Covid-19 lockdown in Bangladesh: Framework for an exit strategy

Since our first article on the subject of exiting a lockdown in a strategically planned manner (To Open or Not to Open:  Lockdown Exit Strategies Can Help; M.Masrur Reaz et al) was published on 2 May 2020 in a number of newspapers, the impact of the Covid-19 outbreak on our society and economy has become more manifest. 

Covid-19 has caused a huge impact on economies and societies across the globe. As governments and communities work towards navigating the challenge created by this pandemic, it is necessary for governments to ensure that efforts are prioritized to maintain continuity of service delivery, especially in the health and financial sectors, and to make strategic shifts to ensure that the increasingly limited resources provide maximum benefit to society. 

For a country like Bangladesh, it is essential to deliver basic sustenance whether through food delivery or cash transfers, to the large number of highly vulnerable people whose numbers are increasing day by day as wage labour and other opportunities for work have mostly disappeared, while savings have in many cases been used up.

Partial re-opening, ambiguity in decision rationale, and nonlinear response  

The government of Bangladesh, at various levels, has taken up proactive measures to manage and mitigate the spread of the pandemic. The number of infections and mortality which so far have been low, are now visibly on the rise, although still at a rate lower than in many other countries. 
However, at this crucial juncture, decisions have been taken to allow industrial units and shops and markets as well as other places of social interaction to open up, albeit subject to often stringent conditions. 

Cross-country public transport remains non-operational, but goods transport is on the rise. Work is progressing in the fields in the agriculture sector. The food and other essentials as well as pharmaceutical products sectors have been operational throughout. 

Other small and/or cottage industries are beginning to consider opening up, particularly with Eid only a few days away. Practically, the conditions imposed by the government will be both difficult to comply with as well as challenging to monitor and enforce; therefore, either some of the sectors and areas targeted for opening will not open (many markets in Bangladesh have already declined to open prior to the upcoming Eid-ul Fitr), and the ones which do will not be fully compliant, hence exacerbating the health hazard. 

Shorter opening times for banks and fewer open branches have resulted in almost unmanageable crowds in many branches. Social distancing in the last week has not been even as well-maintained as in the weeks before.

It is not very clear on what basis these decisions have been taken, and at whose behest in some cases. In any event, a semi-voluntary, partially government-imposed lockdown is still somewhat in place. 

Newspaper reports suggest that the 'general holiday" has been extended till the end of May. It is acknowledged that to a significant extent the lockdown in the initial stages helped us to avoid a larger spread of the infection. 

What is clear though, is that the Covid-19 menace will not disappear on a given day anytime soon unless a vaccine or an effective treatment is discovered. Herd immunity is only achieved at a high cost of lives, which we are not prepared to accept, and neither is the country's health system capable of handling the path to such an outcome. 

While it is not at all clear how long one might have to wait for any level of normalcy to return, it is still necessary to initiate holistic planning and design solutions which are then implemented efficiently and effectively, upon being guided by an appropriately detailed yet flexible 'Covid-19 lockdown exit strategy' for the country, targeting first and foremost health and social well-being, as well as the ultimate revival of the economy. 

A country like Bangladesh cannot close itself down for an unforeseeable length of time. 

Framing a holistic strategy built around local context

Let it be absolutely clear that till today, no country has found the perfect solution which will fit any or all other countries. The particularities of each country will have to be taken into account. 

For example, the population density, climate in the upcoming months, and economic realities of Bangladesh will differ from almost any other country, even in the neighbourhood, and therefore any strategy will have to be designed bearing all of these and many other issues in mind. It is also being reported that countries which have eased the lockdown have seen a rise in infections shortly thereafter.

What this article attempts to do is look at existing practices which appear to have either worked or are being implemented elsewhere upon serious consideration of the risks and rewards, as well as which have not worked well, and identify the salient issues which ought to be looked at in designing a lockdown exit strategy. 

This is not specifically tailored to Bangladesh; however, we do refer to information specifically related to Bangladesh where appropriate. 

