Is our healthcare system ready for Omicron?

The emergence of the highly transmissible Omicron variant of the coronavirus reminds us of how uncertain the world has become. Despite the vaccination, the third wave of the pandemic indicates that the Covid could continue to be a part of our lives. Experts have warned that the virus may not be completely eliminated and may continue to prevail and affect people, but over time it may weaken and the death rate may decrease. Omicron seems to signal the start of this phase. Therefore, we must prepare to navigate through its perils and learn to survive.

In the face of Omicron’s rapid surge, several countries are reinstating strict measures, including travel restrictions and the quarantine of travelers. Citizens are alerted to the dangers. Companies are reviewing their adaptation strategies. For example, a global finance company made vaccination mandatory for its staff if they wanted to keep their jobs. Some companies have announced indefinite work from home policies.

In Bangladesh, the government recently announced some guidelines, while people were urged to strictly follow health protocols. Further directives to control the mobility of people are expected to be announced soon.

However, some of the measures announced are insufficient. People traveling to Bangladesh will need to undergo antigen testing after arrival. This is a very small measure compared to what has been announced in India where travelers will have to undergo seven days of quarantine and an RT-PCR test on the eighth day. Antigen tests are not very reliable at detecting the coronavirus. This is why it is not accepted in most countries. The Ministry of Health should therefore take stronger measures. Recall that the weakness of the measures for international travelers at the start of Covid-19 was a reason for the rapid spread of the virus in Bangladesh.

During the first and second waves, countries imposed border closures and closures. However, it was not very successful. Of course, countries like China have been able to control the spread of the virus quite successfully, but must have seen their economies contract. Indeed, global economic output has declined considerably. The poorest countries were hit hard because they did not have enough fiscal space to support the poor and various economic sectors.

Like many countries, the government of Bangladesh had announced closures in 2020 and 2021. The application of measures such as the nationwide shutdown, the use of masks and the maintenance of physical distancing have helped reduce the spread of the virus. The roll-out of vaccination has further reduced cases. However, there has been a lack of seriousness among the common people in following health protocols lately. A large number of people do not wear masks in public places. This highlights the need for constant awareness efforts across various platforms.

Almost two years after the start of the pandemic, this is also the time for Bangladesh to reflect on how we have prepared in terms of health facilities. The health sector has always been underfunded. With an allocation of around one percent of gross domestic product (GDP), the sector suffers from a lack of human resources, equipment and innovation. Unfortunately, even with only 5.8% allocation in the total annual development program in FY2021-22, the Health Services Division was only able to spend 6.4% of its allocation between July and November of AF22. This is unfortunate because there is a need to increase spending on health services during the pandemic. The allocation for the different ministries and divisions is determined by the Ministry of Finance on the basis of their spending capacity. So naturally there will be a lower allocation for the underperforming.

The capacity of the health system to meet the needs of patients, even in normal times, is far too low. Since the start of the pandemic, some capacity has been developed, but essential facilities such as ventilators, hospital beds and intensive care units in hospitals are still woefully inadequate. A higher allowance is needed. But the quality of health services and the inherent weaknesses of the system cannot be improved with a higher allocation alone. The sector needs to be reorganized through reforms as much of the problem is linked to the governance of the sector. How public funds are used, who gets contracts, who oversees procurement, as well as the quality of supplies are some of the issues that need to be reviewed and rationalized. The number of health professionals also urgently needs to be increased.

While more investment from the government is needed to ensure affordable health care, the private sector must also invest more. The private sector must increase and improve its services given the high demand. Reputable international hospital chains may also be called upon to collaborate with local private investors. It is essential that the government ensure proper regulation and oversight of these hospitals.

Overall, the success of the fight against the coronavirus will largely depend on a robust and affordable healthcare system. Policymakers should build on the lessons learned over the past two years and prepare for a possible third wave.

Dr Fahmida Khatun is the executive director of the Center for Policy Dialogue. The opinions expressed in the article are those of the author.