Impact analysis of Covid 19 pandemic from the cholera epidemic experiences in Bangladesh

Bangladesh has developed a uniquely successful system to control deadly cholera epidemics, which is embedded in the existing health system. Control of the Covid-19 pandemic situation in Bangladesh was a missed opportunity to become a “role model”, as except for case management and mode of transmission, most of the required interventions could have been similar to those as of the cholera epidemics. The “test and trial” processes from the “cholera control” experiences could be followed in building and delivering pandemic preparedness and response in the initial stages of the Covid-19 pandemic and other future pandemics in Bangladesh. The study is descriptive in nature and is limited to frequency distributions in tables and figures. No advanced analysis was attempted due to the nature of the data quality. Analysis of 1,714,091 confirmed Covid-19 cases and 28,965 deaths revealed that the young and middle age populations (86.4%) were the most vulnerable and that 80% of the deaths occurred among people older than 50 years. Diabetes Mellitus (73%) and Hypertension (70.45%) were the two most common co-morbidities and one quarter of the deaths was associated with 4 to 5 co-morbid chronic diseases. Our verbal autopsy results indicated that majority of the deaths (60%) occurred within 10 days following admission to Intensive Care Unit for ventilation support. The study describes the steps taken by the Ministry of Health & Family Welfare (MoHFW), Bangladesh to manage Covid-19 pandemic through the lens of cholera epidemic interventions and early screening, community engagement for active case detection, health messages to curb transmission and an effective, reliable electronic database at each level is important to be early prepared to respond, and mitigate any health crisis in the country. Also, the need for intensive care due to delayed response posed a huge extra burden for the poor and the middle-income people, suggesting the need for an effective Public Private Partnership (PPP) and to initiate a collaborative governance approach for resilient our health system.