The formulation of a lockdown exit strategy should consider at least these 3 phases of exiting the
lockdown:

i. Readiness - What level of readiness in the healthcare system and other related sectors needs to be in place before the lockdown restrictions can be lifted?

ii. Initiation - What actions need to be initiated for an effective exit for the country?

iii. Implementation - What roadmap and strategies should be followed while implementing the lockdown exit process?

The lockdown exit strategy could be formulated keeping in mind the following five key aspects; healthcare, livelihood, economic revival, freedom of mobility, and governance. Healthcare would look primarily to the containment of the spread of Covid-19; planning for the availability of doctors and support staff, infrastructure, equipment and supplies. So far a coherent plan for management of Covid-19 patients, suspected patients, and people in need of tests has not emerged here. Not only that, patients with non-Covid-19 diseases are not being able to access healthcare in many reported cases.

Livelihood concerns would be to ensure access to livelihood and livelihood generation, as well as social security and migrants management. While some industries and sectors did not close down at all or fully, and hence supported their workers' earnings throughout this period, others have curtailed work and often wages. Most industries and sectors, in particular small and cottage industries and the service sectors, a huge majority of them in the informal sectors, have not been able to function in a manner so as to enable income-generation, hence the livelihood issue which is being hotly debated. The Government has stepped in to support the most vulnerable sections of the population, and according to figures released in the press release on 11 May, 1 Lac 13 Thousand and 802 metric tons of rice have been distributed in 64 districts by the district administrations to about 1 Crore families. The quantity of rice allocated for the country so far is 1 Lac 43 Thousand and 67 metric tons. Additionally, Taka 51 Crore 69 Lacs and 13 Thousand have been handed over to 3 Crore 6 Lac and 2 Thousand people, benefitting 59 Lac 11 Thousand and 500 families. The total allocation for the cash transfer is so far Taka 80 Crores. Some other direct allocations and distributions have been made for food support for children, among others. The NGOs and private sector organizations have also stepped in with mostly food support so far. However, depending on the extent and duration of this outbreak, it is difficult to predict to what level such sustenance support will be required, as well as be effective. 

As far as industry and service sectors are concerned, the Government in various forms is providing or facilitating the provision of financial support amounting to about 1 Lac Crore Takas, more than 3% of GDP, whether in the form of subsidizing the interest on salary loans, working capital support or other grants and loans. It must be noted though, that the procedure to access these has been complicated, and acknowledged as much by the policymakers. The credit risk for much of the support is on banks who have been asked to disburse funds on the basis of bank-client relationships, where at least in the CMSME sectors there are few such relationships in fact. This is short-term damage limitation, and therefore a medium and long terms strategy to revive the economy will have to be put in place, sooner rather than later. More on that below.  

The migrant worker issue has two aspects. One, dealing with the need for workers to move from one area of the country to another to their workplaces, which is also covered in freedom of mobility to an extent. Second, much more importantly, management of the migrant workers who have returned to Bangladesh with little or no prospects of going back to their host countries to work in the foreseeable future. 

One of the main issues which will have to be dealt with during and in the immediate aftermath of the Covid-19 outbreak is the revival of the economy. Not a single economy in the world will perhaps survive without suffering serious negative repercussions from the pandemic. Economic revival will require the country to make effective plans to boost the revival of the country's economy in key sectors such as agriculture, manufacturing, exports, and key service sectors as quickly as possible. Budget as usual on the assumption of business as usual will just not do. Steps will have to be taken to boost demand through the injection of liquidity into the economy, and supporting the supply side as well in restarting businesses, among other steps to mitigate immediate job and business losses. Account will have to be taken of the fact that in the immediate aftermath, and perhaps even for the next two to three years the growth of the economy may well be curtailed, remittance inflows will reduce, exports will slow down, domestic demand will be sluggish. 

Freedom of mobility refers to re-establishing the freedom of mobility for people, goods and services, with due attention to health and safety. Already goods have started moving in Bangladesh, as have people, and it remains to be seen what the effects are in the short term. Technology can be used to map the movement of goods and people and correlate that to the spread of the infection, which would then allow the necessary and informed decisions to be taken on how to manage mobility without endangering people's health and lives.

