Lockdown is not the answer, vaccination is

What is the point of herd immunity? How much of the population needs to be vaccinated for a country to stop transmission and return to normal?

The World Health Organisation does not have an answer. Scientists estimate that vaccination of 60-70% can help, but US top immunologist Dr Anthony Fauci himself revised his estimate to 90% from 60% earlier to bring the virus to a halt.

How far is Bangladesh away from the threshold? Miles. With 2.6% of its population vaccinated, the country stands 120th in a global ranking compiled by the Financial Times – only ahead of Afghanistan in the South Asian region.

Though the launch of mass vaccination was impressive in February, the drive has lost its way for a disrupted supply of doses. Prime Minister Sheikh Hasina reaffirmed her government's plan to vaccinate 80% of the population and allocate enough money to procure required doses. However, nationwide vaccination resumes today with Sinopharm and Pfizer doses.

The slow progress in vaccination results in a fresh surge in infections and deaths – more from regions outside capital Dhaka which were believed to be safe zones until the new variant started sweeping the bordering districts from March.

The south-western district Jhenidah reported over 74% positivity rate on Tuesday and northern district Thakurgaon 56%, while Dhaka reported 17% of the tests positive, a 5% jump from the day before.

The fresh wave of transmission could not be checked despite measures like forced quarantines, localised lockdowns, and travel restrictions.

After ending the deadliest week of 716 deaths in June, the country today begins its new fiscal year with the second round of full-scale countrywide lockdown.

The first round of lockdown was enforced in March 2020, shutting businesses and transport for 66 days.

Daily cases shot to 4,014 on 29 June 2020 when the first round of countrywide lockdown was in force. The rate has more than doubled to 8,364 on the same day a year after.

Bangladesh is placed 30th in the Worldometers' index of global infection and death counts from Covid-19.

Another lockdown will bring economic activities to a halt. But will it really help curb the virus?

The global picture shows it will not.

The countries with wider vaccination coverage are reporting slower infections and fewer deaths, paving the way for their faster return to normalcy.

Success in the vaccination drive boosted the confidence in developed countries, where fewer executives now see Covid-19 as the number one threat for economic growth, compared to an earlier survey, says a Mckinsey report.

In its latest quarterly review, Bangladesh Bank also linked the country's recovery until mid-March to business and consumer confidence boosted by the launching of vaccination.

Countries see success in taming infections and deaths by pacing up vaccination.

The USA, though tops the global chart of infections and deaths, now sees a steady fall in both counts as the country heightened its vaccination drive, inoculating more than 46% of its population. Daily infections dropped to 11,427 on 29 June from a peak of 3 lakh on 8 January this year. Daily deaths came down abruptly to 294 on June 29 from a whopping 4,463 on 12 January.

In the UK, 48.8% of people are fully vaccinated, resulting in a drop of daily deaths to 23 and infections to 22,782 on 29 June, from their January peaks of 1823 and 67,803 respectively.

India could vaccinate 4.1% of its population, which helped the country to bring down daily infections to 45,699 and deaths to 816 just in a month from their May peaks of over 4 lakh and 4,896.

In contrast, Vietnam, which was so far able to keep Covid deaths as low as 80 by non-pharmaceutical measures, now sees a rise in infection due to its lower rate of vaccination, just 0.2% coverage. The Southeast Asian country recorded 4 deaths from Covid-19 on 29 June, the highest daily count since August 2020.

Low vaccination rates behind the spike in infections, deaths in Rajshahi, Khulna?

The Covid-19 positivity and death rates have now taken a dangerous turn in Rajshahi and Khulna divisions. 

Rajshahi and Khulna Medical College Hospitals are struggling to handle the rising number of patients even though they are constantly increasing their capacity. Patients from different districts are flocking to these two hospitals. Most of them have not been inoculated yet. 

Experts say a delay in vaccination is one of the major reasons for the spike in infections in the two divisions.

According to a data analysis by The Business Standard, Dhaka division got the highest 4.17% coverage of double-dose vaccination, followed by 3.13% in Khulna, 3.12% in Chattogram, while five other divisions – Sylhet, Rangpur, Rajshahi, Barishal and Mymensingh – are left with around 2% of their populations vaccinated.

Professor Sayedur Rahman, chairman at the Department of Pharmacology, Bangabandhu Sheikh Mujib Medical University, told The Business Standard that the divisions such as Khulna and Rajshahi with a lower vaccination coverage are experiencing an increase in Covid-19 infections and deaths. 

