ArticlePDF Available

Abstract and Figures

Considering the population density, healthcare capacity, limited resources and existing poverty, environmental factors, social structure, cultural norms, and already more than 18,863 people infected, the community transmission of COVID-19 is happening fast. These exacerbated a complex fear among the public. The aim of this article is, therefore, to understand the public perception of socioeconomic crisis and human stress in resource-limited settings of Bangladesh during the COVID-19 outbreak. The sample comprised of 1066 Bangladeshi participants. Principal component analysis (PCA) was considered to design a standardized scale to measure the mental stress and socioeconomic crisis, one-way ANOVA and t-test were conducted to perceive different demographic risk groups; multiple linear regression was applied to estimate the statistically significant association between each component, and classical test theory (CTT) analysis was applied to examine the reliability of each item according to the components to develop a composite score. Without safeguarding the fundamental needs for the vulnerable ultra-poor group can undeniably cause the socioeconomic crisis and mental stress due to the COVID-19 lockdown. It has further created unemployment, deprivation, hunger, and social conflicts. The weak governance in the fragile healthcare system exacerbates the general public's anxiety as the COVID-19 testing facilities are centered around in the urban areas, a long serial to be tested, minimum or no treatment facilities in the dedicated hospital units for COVID-19 patients are the chief observations hampered along with the disruption of other critical healthcare services. One-way ANOVA and t-test confirmed food and nutritional deficiency among the vulnerable poorest section due to loss of livelihood. Also, different emergency service provider professions such as doctors, healthcare staff, police forces, volunteer organizations at the frontline, and bankers are at higher risk of infection and subsequently mentally stressed. Proper risk assessment of the pandemic and dependable risk communications to risk groups, multi-sectoral management taskforce development, transparency, and good governance with inter-ministerial coordination is required along with strengthening healthcare capacity was suggested to reduce mental and social stress causing a socioeconomic crisis of COVID-19 outbreak. Moreover, relief for the low-income population, proper biomedical waste management through incineration, and preparation for the possible natural disasters such as flood, cyclones, and another infectious disease such as dengue was suggested. Finally, this assessment process could help the government and policymakers to judge the public perceptions to deal with COVID-19 pandemic in densely populated lower-middle-income and limited-resource countries like Bangladesh.
Content may be subject to copyright.
Research article
COVID-19 pandemic, socioeconomic crisis and human stress in
resource-limited settings: A case from Bangladesh
Mashura Shammi
, Md. Bodrud-Doza
, Abu Reza Md. Towqul Islam
Md. Mostazur Rahman
Department of Environmental Sciences, Jahangirnagar University, Dhaka-1342, Bangladesh
Climate Change Programme, BRAC, Bangladesh
Department of Disaster Management, Begum Rokeya University, Rangpur-5400, Bangladesh
Perception-based questionnaire
Principal component analysis (PCA)
Linear regression model
Social panic
Social conict
Considering the population density, healthcare capacity, limited resources and existing poverty, environmental
factors, social structure, cultural norms, and already more than 18,863 people infected, the community trans-
mission of COVID-19 is happening fast. These exacerbated a complex fear among the public. The aim of this
article is, therefore, to understand the public perception of socioeconomic crisis and human stress in resource-
limited settings of Bangladesh during the COVID-19 outbreak.
The sample comprised of 1066 Bangladeshi participants. Principal component analysis (PCA) was considered to
design a standardized scale to measure the mental stress and socioeconomic crisis, one-way ANOVA and t-test
were conducted to perceive different demographic risk groups; multiple linear regression was applied to estimate
the statistically signicant association between each component, and classical test theory (CTT) analysis was
applied to examine the reliability of each item according to the components to develop a composite score.
Without safeguarding the fundamental needs for the vulnerable ultra-poor group can undeniably cause the
socioeconomic crisis and mental stress due to the COVID-19 lockdown. It has further created unemployment,
deprivation, hunger, and social conicts. The weak governance in the fragile healthcare system exacerbates the
general public's anxiety as the COVID-19 testing facilities are centered around in the urban areas, a long serial to
be tested, minimum or no treatment facilities in the dedicated hospital units for COVID-19 patients are the chief
observations hampered along with the disruption of other critical healthcare services. One-way ANOVA and t-test
conrmed food and nutritional deciency among the vulnerable poorest section due to loss of livelihood. Also,
different emergency service provider professions such as doctors, healthcare staff, police forces, volunteer or-
ganizations at the frontline, and bankers are at higher risk of infection and subsequently mentally stressed. Proper
risk assessment of the pandemic and dependable risk communications to risk groups, multi-sectoral management
taskforce development, transparency, and good governance with inter-ministerial coordination is required along
with strengthening healthcare capacity was suggested to reduce mental and social stress causing a socioeconomic
crisis of COVID-19 outbreak. Moreover, relief for the low-income population, proper biomedical waste man-
agement through incineration, and preparation for the possible natural disasters such as ood, cyclones, and
another infectious disease such as dengue was suggested. Finally, this assessment process could help the gov-
ernment and policymakers to judge the public perceptions to deal with COVID-19 pandemic in densely populated
lower-middle-income and limited-resource countries like Bangladesh.
1. Introduction
The World Health Organization (WHO) announced COVID-19 as a
global pandemic on March 11, 2020. The disease has advanced into a
pandemic, started with small chains of spreading, further culminating
into larger chains of spread in many countries resulting in the widespread
transmission consequently across the globe affecting all the continents
(Anderson et al., 2020). The fatality case of COVID-19 risk is around 1%
and that it can kill healthy adults, as well as the elderly people with,
existing health problems (Gates, 2020). According to Worldometers
* Corresponding author.
E-mail address: (Md.M. Rahman).
Contents lists available at ScienceDirect
journal homepage:
Received 6 April 2020; Received in revised form 15 May 2020; Accepted 20 May 2020
2405-8440/©2020 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (
Heliyon 6 (2020) e04063
(2020), 14 May 2020, with the total coronavirus cases rising to 4,490,
958, and total deaths 301,616, USA is the worst affected country from the
COVID-19 pandemic with 86,098 deaths. It took 67 days from the rst
reported of COVID-19 to reach 100,000 cases, 11 days for the second
100,000, and just four days for the third 100,000 (WHO, 2020a,b). The
accelerating spread of the COVID-19 and its outcomes around the world
has led people to fear, panic, concern, and anxiety (Ahorsu et al., 2020),
panic buying of surgical masks (Wang et al., 2020), stigma, depression,
racism, and xenophobia. Besides, as there is no medication and vacci-
nation yet, wrong use of disinfectant liquids, methyl alcohols, garlic,
lemon tea is amongst the many misinformation to cure COVID-19.
Moreover, the fear of infection, quarantine, social isolation, a lack of
self-care even leads individuals to suicide. Predictably, any contagious
epidemic outbreak has deleterious effects on individuals and society
(Duan and Zhu, 2020).
Institute of Epidemiology, Disease Control and Research (IEDCR) is
the research institute under the Ministry of Health responsible for
COVID-19 surveillance in Bangladesh, rst conrmed the COVID-19 case
on 7 March 2020, followed by a nationwide lockdown of all educational
institutes, government and private ofces, and industries from 26 March.
The government of Bangladesh (GoB) deployed armed forces from 24
March to facilitate the social-distancing and prevention of the disease.