Capacity enhancement and management towards financial planning, implementation mechanisms, law and order enforcement, public utilities, supply chain, and other such issues will require heightened governance and oversight. The framework for this will have to be laid as best as one can in the shortest possible time. The reported state of the healthcare infrastructure and management does not engender confidence, whereas law enforcement personnel, in particular the police forces have worked ceaselessly and with dedication to support the government and the citizens in the last several weeks. Administrative fatigue is also an issue which may need to be considered. Financial planning requires consultation with stakeholders for any fiscal and non-fiscal support to be properly targeted and implementable.

Key issues that an exit strategy must tackle 

In light of the five major headline areas identified above, the lockdown exit strategy would ideally address the following central issues:

1 Objectives and challenges of the lockdown exit strategy.

2 Centralized assessments and monitoring of the current situation and on a regular basis as the strategy is implemented.

3 Creation of a framework for preparedness assessment, i.e. to assess the level of preparedness for each group of stakeholders to implement its part of the strategy.

4 Creation of a framework for vulnerability mapping and management, from health, social, economic, financial and other points of view.

5 Aspects to be considered for phased sector wise strategy of exiting the lockdown, such as level, severity and spread of infection, location-specific issues, population specific issues in each location, logistics for that sector, and similar other issues.

This article seeks to define the bare contours of lockdown exit mechanism with a broad framework for consideration of the Government. As the Government decides on the overall framework and finalizes it for implementation, detailing for each of the elements would be done subsequently by the Government Departments concerned, in consultation with all relevant stakeholders. 

A high-powered committee formed by the Government, and including experts from the relevant sectors would look into and identify the following issues.

1.    Objectives and challenges of lockdown exit strategy:

i.    Identifying the key objectives (health and non-health related) to be attained through the implementation of lockdown exit strategy. This would be ideally primarily to ensure the highest possible levels of health and safety of the population in the circumstances, commensurate with a safe and phased re-opening of the economy to ensure access to livelihood at all levels.

ii.    Identifying key challenges that the Government could face towards realization of the objectives. Such challenges could include the absence or weakness of governance mechanisms, capacity and training, appropriate human resources in adequate numbers, lack of technology, lack or financial or other resources, and most importantly, the lack of will.

2. Framework for centralized assessment and monitoring:

i.    Forming a national high-powered expert committee on Covid-19 lockdown exit strategy.

ii.    Defining the constitution of the committee, competencies and broad roles of its members.

iii.    Ensuring that the committee has the logistics and human resources to obtain all necessary information, as well as interact with stakeholder groups in a transparent and effective manner.

iv.    Providing an indicative framework for monitoring implementation of the lockdown exit strategy by the Committee.

v.    Designing digital tools and technology platforms such as a national portal on Covid-19 management, including tools for contact tracing and other necessary health-related activities, as well as for delivery of financial and other support. As mentioned herein, a2i is already involved in developing or sourcing relevant digital tools and platforms to facilitate data collection, management and logistics coordination. There are highly talented and competent human resources in this field in Bangladesh who can be brought into the process with good results.

3. Framework for preparedness assessment:
 
i.    Designing a draft framework for preparedness assessment in terms of institutional capacity and infrastructure availability in key sectors. Two obvious sectors would be the health and financial sectors. Others would be, for example, transport and law enforcement.

ii.    Designing a draft framework for preparedness assessment in terms of institutional capacity of administrative units (divisions, districts, upazilas and union councils).

4. Framework for vulnerability mapping, management and criteria for phased lockdown exit; again, technology can be used in this field in an effective manner.:

i.    Preparing an evidence-based (as far as possible) indicative framework for assessment of trends and trajectory of the pandemic at different administrative levels, as well as different sectoral and economic levels. 

ii.    Defining indicators for categorization and mapping of health, social and economic vulnerability at district and upazila levels.

iii.    Designing a framework for the use of tools and technology for Covid hot spots / vulnerable population management, and containment area monitoring.

iv.    Defining phases of exiting lockdown and defining criteria for phasing lockdown.

