DHAKA, Bangladesh – Nasrin Jahan woke up gasping for breath. Her daughter held her in the back of a rickshaw as they drove to a nearby clinic, where she had been given an oxygen bottle. From there, an ambulance took her to one hospital and then another, looking for a bed.
“Ammu, you’ll be fine,” her daughter, Tajrin Jahan Yousha, tried to tell her, using a loving term for “mother.” “We are close to the hospital. They will take care of you.”
Bangladesh’s already tense healthcare system is collapsing under the ferocity of the country’s third and by far deadliest wave of coronavirus infections. About 60 percent of the 23,000 virus-related deaths and more than half of the total infections have been recorded since early April. The hospitals are overrun. Only 4 percent of the population is fully vaccinated.
And yet Bangladesh, a country of 165 million inhabitants, lifted much of the lockdown on Wednesday. Banks, shops and shopping centers were allowed to reopen. Buses and trains are running at half capacity again. They follow the garment industry, a mainstay of the economy, which reopened two weeks ago.
Health experts fear that lifting the restrictions will only exacerbate the outbreak.
“If we reopen everything despite the increasing infection, we will face even more dire consequences,” said Benazir Ahmed, an epidemiologist and member of the government’s advisory group on vaccines.
Bangladesh has strongly felt the pain of shutting down its economy. Despite the country’s great strides to lift hundreds of thousands of people out of poverty, at least 24.5 million people have been pushed into it by the pandemic, according to an April study.
Government advisers have said the country’s leaders have no choice but to reopen. “It is not possible for the government to keep the country locked down forever,” Mohammad Shahidullah, chairman of the government’s Covid-19 committee, told local news media on Wednesday.
Health experts say that by reopening the country after less than three weeks, officials are effectively shifting responsibility to individuals. The government ignored their advice last month, they say, when it eased an earlier lockdown for the Islamic holiday of Eid al-Adha, sparking super-spreading events that sparked a spate of infections. Millions of people packed into buses, cattle markets and shopping malls and gathered for prayers and festivities.
“The infection rate was high when the convenience was announced, despite the warning from experts, and we are now seeing the result,” said Dr. Ahmed.
Prime Minister Sheikh Hasina’s government has said hospitals in the country are being overrun by “an urgent need for intensive care”. Officials rent hotels and create makeshift hospitals to treat patients.
“We can no longer increase the number of beds in our hospitals,” Health Minister Zahid Maleque said on Saturday. “Citizens must now do their part to reduce the Covid-19 infection rate.”
In the capital, Dhaka, one of the world’s most populous cities, ambulances blare their sirens as they transport patients in search of beds, oxygen and intensive care. Some hospitals have put up signs that read, “We’re sorry. There are no beds available.”
Kakoly Akhter, six months pregnant with her fourth child, arrived in Dhaka late last month seeking treatment for Covid-19 after the hospital in her hometown ran out of oxygen 65 miles away. Two days later, Ms Akhter managed to get a bed at Dhaka Medical College Hospital, one of the city’s largest Covid hospitals. Mother and baby died a few hours later.
“If we had been given an intensive care bed earlier, we would not have lost her until she was 34,” said Delwar Hossain, Ms Akhter’s cousin. “She left behind three children. How will they grow up without their mother?”
In the country’s remote villages, home to nearly two-thirds of the population, doctors are scarcer and health infrastructure is already overloaded. Bangladesh has less than one doctor per 1,000 inhabitants, or less than a quarter of the level of the United States or Great Britain, according to the World Bank.
Last month, Jannatul Ferdous Any, a woman in her early 30s, fell ill in the town of Sirajganj. At first she only had a fever. Then she couldn’t breathe.
Her brother, Saiful Islam, took her to Sirajganj General Hospital on July 4. Three days later, the hospital ran out of oxygen for her, he said.
A hospital 20 miles away agreed to admit her and give her oxygen, but she couldn’t get a bed in the intensive care unit.
A week later, Mrs. Any’s condition deteriorated in the middle of the night. She began to gasp. Mr. Islam said the last thing she told him was to take care of their parents.
“This coronavirus has taken her from us forever,” he said. “She was our parents’ only daughter and our only sister.”
The third wave has also taken its toll on doctors and health professionals. At least 180 doctors have died since April 2020, according to the Bangladesh Medical Association. More than 3,000 doctors and 6,000 health professionals, including nurses, tested positive for the virus on Monday.
Nazmul Haque, the director of Dhaka Medical College Hospital, said his biggest challenge was a staff shortage.
“Many of our doctors, nurses and other employees have tested positive for Covid-19,” he said. “Some of our employees have also passed away. It was enough to break the morale of many.”
dr. Shamema Akter, a doctor who works in the hospital’s ICU, said she knew it was only a matter of time before a third wave hit Bangladesh. Across the border in India, where the more contagious Delta strain of the virus was first discovered, the second wave flooded hospitals in the spring. The Ministry of Health of Bangladesh has said that the Delta variant is responsible for more than 60 percent of new cases.
“That’s why we prepared to work long hours,” said Dr. Act. But sometimes they get so exhausted, she said, that they have “mental disorders.”
When Ms Jahan urgently needed a hospital bed last week, doctors at Dhaka Medical College Hospital advised her to have a scan of her lungs. After examining the scan, a doctor told her 16-year-old daughter, Ms Yousha, that one of her mother’s lungs was severely infected, but there was no room for her.
Ms Yousha said she wished doctors had examined her mother more closely, but she didn’t blame them for the bed shortage. “We don’t want to hold anyone responsible,” she said. “It was our fate.”
dr. Haque, the hospital’s director, declined to comment.
In the ambulance, Ms Yousha spoke to her mother to prevent her from losing consciousness. Ms. Jahan told her daughter to “forgive” her and take care of her older twin sisters, who have mental and physical disabilities.
“You have great responsibilities,” she told her daughter. “Live together.”
Minutes later, she heard her mother’s breathing slow. Mrs. Yousha started reciting what she could remember from the Quran until they reached the second hospital.
The staff there took Ms. Jahan to the triage room. Within 10 minutes they told Ms. Yousha that her mother had passed away.
“I never slept alone. I’ve never slept without my mother,” Mrs. Yousha said. Her aunts and uncles will take care of her and her siblings, she said, but they will always feel Ms. Jahan’s absence.
“No one can take the place of a mother.”
Saif Hasnat reported from Dhaka, Bangladesh, and Karan Deep Singh from New Delhi. Fabeha Monir contributed reporting.