Emergency healthcare services and law enforcement services were
exempted from this announcement. Nevertheless, just after the
announcement of lockdown, more than 11 million people left Dhaka to
be in their home districts and commenced the risk of COVID-19 infection
to the entire 64 districts in Bangladesh. On 15 May 2020, with 20,065
conrmed cases, 298 deaths (Figure 1) Bangladesh is within the top 30
affected country. With only 41 labs located in the urban areas, it is not
easy to be tested for COVID-19 and often the tests are done after the
Figure 1. Map of the study area showing number of COVID-19 conrmed patient (Data source: IEDCR).
M. Shammi et al. Heliyon 6 (2020) e04063
patients had expired. Moreover, at present Bangladesh has 1,169 ICU
beds, totalling to 0.72 beds/100,000 citizens. Of these 432 beds are in
government hospitals and 737 in private hospitals. Likewise, there are
only 550 ventilators in the country (IEDCR, 2020).
Amidst the lockdown of the COVID-19 pandemic, Bangladesh also has
been facing other epidemics of panic buying, social stigma, fear, and
hatred. The primary healthcare treatments in the hospitals and private
clinics were disrupted in the lockdown. Moreover, many emergency
service providers such as frontline doctors, healthcare staffs, caregivers,
police and armed forces, bankers and government authority were infec-
ted, isolated and even died. Private practitioners, clinics, and hospitals in
suburban and rural areas were shut down due to the fear of infection.
Moreover, the healthcare workers who have treated the patients and
infected have been socially hatred and stigmatized. Besides, the deceased
was even denied burial in the local graveyards which are basic human
rights and, in most cases, handled by the government authority (TBS,
2020a). The price hike of the daily necessities was observed due to low
supply and shopkeepers and suppliers stopped working fearing infection.
Middle-income, lower-income and daily-wedge earners fell into a severe
nancial shortfall due to loss of jobs, incomes. With their last savings
spent, they are plunged to be ultra-poor.
Considering the population density, environmental factors, social
structure, cultural norms, healthcare capacity, and poverty in
Bangladesh, it is certainly hard to lockdown millions of people. Besides,
Bangladesh hosts the largest refugee camps in Cox's Bazar which is also
about to embrace the COVID-19 pandemic, where, it will have cata-
strophic outcomes (Hopman et al., 2020). Despite the precautions taken
by the government and other international aid bodies, on 14 May 2020,
the Coronavirus cases were detected in Cox's Bazar Rohingya camps
(TBS, 2020b). Moreover, miscommunication among the government
ministries, policymakers, advisers and the country's apex trade organi-
zations such as Federation of Bangladesh Chambers of Commerce and
Industries (FBCCI) and the trade organization of the ready-made garment
(RMG) manufacturers Bangladesh Garment Manufacturers and Exporters
Association (BGMEA) led industry workers to return to the industrial
districts due to the message of reopening at least two times rst on 4
April and later on 11
April. To save their jobs, thousands of RMG
workers travelled back to Dhaka and its surrounding districts on foot, in a
truck, or covered vans without social distancing while ensuring further
transmission. The district of Dhaka and its Upazilas Savar and Ashulia,
Gazipur, Narayanganj, and Chittagong remained the highest infected
clusters of COVID-19 infection (IEDCR, 2020). The latest extension
period declared by the GoB is until 30 May 2020. Yet the RMG factories
and other industrial operations resumed from 26 April 2020. Moreover,
as the biggest Muslim festival Eid-Ul-Fitr approaches, mass people are
gathering in the shopping centres despite the risk of spreading human
transmission. It is utterly depicting the scenario of overlooking risks of
the pandemic by unaware citizens while social anxiety and fear of the
pandemic in concerned citizens. Both should be immediately dealt with
by the Government along with the alliance groups with proper risk
Moreover, the possibility of natural disasters such as tropical cy-
clones, ooding, and landslide preparedness, the rising of dengue fevers,
and other infections are potentially overlooked. Furthermore, the con-
sequences of disposal of used personal protective equipment (PPE)
without proper treatment in the landll will just arise more disease
transmission and environmental disasters leaving the country at stake. In
these circumstances, this study was therefore designed to analyze so-
cioeconomic crisis and mental stress in resource-limited settings of
Bangladesh due to the COVID-19 outbreak. This assessment might be
useful for the government and policymakers of countries with a similar
socioeconomic and cultural structure like Bangladesh.
2. Methodology
2.1. Study procedure
Considering the impact of COVID-19 outbreak in Bangladesh, this
study identies several relevant and possible items based on the country's
situation analysis based on the print and electronic media, and literature
review. We drafted the questionnaire considering demographic charac-
teristics, individual mental health condition (MH), the health system in
Bangladesh (HSB), governance and political issues (GPI), government
decisions and impacts (GDI), socioeconomic issues (SEI), immediate
emerging issues (IEI) and enduring emerging issues (EEI). A total of 49
items was considered in the drafted questionnaires to get people's
perception of the COVID-19 outbreak in Bangladesh. Furthermore, expert
consultation was considered to set and validate these 49 items.
Bangladesh has witnessed a boom in internet usage due to the fast-
growing mobile internet and the government's push for digitalization.
There are 99.428 million internet users in February 2020 according to
the Bangladesh Telecommunication Regulatory Commission (BTRC,
2020). Google Form based online questionnaire was prepared to conduct
the survey. An online database of target participants was prepared by
reviewing the relevant websites and online social platforms of different
groups in Bangladesh, considering their Bangladeshi citizenship, age
above 18 years, current activities, occupation, social responsibilities, and
engagement related to COVID19 response, socioeconomic sector,
country-level planning, and policymaking. The prepared questionnaire
with an introductory paragraph outlining the purpose of the study was
shared through Email, Facebook, LinkedIn, and WhatsApp with selective
and relevant people considering the purposive sampling method. The
questionnaire survey was conducted from 28 March to 30 March 2020.
The inclusion of the respondents was different social groups like
university faculty and scholars, Government ofcials, development
worker or practitioner, doctors, engineers and technologists, youth
leaders and students, businessmen and industry ofcials, banking and
nance corporates, researchers, and others. The answers to the survey
questionnaires are the voluntary basis. Data from 1082 respondents were
collected via a nationwide online survey method, but following the
removal of incomplete 16 questionnaires, 1066 were retained for this
study. A ve-point (15) Likert scale was employed to test whether each
understands the statement descriptions that ranged from strongly
disagree to strongly agree with the statements (Table S1).
2.2. Data analysis
Employing the Statistical Package for the Social Science (SPSS) v.
25.0, datasets were analyzed for Principal component analysis (PCA),
one-way ANOVA and t-Test, multiple linear regression, and classical test
theory (CTT). PCA is considered in this study to design a standardized
scale to measure the socioeconomic crisis and mental stress in
Bangladesh due to the COVID-19 outbreak. PCA is one of the population
data reduction techniques that indicate each potentiality of variables and
their signicance level in a huge sample size. Before conducting the PCA,
Kaiser-Maier -Olkin (KMO) and Bartlett's sphericity tests were applied to
conrm the necessity of this analysis. The results of the KMO >0.5 (the
KMO value was 0.903 in this research) and the signicance of Bartlett's
sphericity test at p <0.01 veried our datasets to be tted for the PCA
(Islam et al., 2020). The number of factors chosen was based on the
Kaiser's normalization principle, where the only factors with
eigenvalues>1.0 were regarded. PCA results were used to nd how many
components are to be retained as well as how many items in each of those
components are to be retained.
