COVID 19 Crisis Management for Military Institutions
By Retired Air Chief Marshal Masihuzzaman Serniabat, Former Chief of Air Staff of Bangladesh Air Force (2018-2021)
Military training is often thought of as a test of physical calibre and mental drive. However, as a commissioned general duty pilot (GDP), my training in the military went far beyond the call of duty many times. It often wasn’t just about operational tasks and managing military personnel on a regular basis, at times it was about handling unprecedented internal crises situations that required risking into unchartered territories for me and my staff. During my tenure as the Chief of Air Staff of Bangladesh Air Force, the COVID 19 pandemic came into the picture and alongside the whole country, Air Force faced a number of challenging situations when it came to containing the spread of the virus, ensuring regular operations and keeping overall fatality rates near zero, not to mention taking care of the staff’s mental health - all turned out to be a monumental crisis management experience for me.
On 8 March 2020, the first official covid case was detected in our country. On 26th we went for a limited lockdown when a mass movement of people created a fear of rapid contamination of the populace. Again on 5 April, with the announcement of garments opening, the workers came back en masse. The rate of infection seemed to be manageable. Considering the way people moved and came in contact with the virus, there had been a fast propagation of the virus resulting in antibody generation among around 70% of slum dwellers (ICDDRB, 2020). Many had been asymptomatic and many in our country could not get a place for testing and yet the recovery rate was higher than the global average. Additionally there is a social stigma with COVID. Trauma in knowing that one is positive. There had been incidents of suicide from being COVID positive. Isolation was another fear.
One of the major challenges during the onset of the pandemic, was the fear factor induced stress through anxiety and it propagated more among the affluent as they were exposed to more mass media being locked up at home. Many medicines came up from folklore and propaganda of social media who sincerely wanted to induce awareness by showing the dead bodies and the funerals. Officially the fatality rate had been 2 percent and below, and the contamination or propagation rate, Ro had been more than one. There had hardly been any country not affected by the COVID 19. Hydro-chloroquine became a fast seller, and remdisivir. Even bleaching materials were preached to be effective. Ventilators and ICU facilities were sought after when breathing became difficult. Though 86 percent of the people put in the ventilator did not come back, it became a highly sought after medical equipment. While simple methods of breathing exercises and lying in a prone position to improve oxygen saturation could have been effective, they were generally omitted or not considered.
Our Story in Bangladesh Air Force
Bangladesh Air Force was set to deploy for the first time to the Central African Republic on 28 March 2020 for the United Nations Peacekeeping Mission. On 11 March, 39 out of 125 personnel were tested positive. At that point of time no established protocol was in vogue to treat the personnel and catch the flight for the UN. Hospitalization was the norm for COVID 19 positive patients. It would take almost a month to get the positive patients back to their healthy selves. Replacement was also very cumbersome and some personnel were irreplaceable. Sitting with the BAF doctors it was decided to keep them isolated in the BAF Shaheen C ollege Dhaka where they were treated under the following protocols:
- Morning Tulsi tea and pineapple with boiled eggs breakfast
- Exercise under the sun
- Hot water vapor inhalation every two hours or so
- Hot water gargle
- Tab IVERMACTIN (Ivera) 12 mg or 18 mg if weight is more
- Tab Favipira, First day 3tabs twice. second day 2 tabs twice daily for five days
- Vitamin D
- Zinc
All except one tested negative on 22 Mar, and being again tested negative on 24th , departed on 26th for BANGUI by the national flag carrier. It may be mentioned that the age varied from mid twenties to fifties. A mixture of seniors and juniors. One pilot was replaced as he tested positive on the second test. The basic challenge here had been to motivate the men that COVID is not a death sentence. High Morale and being happy had been a prominent healer. Fight back with the built in immune system was the key.
