Six years on, have we learned our lessons from Covid?

It has been six years since the first known cases of Covid-19 were reported in Bangladesh, on March 8, 2020. By then, the pattern became difficult to ignore: global Covid infections crossed one hundred thousand, the virus reached more than a hundred countries, and outbreaks across Europe were accelerating rapidly, with Italy emerging as the epicentre outside China. And the illusion that the crisis could be contained geographically was beginning to dissolve. What followed over the next two years would be remembered as a catastrophic, all-consuming global pandemic.

Hospitals filled, borders closed, economies slowed sharply, and in many cities, morgues struggled to keep pace as vaccines were rushed from laboratories into supply chains stretching across continents. Covid also revealed something deeper than the behaviour of a virus: it exposed how fragile many of the institutions designed to protect people, not just here but across much of the world, had become.

In Bangladesh, many national healthcare facilities had already been operating close to capacity before the pandemic appeared. Intensive care units were built for efficiency rather than surge capacity. Medical supply chains depended on global production networks vulnerable to disruption. The systems responsible for disease surveillance and outbreak detection remained chronically under-prioritised. The pandemic only exposed the implications of that imbalance. Even countries with advanced medical capabilities found themselves scrambling for protective equipment, oxygen supplies, and diagnostic capacity and precision. Covid turned what once seemed like “technical” matters—epidemiological modelling, genomic sequencing, infection surveillance—into matters of national emergency.

Epidemics like this leave behind a choice. Countries can treat them as temporary disruptions and move on, or as indications of deeper structural vulnerability requiring long-term redress. Six years after Covid, the question for Bangladesh is whether that process of institutional learning and redress has been embedded in its healthcare system.

During the pandemic, Bangladesh, like most countries, responded through rapid improvisation. Hospitals expanded intensive care capacity. Oxygen supply systems were strengthened. Vaccination campaigns eventually reached millions of citizens within a relatively short period of time, although the vaccine procurement controversy left a lingering shadow. Those efforts demonstrated an ability to mobilise under pressure, but crisis response and institutional resilience are not the same thing. The harder question lies in the years that follow a crisis: whether emergency adaptations become permanent capacity or whether the underlying structure returns to its earlier state.

Recent findings from the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) suggest that vulnerabilities remain. A study conducted in several intensive care units in Dhaka has identified the presence of the drug-resistant pathogen Candida auris, a fungal organism that has drawn global attention because of its resistance to common treatments and its ability to spread within hospital environments. In recent years, there have been several similar disclosures of such superbugs, especially in public hospitals. Hospital-acquired infections tend to reflect broader weaknesses in infection control—hygiene practices, antibiotic regulation, laboratory monitoring, and clinical oversight, to name a few. A surge in such infections thus justifies persistent concerns about our institutional capacity.

This is but one indicator of what changed (or not) in the health sector since the pandemic ended. Financing is another area deserving close scrutiny. True, public spending on health has risen gradually over the past years. Budget allocations have moved from over Tk 32,000 crore in the early pandemic period to nearly Tk 42,000 crore in the most recent fiscal cycle. This upward movement may look encouraging on paper, but the wider budget structure tells a more layered story, with health spending remaining close to five percent of the national budget for years. As a share of GDP, it continues to sit well below one percent, which is frustrating. Even within that envelope, utilisation has seldom kept pace with allocation, with development spending frequently revised when projects struggle to move through procurement and implementation.

Bangladesh allocates significantly larger shares of public expenditure to sectors such as defence, transportation, and major infrastructure. Those choices reflect understandable concerns about national security and economic growth, but the pandemic has demonstrated that a health crisis can affect a nation just as profoundly. Public health infrastructure rarely looks attractive in budget tables, and laboratory networks, oxygen supply systems, infection-control teams, and epidemiological surveillance units seldom command headlines, but their importance becomes visible only when they fail.

Hospitals reveal another layer of the system. Drug-resistant organisms such as Candida auris tend to emerge where infection-control practices are irregular. They appear in environments where antibiotic use is poorly regulated, hygiene protocols are inconsistently applied, and monitoring systems struggle to track transmission patterns early. Vulnerable patients, invasive procedures, crowded wards and heavy antibiotic use all create conditions in which resistant organisms can move between patients. Preventing their spread requires proper institutional support, discipline, and oversight—a combination that, unfortunately, has yet to materialise evenly.

We must remember that outbreaks rarely appear without warnings. Clusters emerge in laboratory reports, unusual symptoms appear in emergency wards, and patterns develop in hospital admissions long before the public hears of a pathogen. The ability to recognise those warnings early is what epidemiologists often describe as epidemic intelligence. Bangladesh expanded elements of its surveillance capacity during the pandemic. Testing laboratories increased. Reporting systems improved in several areas. But the structure still remains irregular.

Information flows among hospitals, laboratories, and central health authorities still do not always move systematically. Private healthcare facilities, which treat a large share of patients, are not consistently integrated into national reporting structures. Environmental monitoring of emerging pathogens remains limited. If the past years have taught us anything, it is that sustained institutional strengthening must be prioritised. The government must treat public health safety as an inseparable part of national resilience, requiring consistent financing for laboratories and hospital infrastructure, systematic strengthening of infection-control systems across public and private hospitals, and making surveillance networks capable of detecting unusual disease patterns early. These investments and tasks may not seem politically urgent but they remain paramount.

Six years after Covid first reached Bangladesh, the memory of that crisis should serve as more than a historical marker. It should function as a reminder that pandemics do not just test hospitals; they also test the preparedness, coordination, and foresight of entire systems. We must ensure that this lesson is fully learned and properly acted on.

Tasneem Tayeb is a columnist for The Daily Star. Her X handle is @tasneem_tayeb.

Views expressed in this article are the author's own. 

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