M. Shammi et al. Heliyon 6 (2020) e04063
Furthermore, the test of association between each principal compo-
nent and the demographic characteristic of the respondents were per-
formed to see how people of different demographic status to perceive
socioeconomic crisis and mental stress using the one-way ANOVA and t-
test. Moreover, multiple linear regression was applied to estimate the
statistically signicant association between each component.
Classical Test Theory (CTT) analysis was applied to examine the
reliability of each item according to the components to develop a com-
posite score. Cronbach's alpha was employed to test the consistency and
reliability of the factor loadings in this study (DeVellis, 1991). Descrip-
tive statistics (e.g., Mean, Standard Deviation, Variance, Skewness, and
Kurtosis) of respondents perceived socioeconomic crisis and mental
stress was considered based on the developed composite score for the
entire scale. The hierarchical cluster analysis (HCA) and Pearson's cor-
relation coefcient was applied for identifying the relationships among
all-composite items.
2.3. Ethics statement
The consent of participants was taken, and they remained anony-
mous. We have applied for the ethical clearance to the ethical clearance
authority of Jahangirnagar University, Bangladesh. The studies involving
participants of this questionnaire was reviewed by the Department of
Public Health and Informatics and permit to conduct this study.
3. Results
3.1. Demographic information
According to the survey results, the ratio of male to female partici-
pants was 3:2, whereas the composition of age groups were 75.2%
(1830 years old), 16.7% (3140 years old), 6.7% (4150 years old),
1.1% (5160 years old) and 0.3% (>60 years old), respectively. The
young people responded more maybe because of their frequent access to
the internet depending on the socioeconomic structure of Bangladesh.
However, the average age of the participants (n ¼1066) was 27.80 years
(SD 10.05), and the participants had, on average, 12.5 years of formal
education (SD 8.1). More than half of the participants were males (n ¼
661; 61.5%) and remaining (n ¼405; 38.5%) females. Nearby, 60% of
the youth group was mostly students as Bangladesh is a youth dividend
country and they are the most dynamic groups of the society as well as
dynamic on online platforms. The rest of the 40% were from various
professions of doctors and health workers, civil service ofcials, non-
government ofcials, teachers and scholars, policymakers, researchers,
and businessmen (Table S1).
3.2. Relationships among demographic characteristics, socioeconomic
components, and mental stress
The scree plot (Figure 2) shows that a total of eight components can
be retained (determined by components with eigenvalues greater than
1). Items with factor loadings (items loading on a component) less than
0.5 were omitted from the analysis and analysis repeated on the
remaining items until a perfect scale was developed (Hair et al., 2014).
We inspected the loadings of the items on each component and omitted a
total of 12 items (have not met the 0.5-factor loading requirement) from
the questionnaire. The scores of the items that loaded well on each
component are represented in Table 1.
The loading scores were demarcated into three groups of weak
(0.500.30), moderate (0.750.51), and strong (>0.75) respectively (Liu
et al., 2003;Bodrud-Doza et al., 2016;Islam et al., 2017). The PC1 (First)
elucidated 8.85% of the variance as it encompassed a condence level of
moderate positive loading, depicts the weakness of healthcare system in
Bangladesh including lack of trained doctors and health professionals to
deal with the COVID-19 (HSB1: 0.651); lack of health facilities to combat
the COVID-19 outbreak in Bangladesh (HSB2: 0.74); lack of health
infrastructure to deal with COVID-19 (HSB3:0.745); severe lack of
biomedical waste management facilities in Bangladesh (HSB4: 0.683);
lack of COVID-19 testing facility in Bangladesh (HSB5:0.69); and lack of
budget or nancial support to respond to this outbreak (HSB6:0.536). All
the elements of the statement (HSB) showed moderate loading score
revealing the fragility of the healthcare system of Bangladesh in dealing
Figure 2. Scree plots of the eigenvalues of PCA.
M. Shammi et al. Heliyon 6 (2020) e04063
Table 1. Retained items after principle component analysis.
Sector Items PC1 PC2 PC3 PC4 PC5 PC6 PC7 PC8
Age 0.047 -0.033 -0.045 0.009 -0.056 0.042 -0.007 0.893
Occupation 0.019 -0.027 -0.001 0.057 0.031 0.027 -0.017 0.883
Individual Mental
health condition (MH)
I am most afraid
of coronavirus recent
outbreak in
Bangladesh (MH1)
0.112 -0.005 0.029 0.24 0.758 0.074 -0.057 0.034
I am afraid of getting
coronavirus (MH2)
0.033 0.04 0.062 0.148 0.838 0.032 -0.049 0.055
I am afraid of losing my
life or my relatives' life
due to this outbreak (MH3)
0.055 0.063 0.076 0.13 0.788 0.074 -0.091 -0.06
All the news and numbers
of COVID-19 in different
media increasing my
tension (MH4)
0.117 0.114 0.097 0.049 0.624 0.086 0.039 -0.046
Health system in
Bangladesh (HSB)
There is a lack of trained
doctors and health professional
to deal with the COVID-19 (HSB1)
0.651 0.03 0.099 0.011 0.034 -0.014 -0.022 -0.042
There is a lack of health
facilities to combat the COVID-19
outbreak in Bangladesh (HSB2)
0.74 0.079 0.103 0.214 0.092 0.215 -0.079 0.05
There is a lack of health
infrastructure to deal with
0.745 0.068 0.144 0.202 0.099 0.111 -0.056 0.026
There is a severe lack of
bio-medical waste management
facilities in Bangladesh (HSB4)
0.683 0.11 0.138 0.21 0.055 0.229 -0.077 0.022
There is a lack of COVID-19
testing facility in Bangladesh (HSB5)
0.69 0.133 0.032 0.216 0.041 0.274 -0.038 -0.015
There is a lack of budget or
nancial support to response
to this outbreak (HSB6)
0.536 0.255 0.137 -0.033 0.124 -0.217 0.004 0.104
Governance and
Political issues (GPI)
Bangladesh government can
deal with this outbreak (GPI1)
-0.164 0.003 -0.128 0.008 -0.028 0.114 0.563 -0.102
Government is taking this
outbreak seriously to deal with (GPI2)
-0.007 -0.036 -0.018 -0.13 -0.063 0.112 0.819 0.032
Government is taking proper
decisions in the right time (GPI3)
-0.07 -0.051 0.012 -0.138 -0.046 -0.04 0.811 0.055
Government is involving other
sector actors to combat the
COVID-19 outbreak (GPI4)
0.03 -0.024 0.009 -0.028 -0.006 0.025 0.748 -0.005
Government decisions
and impacts (GDI)
Government need support from the
people to reduce the impact
of COVID-19 (GDI1)
0.203 -0.006 0.092 0.254 0.033 0.627 0.216 -0.06
Government need to formulate
a policy and action plan and
implement it immediately (GDI2)
0.235 0.131 0.036 0.338 0.043 0.592 0.02 -0.064
Shut down or lockdown of
regular activities is a good
decision to reduce the chance of
infection of COVID-19 (GDI3)
0.064 0.042 0.051 0.079 0.191 0.585 0.067 0.08
Shut down or lockdown or social
distancing will have an economic
and social impact in future (GDI4)
0.051 0.362 0.333 0.005 0.04 0.513 0.082 0.094
The formal and informal business
will be hampered (GDI5)
0.075 0.376 0.387 0.003 0.023 0.543 -0.032 0.14
issues (SEI)
Most of the poor people living
in urban areas have to leave
due to not having any options
for income (SEI1)
0.081 0.586 0.155 0.051 0.034 0.203 0.045 -0.01
Many people will lose their
livelihood/jobs at a time (SEI2)
0.016 0.681 0.192 0.171 0.056 0.163 -0.053 0.101
There will be less supply of basic
goods/products for daily use (SEI3)
0.096 0.734 0.154 0.084 0.044 -0.085 0 -0.134
Price of most of the basic products
will be higher than usual (SEI4)
0.11 0.665 0.116 0.073 0.006 0.11 -0.114 -0.048
Poor people will suffer food and
nutritional deciency (SEI5)
0.128 0.576 0.211 0.127 0.002 0.365 -0.075 -0.088
There is a chance of social conict
due to this outbreak (SEI6)
0.119 0.62 0.128 0.12 0.126 -0.103 0.016 0.051
(continued on next page)
M. Shammi et al. Heliyon 6 (2020) e04063
with COVID-19 pandemic, for instance very low ratio of intensive care
unit (ICU) beds to population, limited or centralized COVID-19 testing
facilities along with bias in selecting the test candidates, low test rate,
lack or a substandard quality of personal protective equipment (PPE) for
the caregivers, lack of institutional isolation units, and very poor coor-
dination in health management systems, etc.