5. Points and aspects to be considered for a phased sector-wise lockdown exit strategy - based on various scenarios and learnings from other countries: This aspect will include the following metrics, regarding which we shall endeavor to provide more detail in the third and last instalment of our article:

i. Healthcare
a. Tracing and testing
b. Transmission control
c. Covid-19 patient management system
d. Healthcare infrastructure, PPEs, medicines and vaccine management
e. Use of technology for monitoring
f. Virtual Healthcare Training
g. Covid-19 relapse preparedness

ii. Livelihood
a. Resuming livelihood activities
b. Livelihood generation
c. Workspace safety

iii. Vulnerable population management
a. Welfare of children, women, disabled and aged population
b. Economic relief for bottom-of-the-pyramid households

iv. Goods and services
a. Supply chain management
b. Reopening of markets and commercial establishments

v. Governance
a. Capacity building requirements
b. Law and order, crowding management
c. Empowering upazilas and union councils
d. Public finance management
e. Taxation and economy revival
f. Covid-19 insurance policies and impact funds

vi. Mobility
a. Ease of mobility of goods and people inside country
b. Ease of mobility of goods and people from outside the country
c. Public mobility systems

vii. Public Utilities
a. Basic utilities such as water and sanitation
b. Utilities at urban as well as rural level

viii. Communication
a. Information Education and Communication (IEC) systems towards targeted messaging
b. Grievance redressal processes

ix. Agriculture
a. Agriculture continuity
b. Integration with supply chain
c. Subsidies and economic packages

x. Education
a. Use of technology
b. Streamlining continuity of formal education with backlog management

xi. Migrant Population Management
a. Migrants management and welfare, returning to home districts within the
country
b. Migrants management and welfare, returning from other countries
c. Tracking of migrants and containment of disease spread
d. Livelihood generation and rehabilitation

xii. Industries
a.    CMSME revival (with focus on industries such as textiles, food processing, etc.)
b. Large industries revival
c. Subsidies and economic packages, fiscal and non-fiscal, primarily to boost domestic demand.

The importance of a well-thought out exit plan cannot be emphasized sufficiently, particularly where in the context of a critical need to open up the economy, various activities seem to be opening up on an unplanned basis with little input on the aspect of health and safety, save for some conditionalities, which as we have seen are often impractical to implement. Almost every country which is thinking about opening up, including the UK and USA, is having to consider whether a premature opening up could lead to a more devastating second round of infections. The top American Virologist Dr. Fauci has firmly confirmed the same to the US senate on 12 May. 

The Government of Bangladesh has been taking various steps (e.g. issuing detailed guidelines on health and safety; keeping public transportation mostly closed, providing increasing sustenance support to vulnerable groups, setting in place cash transfer mechanisms through mobile financial services, etc), some of which will qualify as elements of a lockdown exit strategy. A2I, the Government's technology arm, for example, has been involved in designing logistics for agriculture and food supplies to coordinate with transport and transport workers, as well as sources and markets; remote working and remote education; among other things. However, what is still missing is a holistic plan with all or most appropriate elements taken into account, and a clear, coordinated engagement with the citizenry. What this article has tried to provide above is based on a review of exit plan practices around the world, to share a framework which attempts to provide a clear sense of the 'what' and 'how' which needs to be contained in a good exit strategy. This is not by any means an immutable prescription to be followed. There are too many variables and "unknown unknowns" which will need to be factored in on an ongoing basis.

Only the Government of a country is able to develop and roll out a lockdown exit strategy. However, clarity and information on what such plans entail is something that helps build the consensus for such approach and in the preparation of the plans. An approach which is inclusive and transparent will engender support for and confidence in any such Strategy devised by the Government. This article is an effort to help infuse some clarity and possible best practices which we hope will benefit both the general public and the Government in visualizing the process going forward. 

Asif Ibrahim is Chairman of Chittagong Stock Exchange. Barrister Nihad Kabir is President of MCCI, Dhaka. Abul Kasem Khan is Chairman of Business Initiative Leading Development (BUILD). Syed Nasim Manzur is an Adviser at Leather Footwear and Good Manufacturers and Exporters Association, and Dr. M. Masrur Reaz is Chairman of Policy Exchange.