affected person hides the matter that he/she already is affected, he/she could be guilty under this particular section and can be punished with imprisonment for not more than 6 months and also can be fined not more than BDT 1 lac. It appears that no such action has been taken by the authorities for violation of section 24 of the 2018 Act even though there are numerous cases where infected people and/or their family hide about contracting the infection. Such violations are putting other people in danger and these can easily be avoided by strict enforcement of the 2018 Act. Moreover, section 14 of the 2018 Act states that, the affected people should be quarantined or isolated for a prescribed period. If anyone does not follow the guidelines, necessary measures should be taken against him/her. However, in many cases, the guidelines for quarantine have not been maintained, and the concerned authority is not using adequate force to enforce this section of 2018 Act.
Recently, the Directorate General of Health Services in Bangladesh has taken further steps and issued a circular under the purview of the 2018 Act. The circular states that if any individual does not wear mask in public places, it will be considered as illegal and he/she will be guilty under an ‘offence’ which carries a maximum sentence of 6 months or taka BDT 1 lac fine, or both. Under current circumstances, strict application of the said circular may help to reduce the spread of the virus.
Furthermore, to fight the recent outbreak of Covid19, coordination and co-operation between ministries and numerous policy actors is one of the most important factors that has also been confirmed by section 21 of the 2018 Act. Recently, we have seen many incidents where there has been a lack of cooperation and coordination between the Governments authorities. For instance, in the beginning of the COVID-19 outbreak in Bangladesh, it was reported in the national news that the health minister was seeking to request all those concerned to at least consult the health ministry if others are unwilling to take decisions from the ministry remains the worst of self-defeating stand that questions the raison d’être of the minister and the ministry. The minister as the head of the committee has also not been heard of having taken any initiatives to entertain such issues of incoordination. Recently, the Government took the decision of reopening the RMG factories where the risk of infection spreading is higher. Not only that, as the number of affected persons increases day by day, they authorised shopping malls to reopen for Eid shopping and reopening the mosques across the country. This can put the whole nation in a very dangerous situation. Ideally the Institute of Epidemiology, Disease Control and Research that runs the tests and oversees quarantine and isolation issues, the health ministry that looks into health care, the home affairs ministry that ensures the home quarantine and lockdown issues, the food and the commerce ministry that play the crucial role in keeping the supply chain uninterrupted and the disaster management and relief ministry that makes relief supplies available to make the holiday and quarantine issues successful and as per section 21 of the 2018 Act, all of them should work together. But unfortunately, the co-operation and coordination is very less visible in many cases and such a lack of coordination is unacceptable when a further threat of the new coronavirus is impending. If this incoordination keeps going on, the novel coronavirus infection will eventually spread everywhere and therefore, the situation would be difficult to handle. The government must understand that the fight against the spread of the new coronavirus infection entails that all relevant agencies work in sync with each other under a central coordination committee, which would plan the mitigation efforts, oversee the execution of all the steps and make further recommendations or make changes in decision, if required.
In light of the above discussion, it can be said that the existing Infectious Disease (Prevention, Control and Elimination) Act, 2018 is legally good enough to mitigate the spread of COVID-19. However, proper implementation and enforcement is needed to achieve full benefit out of it. There is no doubt that the Government is trying hard to reduce the bad impact of the pandemic both in the healthcare system as well as in the economic sector. But due to lack of inter-sectoral coordination, there is a pervading sense of concern among citizens. Therefore, lack of implementation and enforcement of the 2018 Act could be more dangerous and may spell disaster. Alongside the Government, the citizen must be self-educated and aware about the crisis of COVID-19. It would be an impossible task for the government to fight against the threat alone without the required cooperation from the society and private sectors and the citizen of the country as a whole. Therefore, it is needed to circulate the existing laws, news and instructions regarding COVID-19 continuously to the people of Bangladesh to increase public awareness.
Benajir Anjum Chandni is a Research Associate at Mahbub & Company