Afterwards, the PC2 (Second) elucidated 8.82% of the total variance,
and it was moderately positive loaded with the socioeconomic issues
(SEI), including the risk of poor people from urban areas forced to tem-
porary migration while having no options for income along with the
chance of inducing social conicts due to this outbreak; restriction of
basic supplies including foods; price hikes of commodities, losing jobs
(SEI1-6: 0.5760.734). However, weak but positively loaded socioeco-
nomic issues such as shut down or lockdown or social distancing might
have an economic and social impact in the future (GDI4; 0.362) along
with the small formal and informal business will also be hampered. For
example, small business will lose their regular customers due to shutting
down their business (GDI5:0.376).
The PC3 (Third) explained 8.45% of the variance which was strong
positive loaded with enduring emerging issues (EEI: 0.548 to 0.805). The
major EEIs were stated here as occurring any further natural disasters
such as ood and tropical cyclone (EEI1: 0.548) and their burden on food
security (EEI2: 0.648), mounted economic loss (EEI3: 0.805) due to
damages of business and industrial chains both locally and globally, these
may put further stress as elevating poverty level (EEI4: 0.732) followed
by a chance of inducing severe socioeconomic and health crisis (EEI5:
Furthermore, PC4 (Fourth) elucidated 8.14% of the variance and was
moderate positive loaded of immediate emerging issues (IEI: 0.581 to
0.701). This sector covered very important elements of COVID-19
pandemic in Bangladesh including the chance of community trans-
mission (IEI1: 0.688), huge infection potentials (IEI2: 0.701), but this
Table 2. Test of association between each component and the demographic characteristic using T-test.
t df Sig. (2-tailed) Mean Difference 95% Condence Interval of the Difference
Lower Upper
PC1 4.926 36 0 0.18881 0.1111 0.2665
PC2 5.215 36 0 0.19492 0.1191 0.2707
PC3 5.066 36 0 0.18757 0.1125 0.2627
PC4 5.006 36 0 0.18278 0.1087 0.2568
PC5 3.622 36 0.001 0.13649 0.0601 0.2129
PC6 4.763 36 0 0.15951 0.0916 0.2274
PC7 1.326 36 0.193 0.05481 -0.029 0.1387
PC8 1.472 36 0.15 0.05159 -0.0195 0.1227
Table 1 (continued )
Sector Items PC1 PC2 PC3 PC4 PC5 PC6 PC7 PC8
Immediate emerging
issues (IEI)
There is a chance of community
transmission of COVID-19
in Bangladesh (IEI1)
0.099 0.141 0.12 0.688 0.15 0.054 -0.034 0.093
A huge number of people
will be infected (IEI2)
0.072 0.141 0.13 0.701 0.279 -0.014 -0.084 0.03
There is a chance of not
detecting most of the infected
patients due to lack of health
facilities leads to undermining
the actual infected case (IEI3)
0.218 0.13 0.144 0.661 0.066 0.23 -0.185 0.017
There is a chance to increase
in the number of death for not
having proper health facilities (IEI4)
0.233 0.105 0.244 0.694 0.125 0.228 -0.092 -0.027
Lack of bio-medical waste
management facilities in Bangladesh
will create more problem (IEI5)
0.234 0.111 0.269 0.581 0.162 0.201 -0.037 -0.048
Enduring emerging
issues (EEI)
If any disaster (ood, cyclone etc.) occur
after the COVID-19 situation then it
will create a double burden to
the country (EEI1)
0.199 0.123 0.548 0.299 0.056 0.215 -0.073 -0.013
There is a chance of severe food scarcity
due to these events (COVID-19 þ
Disasters) in the country (EEI2)
0.165 0.227 0.648 0.147 0.103 -0.119 0.028 -0.14
High possibility of huge
economical loss (EEI3)
0.127 0.187 0.805 0.099 0.094 0.159 -0.048 0.03
High possibility of increasing the
poverty level (EEI4)
0.091 0.296 0.732 0.169 0.088 0.123 -0.039 0.003
High possibility of severe socio-
economic and health crisis (EEI5)
0.153 0.265 0.699 0.254 0.044 0.168 -0.071 0.018
Varimax Rotation
Sums of Squared
Eigenvalues 3.275 3.265 3.126 3.012 2.58 2.436 2.389 1.736
% of Variance 8.852 8.824 8.45 8.14 6.974 6.584 6.456 4.692
Cumulative % 8.852 17.676 26.125 34.265 41.239 47.823 54.28 58.971
Bold denotes signicance at >0.5.
M. Shammi et al. Heliyon 6 (2020) e04063
huge number of infection might not be reported due to lack of health
facilities which ultimately undermine the actual cases (IEI3: 0.661), the
lack of health facilities further trigger the chance of a high number of
deaths due to infection (IEI4: 0.694), and the poor facility of biomedical
waste management might be a risk factor for further virus transmission
(IEI5: 0.581) through an unconventional pathway in Bangladesh.
While, PC5 (Fifth) explained 6.97% of the total variances, and it
showed strong positive loadings with mental health issues (MH: 0.624 to
0.838) such as people are afraid of coronavirus recent outbreak in
Bangladesh (MH1), fear of getting coronavirus infection (MH2), and
afraid of losing life or relatives' life due to this outbreak (MH3) (MHI1-
3:0.758-0.838); and a moderate positive loading of all the news and
numbers of COVID-19 in different media increasing tension and anxiety
(MH4: 0.624). This result indicates the mental health burden in
Bangladesh due to COVID-19. Thus the question arises: What should be
the role of the GoB during the global pandemic to safeguard its citizens?
The following PC6 (Sixth) might produce some indication regarding
the question, which accounted for 6.58% of the variance. The PC6 was
Table 3. Estimated model of multiple regression.
