April 17, 2021

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What to do in lockdown, covid control and patient management

A week-long lockdown has been declared across the country on the instructions of Prime Minister Sheikh Hasina to deal with the second wave of Kovid in Bangladesh. Hopefully, if the lockdown is observed effectively, its purpose will be achieved. The Initiative for Health and Development (IHD) has prepared some necessary suggestions on how to make the lockdown more effective and in consultation with experts on overall issues including covid control, patient management, which has been put forward for consideration by all concerned.

Which should be done until the covid is completely under control

1. Ensuring the use of masks everywhere by involving the people with the cooperation of people’s representatives, local administration, religious leaders, political leaders, social workers, NGO workers, media and all concerned. Take strict action if necessary. Free masks at the entrances to markets, bus and railway stations, launch terminals and other places where crowds are high.

2. Adhere to hygiene rules, undertake extensive activities to raise public awareness about the real risks of covid, and, if necessary, create effective communication materials on the advice of health communication experts and conduct effective campaigns accordingly.

3. Facilitate the process of covid vaccine registration and introduce onspot registration if necessary.

4. To encourage people to get vaccinated, including public representatives, local administration, religious leaders, political leaders, social workers, NGO workers, the media and all concerned.

5. To take necessary steps to remove the existing doubts in the minds of the people about the effectiveness of the vaccine.

. To increase the morale of frontline health workers and take steps to implement it by rationally revising the incentive package in terms of reality.

. Regularize genome sequencing and sero prevalence studies to find out the real situation. Specifically, what is the condition of the hospital bed, its real time update published through the dashboard.

. Strengthen research and information sharing. Provide clear instructions on who can get the information.

 

What to do during the lockdown announced by the government

1. Creating a pool of private ambulances, setting fair fares and enforcing them. To run an effective campaign to inform the people about this.

72. Introduce Sample Collection Center of Covid Test up to Union level and make arrangements to bring it closer to the people in urban areas.

63. Repeal of government prescribed fee for Covid Test.

4. To keep some public transport in government management so that the movement of doctors and other health workers, people engaged in emergency services and patients is not disrupted.

5. To keep the transaction deadline as normal and to give necessary instructions to the banks to ensure the physical distance between the customers to avoid the congestion caused due to limiting the transaction deadline of the bank. The same can be said about raw materials.

. Continue all other services including maternity care at the hospital along with covid treatment. In this case, a triage system should be developed in each hospital to identify covid patients and non-covid patients.

. If the lockdown period is long (more than a week), identify the poor people in the area through the combination of public representatives and local administration and provide necessary financial assistance on a regular basis.

To provide guidance and assistance to the appropriate private, NGO and non-profit hospitals at the divisional and district headquarters level to develop the necessary framework for covid treatment. In this case, the government should take necessary steps under the leadership of the Civil Surgeon to ensure the quality of service and fix the fair price and implement it. At the same time, the price list should be displayed at the entrance of the hospital
What to do after the lockdown is over

1. In the first phase, all kinds of public gatherings and gatherings including political, social and religious will be completely banned till May 31.

2. Tourist and entertainment centers across the country will be completely closed till May 31.

3. Prohibition of leaving the area during Eid or any other festival from the most infected areas including Dhaka, Chittagong, Gazipur, Narayanganj.

Covid-19 Patient Management (most emphasis)

1. Within the next two weeks, all district hospitals, general hospitals and public and private medical college hospitals will be provided with oxygen suitable for the use of high flow nasal cannula or ribrider mask to ensure covid treatment at district and divisional level and reduce unnecessary referrals.

72. To develop effective central oxygen supply system in all District Hospitals, General Hospitals and Public and Private Medical College Hospitals within the next three months.

3. Encourage less severe covid and non-covid patients to be placed in home care and provide their services through local doctors. If necessary, strengthen health windows and other national helplines to ensure services through telemedicine.

4. To provide guidance and co-operation to the appropriate private, NGO and non-profit hospitals at the divisional and district headquarters level to develop the necessary framework for covid treatment. In this case, the government should take necessary steps under the leadership of the Civil Surgeon to ensure the quality of service and fix a fair price. At the same time, the price list should be displayed at the entrance of the hospital.

5. To take necessary steps by reviewing the data from time to time for admission and management of patients in large hospitals.

Hopefully, through the effective implementation of these suggestions, Covey

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