Actions Taken
BAF Medical Services Director {DMS} issued instructions with all the necessary precautions and health activities to be done in accordance with the national guidance. Simultaneously, BAF had been providing air evacuation medevac services and thus few crew were exposed. A new type of stretcher was developed indigenously and was appreciated. Our SOP was appreciated by our friends from other countries also. And many requested for sharing the COVID mission SOP which we did. Few interesting phenomena occurred during the process of handling COVID. There was a sort of social denial and stigma for the disease. Many considered it can happen only to the sinner. And others got so agitated as if he/she is about to die. Thus our approach had been to have sermons delivered by the Imams on Friday jummah prayers on disease and the way to tackle it. Unorthodox method of not telling the person that he is positive was also followed in the early days of the pandemic breakout. Interestingly those who did not know recovered faster and without many symptoms. Another matter that we observed was that families staying together recovered quite fast then being isolated. One officer was doing a course in Dhaka when his wife - a doctor in Bir Sreshtho Matiur Rahman Base contacted COVID. We gave him leave and sent him back to stay home and look after his wife and two children. They all were okay in seven days, and the children -without even fever. I kept wondering about the possible effects of mass anxiety/stress from fear of pandemic. The psychological aspect of isolation was totally ignored. But we kept the husband and wife in the same cabin once they both were positive.
Once the lock down started and flights closed, gradually the sitting of the pilots not flying and the airlines not having cash flow was about to starve the industry. In the month of May 2020, we started arranging non-scheduled special flights for our flag carrier and other national airlines. First one had been to the UK to send BAF crews, who would later on, fly back our C-130 J. The whole episode had been quite a challenge. Discussion with the foreign ministry, embassies and support providers often ended up into the dead night and the negotiations with the airlines demanded a lot of skill hitherto unknown to the Air Force. However, because of our experience in sending BAF aircraft on non-schedule flights abroad, we could do it. The only addition was the interfacing of the commercial part of it. So, we put in the good office of BAF Welfare Trust to be the buffer zone and to do the work which BAF proper cannot - welfare business. In addition BAF also kept the lines of communication and transportation open by its own fleet. Those missions had also been full of extreme challenges - for example on landing at certain foreign land, no crew allowed to visit the toilet even. Keep putting on the PPE-we did it for the country. We with our meager resources carried the best quality PPE along with western certificates of quality even to distant UK, Korea, Malaysia. We were one of the first to go to Maldives in support of our expatriates and we had been in Lebanon after their blast to show our solidarity with the sufferers. While we carried the stranded and the needy Bangladeshis, we also transported some essentials and some seasonal fruits for the Bangladeshi workers in those countries. The look on their faces could tell how pleased our people abroad were to have those, not for the item, but for the feeling that they are not forgotten at home - their country Bangladesh.
My wife and myself were tested positive on 28 Mar 2021. Except for fever, we did not have many symptoms. Together, we had our holidays at our residence. On a routine checkup, CMH did not want to leave me. I asked that with oxygen saturation 96% and with breathing exercise increasing to 98% would you keep someone in hospital. They said that no, but we cannot take a risk on you. I said my house is only three minute away, I will come back if oxygen reduces. Continued with Ivermectin, Favipira and few other medicines as per BAF doctors' protocol and enjoyed being together at home for 14 days. Tested negative on 11 Apr and again on 17 Apr. Departed for an official visit to Turkey on 18th by our own C-130J as all airlines were closed. We carried with us goodwill items and Covid medicines made in Bangladesh to stand beside our brothers at the testing time of pandemic. On the return journey we could bring back 49 of our stranded Army personnel who had been on training in Turkey. Travel time was 17 hours including refueling halt at Al Ain of UAE. We did not feel any weakness during the long and arduous journey which is normal after immediate recovery of Covid. Thanks to BAF Doctors and above all Almighty Allah SWT mercy. Superb performance of our technicians and pilots had been unparalleled. These aircraft were supposed to be flown into Bangladesh from Cambridge.
Advice For Military Institutions
- Keep serving the nation as in normal crisis time.
- FOLLOW the national pandemic guidelines but also continue with primary duties.
- To keep the morale high, do give frequent sermons and be present among the men in uniform.
- Certain amount of physical exercise should be continued and good food habit should be maintained.
- The fear factor is to be neutralised through effective and positive briefings based on factual data.
- As far as possible families to be kept together in case of Covid positive.
- All personnel to be caring for the sick, a simple sharing of fruits can boost the morale sky high.
- Last but not the least precautions , like mask and washing to be ensured.