Model-1: Dependent Variable: MH1 (R ¼0.991, R Square ¼0.975)
Unstandardized Coefcients Standardized Coefcients t Sig. 95.0% Condence Interval for B
B Std. Error Beta Lower Bound Upper Bound
(Constant) -0.009 0.02 -0.453 0.669 -0.06 0.042
MH2 0.897 0.055 0.976 16.179 0 0.754 1.039
IEI3 0.17 0.065 0.157 2.597 0.048 0.002 0.338
Model-2: Dependent Variable: HSB6 (R¼1, R Square¼1)
(Constant) 0.085 0 3087.118 0 0.084 0.085
HSB1 0.86 0 0.893 2436.454 0 0.856 0.865
GDI1 -0.401 0 -0.392 -1583.19 0 -0.404 -0.397
SEI1 0.73 0.001 0.633 1256.524 0.001 0.723 0.738
SEI5 -0.497 0.001 -0.51 -863.253 0.001 -0.504 -0.489
GPI3 -0.06 0 -0.082 -324.713 0.002 -0.062 -0.057
HSB2 -0.037 0 -0.041 -96.705 0.007 -0.042 -0.032
Model-3: Dependent Variable: GDI1 (R¼1, R Square¼1)
(Constant) 0.087 0 364.433 0.002 0.084 0.09
GDI2 0.712 0 0.707 2025.783 0 0.707 0.716
GPI2 0.153 0 0.214 560.211 0.001 0.149 0.156
SEI6 -0.903 0.002 -0.883 -500.629 0.001 -0.926 -0.88
SEI3 0.503 0.001 0.625 376.743 0.002 0.486 0.52
GDI3 0.081 0 0.069 313.709 0.002 0.077 0.084
EEI5 0.023 0 0.025 74.962 0.008 0.019 0.026
Modle-4: Dependent Variable: SEI5 (R¼0.997, R Square¼0.993)
(Constant) -0.076 0.014 -5.529 0.005 -0.114 -0.038
SEI1 0.997 0.049 0.841 20.43 0 0.862 1.133
GDI2 0.304 0.045 0.287 6.731 0.003 0.178 0.429
EEI1 0.225 0.049 0.195 4.585 0.01 0.089 0.361
Model-5: Dependent Variable: IEI2 (R¼1, R Square¼1)
(Constant) -0.05 0 -1261.6 0.001 -0.05 -0.049
IEI1 1.07 0 0.956 10993.03 0 1.068 1.071
MH4 0.274 0 0.229 600.686 0.001 0.269 0.28
GDI3 -0.089 0 -0.066 -1241.36 0.001 -0.09 -0.088
EEI4 0.042 0 0.042 887.841 0.001 0.041 0.043
HSB1 -0.023 0 -0.021 -422.45 0.002 -0.024 -0.022
MH3 0.014 0 0.016 41.82 0.015 0.01 0.019
Model-6: Dependent Variable: EEI5 (R¼0.996, R Square¼0.993)
(Constant) -0.001 0.011 -0.045 0.966 -0.03 0.029
EEI4 0.623 0.076 0.645 8.23 0 0.428 0.818
EEI1 0.46 0.094 0.383 4.889 0.005 0.218 0.702
Table 4. Cronbach's alpha value for composite score development.
Cronbach's Alpha N of Items
Individual Mental health condition (MH) 0.79 4
Health system in Bangladesh (HSB) 0.783 6
Governance and Political issues (GPI) 0.742 4
Government decisions and impacts (GDI) 0.719 5
Socio-economic issues (SEI) 0.78 6
Immediate emerging issues (IEI) 0.821 5
Enduring emerging issues (EEI) 0.839 5
M. Shammi et al. Heliyon 6 (2020) e04063
moderate but positively loaded of the government decision and impacts
issues (GDI: 0.513 to 0.627), including the government need supports
from the people to reduce the impact of COVID-19 (GDI1: 0.627) and also
need to formulate a strong policy and action plan, and implement it
immediately (GDI2: 0.592); also moderate positively loaded of the gov-
ernment decision and impact issues (GDI3-5: 0.5130.585). These de-
cisions were declared without a proper strategy of implementation and
exit plan that might lead to huge mismanagement during the partial
lockdown period in Bangladesh. This lack of coordination in policy
formulation further linked with the PC7 (Seventh), elucidated 6.46% of
the total variances and were strong positive loading of the government
and political issues (GPI: 0.563 to 0.819). The loading elements were as
follows: the capacity of dealing with the pandemic (GPI1: 0.563); seri-
ousness in dealing with it (GPI2: 0.819); timely decision taking (GPI3:
0.811); involvement of other stakeholders properly (GPI4: 0.748). These
are very crucial elements in terms of COVID-19 pandemic management,
therefore failing to address this issue might produce huge aftermath.
Finally, the PC8 (eighth) elucidated 4.692% of the total variances and
strongly loaded with demographic characteristics such as age (0.893) and
occupation (0.883).
3.3. Professional risk groups of socioeconomic crisis and mental stress
Results of t-Test and one-way ANOVA showed that all PCs exhibited a
strong association among them except for PC7 (Governance and Political
issues) and PC8 (demographic characteristics) (Table 2). However, a
One-way ANOVA test between 35 items and the age and occupation of
the participants were conducted which is presented in Table S2 and S3. A
strong association between age and MH3, MH4, and EEI2 were found
which represents that different age groups are afraid of getting corona-
virus and losing their lives due to this outbreak. Also, climate change
vulnerability and possible dengue outbreak in the country are creating
mental stress among different age groups. Furthermore, a strong associ-
ation between occupation and HSB1, SEI3, SEI5, and EEI2 represents that
there is lack of trained health professional in the country, a supply of
basic products will be reduced due to lockdown and fewer supplies, and
poor people will suffer food and nutritional deciency due to loss of
livelihood. Also, different professions such as doctors, police, and banker
are at higher risk of infection.
3.4. Strategy, actions and individual role in public wellbeing and
socioeconomic crisis
The multiple linear regression model was applied to estimate the
individual mental health condition (MH) performance in model 1
(Table 3). The results indicate that the independent variable MH2 and
IEI3 was statistically signicant and had a positive inuence on MH1
(dependent Variable). From this model, it was found that coronavirus
outbreak, lack of testing capacity undermining the actual cases with a
lack of health facilities are inducing individual mental stress.
For model 2, the results indicate that HSB1 and SEI1 had a positive
impact whereas GDI1, SEI5, GPI3, HSB2 had a negative impact on HSB6.
From this model, it is found that lack of budget or nancial support has
created constrained to COVID-19 response and created a scarcity of
trained health professionals, which enforced to shut down the regular
activities in the urban areas and poor people lose their income options.
Due to this, people are suffering food and nutritional deciency and the
government is not getting proper support from the people to reduce the
impact of the COVID-19 outbreak. Not having a proper response plan
with the budget was not a good decision of the government, which
created a lack of health facilities to combat this outbreak in Bangladesh.
For model 3, GDI2, GPI2, SEI6, SEI3, GDI3, and EEI5 were statistically
signicant and had a signicant effect on GDI1. This model depicts the
role of general people to assist the implementation of government actions
against COVID-19 in Bangladesh such as the implementation of proper
lockdown and social distancing, relief supports to the poor people, pre-
venting potential socioeconomic burden, and ensuring the safeguard of
the country.
