100% mask, handwashing can help Bangladesh keep going, says CDC Bangladesh chief

A US public health expert has suggested that reopening of schools in Bangladesh could be considered during Covid-19 'as school closures have clear negative impacts on child health, education and development'.

"It should be considered in a policy decision about keeping schools closed or open," Country Director of Centres for Disease Control and Prevention (CDC) Dr Michael Friedman told Dhaka Courier in an interview saying he would prefer keeping schools open instead of restaurants.

Shedding lights on the global scenario, the expert, having a diverse 27 years of work experience in the US and the global stage, said the decision makers have decided to emphasise the current population of adults, not the future generation of children.

He said the decision makers apparently have decided to sacrifice the future generation of children to help survive the current generation of adults.

"It's a huge question. Is closing schools helping? Is it a smart thing to do? If you ask me, you've a choice between closing schools and closing restaurants. I would say close the restaurants but keep the schools open," said the expert.

School closures have clear negative impacts on child health, education and development, family income and the overall economy, says the World Health Organisation (WHO).

The decision to reopen schools should include consideration of the following benefits -- allowing students to complete their studies and continue to the next level, essential services, access to nutrition, child welfare, such as preventing violence against children, social and psychological wellbeing, access to reliable information on how to keep themselves and others safe, reducing the risk of non-return to school and benefit to society, WHO said.

Dr Friedman said children are less likely to get Covid-19 and much less likely to transmit the virus to their parents and grandparents.

And, he said, there are less likely for children to get severe diseases.

"If there's a child sitting here with an adult and both have Covid, you'll be more likely to get Covid-19 from the adult, not from the child," the public health expert explained.

So, the question is: Are schools going to increase transmission? Dr Friedman said that is not true for Covid-19 but it is true for influenza.

The expert who lived and worked in four continents said it is an extremely important issue and that is not an easy decision (reopening schools).

Dr Friedman said education, especially female education, is the number one reason for the improved health outcomes in the world. "The damage is huge if you no longer educate people almost for a whole year.

We need to understand the public health implications of not having kids going to school for a year," he added.

Dr Friedman said online education is mostly effective for the advanced students and they are having a productive year. "But for the vast majority of students - I feel very bad for them. They don't have the same capability and resources."

The public health expert referred to a modeling study in the US on the first three months of the pandemic and estimated 5.7 million years of life lost due to school closures.

These findings suggest that the decision to close US public primary schools in the early months of 2020 may be associated with a decrease in life expectancy for US children.

Serology Study

The CDC is conducting serology study in six metropolitan cities in Bangladesh.

"We don't have the results yet. We'll know it soon. That will give us a lot more information about how well we're controlling the virus and what we can expect in the future," said the CDC expert.

Serology is the study of antibodies in blood serum and it is being done throughout the world.

Serologic testing helps retrospectively determine the size of an outbreak or extent of infection in a population under study.

The US expert visited 15 districts of Bangladesh in the first four months of Covid-19 to see what is happening on the ground and remote areas. "That's not easy."

100% Mask, Handwashing Policy

Dr Friedman said Bangladesh still can continue allowing restaurants and keep businesses running keeping people safe.

"The only way you can really do that by introducing 100 percent mask policy and 100 percent handwashing policy," he said adding that social distancing is more difficult in Bangladesh.

He said Bangladesh can keep its economy growing at the same time following these two strategies strictly.

The expert said the challenge in Bangladesh is that it wants some relaxation to help keep the economy growing, help people eat and earn.

"As a public health person, I've to balance between people's livelihoods and their protection. So, that's the tough balance," he said.

Dr Friedman said the government of Bangladesh has so far done pretty good job balancing between the two.

Second Wave or Still 1st Wave

The US expert said the second wave could happen once the first wave is over, and the first wave has really never ended.

He said the current wave may go up because people are less worried about protecting themselves. "That will increase the risk of getting infected apart from cold weather as a reason."

Dr Friedman thinks the big factor is not the weather but people's behaviour is the big factor.

"If people don't take viruses seriously thinking it's almost over, if they don't wear masks, go to social events and use public transportation, they can get Covid and the wave may go bigger," he said, adding that these all together can make a second wave of Covid-19 infection.

Asked about Bangladesh's success in dealing Covid-19, the US expert said it is a difficult thing to judge but history will look back whether it was a success or not.

"At this moment, it's hard to say because we don't have all the information yet whether global response on Covid-19 has been successful or unsuccessful. But we know there're things to learn already from this crisis," he said.

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