Health infrastructure in Cox’s Bazar does not have the capacity to respond to such a large-scale outbreak. Bangladesh, at the time of writing, has reported over 2,948 cases of COVID-19 with a case in the local community bordering the camps[4]. And whilst delay and prevention measures are urgently underway, health professionals and organisations agree it is simply a matter of days before cases are reported inside the camps. Current projections predict a major spike in infections and between 459,968 and 591,349 infections over the next 12 months[5]. Specialised medical equipment needed to treat the most severe symptoms, such as oxygen support or ventilators, is not commonly available, with the closest ventilation equipment hundreds of kilometres away and not accessible to refugees. Staff are only now being trained in detection and management of COVID-19 and there are no triage or isolation facilities available. Even without an outbreak, the inpatient bed capacity in Cox’s Bazar is often close to full occupancy. Families will have no choice but to care for their sick in their homes and communities, which further fuels the rapid spread of the virus.
And all of this is occurring at the same time as heavy monsoon rains in upstream regions continue to cause flooding in 30 districts in the north, north-east and south-east of Bangladesh, affecting 5.4 million people. As of early August, 135 deaths, mostly as a result of drowning, have been reported. Flooding has damaged houses, dykes and embankments, water sources, hygiene facilities, and has severely impacted livelihoods, especially in the agricultural sector. Access to basic services such as health care and education have been disrupted. Humanitarian actors continue to respond the needs of affected people in coordination with the Government of Bangladesh.
The COVID-19 crisis is unlike any we have seen in our lifetimes. It is a virus that does not discriminate between wealthy or poor countries, weak or strong health systems. We have seen well-established national health systems in wealthy countries become overwhelmed. For the most vulnerable refugee and host communities in Bangladesh’s Cox’s Bazar, a major outbreak of COVID-19 is imminent, and the potential death toll unimaginable. With the first case in the local community reported in recent days, we are in a race against time. The critical window to save thousands of lives is now.
[1] https://reliefweb.int/sites/reliefweb.int/files/resources/20200319_acaps_covid19_risk_report_rohingya_response.pdf (accessed 17 April 2020)
[2] https://apnews.com/5bf8d0ce6f3ff0e2746317ba372d0999 (accessed 20 April 2020)
[3] https://reliefweb.int/sites/reliefweb.int/files/resources/20200319_acaps_covid19_risk_report_rohingya_response.pdf (accessed 17 April 2020)
[4] https://qap.ecdc.europa.eu/public/extensions/COVID-19/COVID-19.html#tab1 (accessed 17 April 2020)
[5] http://hopkinshumanitarianhealth.org/assets/documents/COVID-19__Rohinya_Refugees__Beyond_-_Summary_FINAL_March_25_2020.pdf (accessed 17 April 2020)
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