For model 4, GDI2 and EEI1 were statistically signicant and had a
signicant effect on SEI5. This means a strong coordinated strategy is
warranted to tackle such unprecedented events as Bangladesh is one of
the vulnerable countries in the world. Especially, the months from April
to September is especially important in terms of natural disaster
vulnerability in Bangladesh.
For model 5, IEI1, MH4, GDI3, EEI4, HSB1, MH3 were statistically
signicant and had a substantial effect on IEI2. This model can be suit-
able to explain the most potential risk factors for the negative impacts of
COVID-19 pandemic in Bangladesh including mental health and poverty.
For model 6, EEI4 and EEI1 were statistically signicant and had a
signicant effect on EEI5. This unprecedented chain of events could be a
Table 5. Descriptive overview of respondents on psychosocial, and socio-economic crisis due to COVID-19 pandemic in Bangladesh.
Mean Std. Error of Mean Median Mode Std. Deviation Variance Skewness Kurtosis Minimum Maximum
Individual Mental health condition (MH) 4.04 0.03 4.25 5 0.83 0.69 -1.04 0.94 1 5
Health system in Bangladesh (HSB) 4.47 0.02 4.67 5 0.61 0.37 -2.28 7.93 1 5
Governance and Political issues (GPI) 2.63 0.03 2.50 2.25 0.91 0.83 0.29 -0.38 1 5
Government decisions and impacts (GDI) 4.56 0.02 4.60 5 0.51 0.26 -2.70 12.53 1 5
Socio-economic issues (SEI) 4.28 0.02 4.33 5 0.62 0.39 -1.30 2.93 1 5
Immediate emerging issues (IEI) 4.44 0.02 4.60 5 0.61 0.37 -1.75 5.11 1 5
Enduring emerging issues (EEI) 4.49 0.02 4.60 5 0.58 0.33 -1.49 3.28 1 5
Table 6. Correlation matrix of people's perception.
MH 1
HSB .254** 1
GPI -.117** -.148** 1
GDI .235** .384** .083** 1
SEI .205** .349** -.100** .447** 1
IEI .426** .465** -.225** .475** .390** 1
EEI .267** .417** -.124** .482** .561** .527** 1
Correlation is signicant at the 0.01 level (2-tailed).
M. Shammi et al. Heliyon 6 (2020) e04063
potential threat to the COVID-19 response and rehabilitation efforts by
the GoB. However, there was signicant evidence (R
¼>0.97) that the
independent variables in the proposed models adequately described in
the inuence of dependent variables (Table 3).
3.5. Descriptive overview of governance, perceived socioeconomic crisis
and mental stress
CTT analysis was applied to examine the reliability of each item ac-
cording to the components to develop a composite score. The Cronbach's
alpha values varied from 0.719 to 0.839 (>0.70), indicating that a
composite score for the entire scale can be generated to have a descrip-
tive overview of respondents' perceived mental stress, and socioeconomic
crisis (Table 4). On the scale of 15 (strongly disagree to strongly agree),
for an individual mental health condition (MH), it was found that the
composite mean is 4.04 0.03 which represents that the participants are
mentally stressed and afraid of COVID-19 outbreak in Bangladesh
(Table 5). The source of such stresses and fears might be linked to factors
such as fragile healthcare systems with poor management, low test rates,
weak medical infrastructures, weakness in planning, and implementation
of the COVID-19 response strategy by the GoB. The following further
sectors results indicate the correctness of the claims as to the case of the
health system in Bangladesh, with a mean of 4.47 0.02 represents that
the health systems in Bangladesh are very fragile to combat the COVID-
19 spread in Bangladesh. The weak coordination is consenting to gov-
ernment political issues (GPI), with a mean of 2.63 0.03 represents that
the government is not taking a proper decision at the right time to reduce
the effect of this pandemic. In summary, respondents had negative
viewpoints about the government is taking a proper decision in the
For government decisions and impacts (GDI), with a mean of 4.56
0.02 represent that the government's decision to lock down the activities
was right. Also, the lockdown of activities created economic impacts.
Despite the huge future economic burden, the GoB took the challenge to
implement partial lockdown in the country. However, this lockdown for a
long time might not be carried out rather it become loosen day by day
due to many socioeconomic factors and pressure from the industrial
sectors in Bangladesh. With a mean value of 4.28 0.02 for the socio-
economic issues (SEI) that represents the poor and marginalized people
will suffer a lot due to the COVID-19 outbreak in Bangladesh. Besides,
with a mean value of 4.44 0.02 for the immediate emerging issues
(IEI), it can be summarized as: the number of infections and death will
increase due to the fragile heal care system and improper biowaste
management. Some mismanagement in the industrial stakeholders and
lack of coordination among the responsible national COVID-19 response
committee already happened in Bangladesh. Furthermore, with a mean
value of 4.49 0.02 for enduring emerging issues (EEI), there is a change
of sever health and socioeconomic crisis if climate change-induced di-
sasters and dengue outbreak happen in the same year. For instance, the
early ash ood might bring sufferings for the poor people and farmers of
Bangladesh. Which in turn, puts excessive stress on the food security
issue of the country.
The individual mental health (MH) had a statistically positive sig-
nicant correlation with other issues (MH vs HSB, SEI, IEI, GDI, EEI) and
their correlation values ranged from 0.205 to 426 while MH had a sta-
tistically negative signicant correlation with GPI (r ¼-0.117, p <0.01)
(Table 6). The GPI had a statistically negative relationship with other
issues (GPI vs SEI, IEI, EEI, MH) and their correlation values varied from
-0.10 to -0.225 whereas the GPI had a signicant positive relationship
with GDI (r ¼0.083, p <0.01). The moderate signicant correlation was
observed between pairs e.g., SEI vs EEI (r ¼0.561, p <0.01), and EEI vs
IEI (r ¼0.527, p <0.01). The weak positive signicant correlation was
identied between pairs such as HSB vs GDI (r ¼0.384, p <0.01), EEI vs
GDI (r ¼0.482, p <0.01), and SEI vs HSB (r ¼0.349, p <0.01). These
results indicate a diversied nature of the peoples' perception regarding
the COVID-19 management and response in Bangladesh.
Further, the cluster analysis detected the total status of regional
variations, and how socioeconomic and environmental crises inuence
Figure 3. Dendrogram showing the clustering of people's perceptions on COVID-19 outbreak in Bangladesh.
M. Shammi et al. Heliyon 6 (2020) e04063
further mental stress development (Figure 3). All the parameters were
classied into two major groups: cluster-1(C1), and cluster-2 (C2). C1
composed of socioeconomic issues (SEI), enduring emergency issues
(EEI), government decision and impact issue (GDI), immediate emer-
gency issue (IEI), the health system in Bangladesh (HSB) and individual
mental health (MH). C2 consisted of government political issues (GPI). It
can be concluded that all the issues depend on governance and political
aspects in Bangladesh.