The positivity and death rates in Dhaka and Chattogram are low this time as most people in the divisions have been vaccinated. Half of the patients now undergoing treatment in Dhaka's different hospitals are from different districts outside the city.

Sayedur said it has been proven that vaccination reduces Covid deaths and hospitalisation of patients. The rate of infections is lower among people who got two shots.  That is why the number of positive cases and deaths of healthcare workers is now negligible compared to those in the first wave. 

Had the age limit for vaccination not been reduced and people aged over 55 across the country vaccinated, the death rate would not have increased so much this time, he added.

Bangladesh started the countrywide vaccination programme on 7 February with the Oxford-AstraZeneca doses, targeting people aged 40 and above. As of now, 58.2 lakh people have completed the course of the double-dose AstraZeneca vaccine. And, another 42.87 lakh people have received the first jab and are waiting to get their second shot.

Brigadier General Dr Shamim Yazdani, director at Rajshahi Medical College Hospital, told TBS, "Our hospital now has 80% patients from villages, who have not received the jab. The patients, residing in towns, coming to us have not been immunised too. As per my knowledge, there are no patients in our hospital, who were administered two vaccine doses. Usually, a person who has got two vaccine doses not need hospitalisation if they catch Covid-19.

Dr Shamim said, "We have increased the number of beds for Covid-19 patients from 65 to 405, are still struggling to handle patients increasing with each passing day. At present, our hospital has 460 patients. Every day 60-70 new patients are taking admission to the hospital."

There are no empty beds in the 20-bed ICU unit.  There is a serial of 60-patients against each bed, he also said, adding, "The only relief is now that this time, our doctors have not been infected much like in the first wave, thanks to their two-dose vaccination."

Patients from Chapainawabganj, Natore, Pabna and Kushtia have also been admitted to Rajshahi Medical College Hospital. The vaccination rate is also very low in those districts.

Within two weeks after receiving the second dose of the Oxford-AstraZeneca vaccine, 93% of the recipients developed antibodies, according to a recent study. Four weeks after the first dose of the vaccine, antibodies were found in 41% of the vaccine recipients.

The Department of Microbiology at Dhaka Medical College Hospital conducted the study on 308 teachers, doctors and staff of the hospital to see the antibody response after administering the vaccine.

Currently, Khulna division is now experiencing the highest Covid-19 deaths every day. On Wednesday, the number of admitted patients in Khulna Medical College was 201 against the hospital's capacity of accommodating 130.

The number of new patients and deaths in the hospital is increasing day by day. Covid patients are also receiving treatment at Khulna General Hospital and private Gazi Medical College Hospital. 

Doctors say most patients being treated at those hospitals have not been vaccinated.

The administering of the first dose of the Covid-19 vaccine has remained suspended since April 26. The second dose of the AstraZeneca vaccine is being given to people in a limited range in different vaccination centres of Dhaka. Bangladesh now has about 93,000 doses of the Oxford-AstraZeneca vaccine in stock. But the vaccination drive is going to restart with Sinopharm and Pfizer vaccines.

Administering of Sinopharm vaccine starts Thursday

The administering of the Sinopharm Covid-19 vaccine from China among the people will start on Thursday.

The vaccination programme will be conducted at all medical college hospitals, district hospitals, Bangladesh Institute of Tropical and Infectious Diseases and Syedpur Sadar Hospital across the country from 8 am to 3 pm, said  Dr Shamsul Haque, director of Expanded Program for Immunisation (EPI),.

The drive will start simultaneously in 40 centres except eight in Dhaka. Students of medical and nursing colleges and those of Medical Assistant Training School, Institute of Health Technology and government universities, police members and others on the priority list will receive the Sinopharm vaccine.

Vaccination with Pfizer doses will start at seven centres in Dhaka, including Dhaka Medical College Hospital and Kurmitola General Hospital, Dr Shamsul said.

Expatriates from Saudi Arabia and Kuwait, who cannot enter the countries without Pfizer and Moderna vaccines, will receive the doses. After sending their list from the Manpower Development Bureau, they have to register for vaccination, said Shamsul.

Mentioning that there will be no opportunity of getting vaccinated without registration, he said that those who have already registered in those seven centres will get the vaccine upon receiving SMS.

Registration of those who are on the priority list has started on Wednesday. Expatriate workers will be able to register and get the Pfizer vaccine from Thursday.

Students will be vaccinated based on the list that has been added to the University Grants Commission's (UGC) database.

Bangladesh has 95,177 doses of the Sinopharm vaccine in stock. Besides, a shipment of 20 lakh doses of the vaccine will arrive from China soon, and 25 lakh doses of Moderna will reach Bangladesh next week.