4. Discussion
4.1. Strengthening healthcare system
The remarkable interferences and ventures in public health by the
governmental authority can control a pandemic where good governance
and good functional policy in the healthcare system exists. Tight lock-
down, mass people quarantine, increased testing facilities, government
stimulus packages, faster policy intervention and implementation have
prevented COVID-19 virus from spreading transmission between humans
in China, Hong Kong, South Korea, Vietnam, Taiwan, Singapore well to
date, despite initial cases (Anderson et al., 2020;Zhang et al., 2020). The
experiences gathered from across the globe, indicates that the
patient-management decisions, early diagnosis, and rapid testing and
detection are urgent in COVID-19 pandemic management (Binnicker,
2020). There is no doubt that the number of infections and death from
COVID-19 increases where a fragile and corrupt healthcare system exists.
So far, the fatality rate due to the COVID-19 is 1.52% in Bangladesh
(WHO, 2020a,b). However, the reported case numbers are given by the
Bangladesh Government certainly underestimates the actual number of
infected persons given the shortages or unavailability of test kits (Ebra-
him et al., 2020). The laboratory facilities for testing are only accessible
in the urban areas and 33 testing laboratories are still a few numbers in a
country of 165 million population. The fear of getting the virus-infected
along with the administrative procedure of testing and reluctance of
other private clinics and hospitals to admit patients is a sign of weak
governance in the healthcare of Bangladesh. In this scenario, other crit-
ical care patients are denied admittances, negligence, and often left to die
without treatments. After the detection of the rst COVID-19 case in
Bangladesh, at least 929 þdeath cases having COVID-19 like symptoms
were reported in the different national daily newspapers until 10 May
2020, which is 3 times higher than the reported deaths by the GoB. This
indicates a serious level of community transmission is occurring in
Decentralization of testing and strengthening treatment facilities are
therefore required for the healthcare systems to combat the pandemic
and the treatment should reach in rural areas. The urban-rural disparity
in the facilities should be reduced as the rural practitioners and health-
care workers are equally at the risk of the pandemic. Moreover, the
administrative procedure of the deceased to burial put another confusion
and religious fear in the minds of the common people as the victims to
COVID-19 are buried without Muslim funeral procedures of baths and the
presence of family members and relatives. In this scenario, it is impera-
tive to deal with the peoples' fear and anxiety by the government. Proper
information should be circulated to get the people out of confusion.
Media partnerships should be created to prevent societal fear (Hopman
et al., 2020).
4.2. Taking intervention in mental stress and social conict counselling
By quick administrative action and raising awareness in individuals
for social-distancing and stringent steps were taken to manage the spread
of disease by cancelling thousands of activities of social gatherings in
ofces, clubs, classrooms, reception centres, transport services, travel
restrictions, contact tracing leaving the countries in complete lockdown
(Hopman et al., 2020;Cohen and Kupferschmidt, 2020). Yet weeks of
being in isolation, quarantine, physical trauma creates further loneliness
and anxiety and issues of a mental health crisis that have been mostly
overlooked. At the individual level and the government level, proper risk
communication is required. Special attention should be given to combat
child and women abuse. Necessary action should be proposed for the
post-recovery phase, suicide prevention, and mental health management
(Duan and Zhu, 2020;Gunnell et al., 2020;Mamun et al., 2020). Several
cases of suicide were reported due to the fear and stress of COVID-19
infection symptoms, job-loss, sudden fall to extreme poverty, economic
crisis, hunger, and unable to cope with social hatred. This kind of trau-
matic situation should be dealt with immediately by the government
through proper community counselling.
Small children are highly vulnerable to abuse if parent(s)/caregivers
are quarantined. Moreover, with limited or no outdoor activities and no
schooling makes them mentally stressed. Moreover, to maintain family
hygiene in the pandemic, the burden just increases on the women along
with her regular household activities. Likewise, it escalated family con-
icts between men and women arising from physical and mental assault
towards women. Students are also vulnerable to mental pressure as their
education life is extended and posing an uncertain future caused by the
pandemic. The Shutdown of all educational institutions may increase
hatred and mentally depressed young which should be dealt with proper
4.3. Backing up emergency service providers
In any successful governance, a competent early warning system and
efcient analysis of the situation, interpretation, sharing, and use of
relevant evidence and epidemiological knowledge is required (Gu and Li,
2020). In particular, epidemiological outcomes need to be informed on
time so that they can be accurately evaluated and explained to the gen-
eral people (Xiao and Torok, 2020). The low quality and an inadequate
number of personal protective equipment (PPE) along with insufcient
training to use PPE caused doctors and healthcare professionals infected
across the country. Already 11% of the doctors and healthcare workers
are infected with COVID-19. Moreover, members of Bangladesh police,
armed forces, and rapid action battalion (RAB) along with other security
agencies who have been jointly working to ensure social distancing
across the country are at high risk of being infected. Already 914 mem-
bers of security forces have been infected with several reported deaths.
Besides, bankers, RMG factory workers, businessmen, shop keepers, daily
wedge earners are at higher risk of infection.
4.4. Inclusive plan to protect the vulnerable communities amidst the
pandemic and upcoming environmental disasters
Societies where underserved communities exist, they strongly fear
government information and politics. The ultra-poor are often being left
out of the relief program during the disasters. Public risk communica-
tions are therefore needed to let people know about the mental and social
risk of elderly, children, people with special needs, disabled as they are
susceptible to mental stress, and other disasters.
It should be mentioned here that government plans on pandemic
control, risk alleviation, and social management must be as inclusive as
possible. An inclusive commitment means responding to COVID-19
pandemic in a way that is sensitive to the most vulnerable commu-
nities, including ultra-poor, daily wedge earners, homeless people, un-
employed, indigenous communities, immigrant communities, people
with disabilities, and certain frontline healthcare workers and emergency
responders. Prison centres, nursing homes, orphanages, homeless shel-
ters, and refugee camps can be a focus for disease outbreaks; people in
such settings often have inadequate access to basic healthcare and
comorbidities that increase the risk of serious illness (Berger et al., 2020).
Moreover, the government should take proper strategy to protect the
agricultural farmers and their crops amidst the pandemic to strengthen
the food security of the country and maintain the supply chain to
M. Shammi et al. Heliyon 6 (2020) e04063
As a country of climate change vulnerability, there might be some
additional risk factors of occurring natural disasters such as tropical cy-
clones, ash oods which may add further tolls for the country. More-
over, the shutdown of all kinds of business centres except groceries,
pharmacies, and other daily necessities puts stress on the country's
economy and nancial burden. With RMG factories and other industrial
production resumed from 26 April, another infectious outbreak of
dengue along with critical level community transmission of coronavirus
might have a cumulative/synergistic negative impact on the public
health systems in Bangladesh. In this situation factory operation should
be maintained with minimum social distancing; water, sanitation, and
hygiene (WASH) kit; occupational health and safety guideline, and good
healthcare management. BGMEA should be the monitoring body and
draw safety protocols to protect the workers while maintaining public
5. Concluding remarks
This perception-based study tried to visualize the mental stresses as
well as the socioeconomic crisis due to the COVID-19 pandemic in
Bangladesh. It can be undoubtedly established that mental stress due to
the COVID-19 is because of the lockdown without ensuring the funda-
mental needs of the vulnerable ones. The weak governance in the
healthcare systems and the facilities further exacerbates the general
public's anxiety. The urban COVID-19 testing facilities, long serial to be
tested, lowest facilities in the dedicated hospital units for COVID-19
patients hampered the other critical patients to get healthcare services.
It was a good decision by the government to recruit 6000 doctors and
nurses to combat this pandemic. The government needs to take decisions
to implement testing facilities for both public and private clinical labo-
ratories all over Bangladesh. As with the COVID-19 outbreak, other
critical care patients and infectious diseases such as dengue testing are
being affected and patients are being deprived. It is also timely steps that
the government starts measures on dengue testing as well to all the
COVID-19 patients.
However, numerous mental wellbeing and socioeconomic factors that
have been identied in the study are already threatening public with fear
and anxiety can be considered for the upcoming threat due to COVID-19
in Bangladesh are as follows; risk of community transmission, healthcare
capacity, governance coordination and transparency, relief for the low-
income population, proper biomedical waste management through
incineration, and preparation for the possible natural disasters. The
recommendations collected in the perception study can be summarized
as to increase COVID-test rate and medical facilities. The strengthening
and decentralization of the COVID-19 medical facilities and treatment
are especially important for all 64 districts as the disease spread to entire
Bangladesh. Besides, proper risk assessment and dependable risk com-
munications, multi-sectoral management taskforce development, take
care of biomedical waste, ensure basic supports to the people who need,
and good governance was suggested to reduce mental and social stress
causing a socioeconomic crisis of COVID-19 outbreak in Bangladesh.
Finally, this assessment process could help the government and policy-
makers to judge the public perceptions in an emergency situation to deal
with COVID-19 pandemic in densely populated lower-middle-income
countries like Bangladesh.
Author contribution statement
M. Shammi: Conceived and designed the experiments; Analyzed and
interpreted the data; Wrote the paper.
M. Bodrud-Doza: Conceived and designed the experiments; Per-
formed the experiments; Analyzed and interpreted the data; Contributed
reagents, materials, analysis tools or data.
A. R. M. Towqul Islam: Performed the experiments; Analyzed and
interpreted the data; Contributed reagents, materials, analysis tools or
M. Mostazur Rahman: Conceived and designed the experiments;
Performed the experiments; Wrote the paper.
Funding statement
This research did not receive any specic grant from funding agencies
in the public, commercial, or not-for-prot sectors.
Competing interest statement
The authors declare no conict of interest.
Additional information
Supplementary content related to this article has been published
online at
The authors would like to acknowledge all the frontline doctors
ghting this pandemic and all the researchers cited in the references.
Also, the authors are gratefull to all the participants in this study.
Ahorsu, D.K., Lin, C.-Y., Imani, V., Saffari, M., Grifths, M.D., Pakpour, A.H., 2020. The
fear of COVID-19 scale: development and initial validation. Int. J. Ment. Health
Anderson, R.M., Heesterbeek, H., Klinkenberg, D., Hollingsworth, T.D., 2020. How will
country-based mitigation measures inuence the course of the COVID-19 epidemic?
Lancet 395 (10228), 931934.
BTRC, 2020. Internet Subscribers in Bangladesh February, 2020. http://www.btrc.g
Berger, Z.D., Evans, N.G., Phelan, A.L., Silverman, R.D., 2020. Covid-19: control measures
must be equitable and inclusive. BMJ 368, m1141.
Binnicker, M.J., 2020. Emergence of a novel coronavirus disease (COVID-19) and the
importance of diagnostic testing: why partnership between clinical laboratories,
public health agencies, and industry is essential to control the outbreak. Clin. Chem.
Bodrud-Doza, M., Islam, A.R.M.T., Ahmed, F., Das, S., Saha, N., Rahman, M.S., 2016.
Characterization of groundwater quality using water evaluation indices, multivariate
statistics and geostatistics in central Bangladesh. Water Sci. 33 (1), 1940.
Cohen, J., Kupferschmidt, K., 2020. Countries test tactics in waragainst COVID-19.
Science 367 (6484), 12871288.
DeVellis, R.F., 1991. Scale Development: Theory and Applications. SAGE Publications,
Newbury Park, CA.
Duan, L., Zhu, G., 2020. Psychological interventions for people affected by the COVID-19
epidemic. Lancet Psychol. 7 (4), 300302.
Ebrahim, S.H., Ahmed, Q.A., Gozzer, E., Schlagenhauf, P., Memish, Z.A., 2020. Covid-19
and community mitigation strategies in a pandemic. BMJ 368, m1066.
Gates, B., 2020. Responding to Covid-19 a once-in-a-Century pandemic? N. Engl. J.
Med. 2003762.
Gu, E., Li, L., 2020. Crippled community governance and suppressed scientic/
professional communities: a critical assessment of failed early warning for the
COVID-19 outbreak in China. J. Chin. Govern 118.
Gunnell, D., Appleby, L., Arensman, E., Hawton, K., John, A., Kapur, N., Yip, P.S.F., 2020.
Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychol.
Hair, J.F., Black, W.C., Babin, B.J., Anderson, R.E., 2014. Multivariate Data Analysis.
Pearson Education limited.
Hopman, J., Allegranzi, B., Mehtar, S., 2020. Managing COVID-19 in low- and middle-
income countries. JAMA.
IEDCR/DGHS/GoB, 2020. Coronavirus COVID-19 Dashboard, p. 2020. http://103.247.2
Islam, A.R.M.T., Mamun, A.A., Zahid, A., Rahman, M.M., 2020. Simultaneous comparison
of modied-integrated water quality and entropy weighted indices: implication for
safe drinking water in the coastal region of Bangladesh. Ecol. Indicat. 113, 106229.
Islam, A.R.M.T., Ahmed, N., Bodrud-Doza, M., Chu, R., 2017. Characterizing groundwater
quality ranks for drinking purposes in Sylhet district, Bangladesh, using entropy
method, spatial autocorrelation index, and geostatistics. Environ. Sci. Pollut. Res. 24
(34), 2635026374.
Liu, C.W., Lin, K.H., Kuo, Y.M., 2003. Application of factor analysis in the assessment of
groundwater quality in a Blackfoot disease area in Taiwan. Sci. Total Environ. 313 (1-
3), 7789.
M. Shammi et al. Heliyon 6 (2020) e04063
Mamun, M.A., Siddique, A.B., Sikder, M.T., Grifths, M.D., 2020. Student suicide risk and
gender: a retrospective study from Bangladeshi press reports. Int. J. Ment. Health
TBS, 2020a. Fear, Hatred and Stigmatization Grip Bangladesh amid Covid-19 outbreak.
In: Archived Newspaper the Business Standard.
(Accessed 26 March 2020).
TBS, 2020b. Coronavirus Cases Detected in Cox's Bazar Rohingya camps. In: Archived
Newspaper the Business Standard.
(Accessed 15 May 2020).
Wang, G., Zhang, Y., Zhao, J., Zhang, J., Jiang, F., 2020. Mitigate the effects of home
connement on children during the COVID-19 outbreak. Lancet 395 (10228),
WHO, 2020a. Coronavirus Disease 2019 (COVID-19) Situation Report 51.
reports/20200311-sitrep-51-covid-19.pdf?sfvrsn¼1ba62e57_10 access. (Accessed 30
March 2020).
WHO, 2020b. Coronavirus Disease 2019 (COVID-19) Situation Report 63.
/20200323-sitrep-63-covid-19.pdf?sfvrsn¼b617302d_4 access. (Accessed 30 March
Worldometers, 2020. COVID-19 Coronavirus Pandemic. https://www.worldometer
Xiao, Y., Torok, M.E., 2020. Taking the right measures to control COVID-19. Lancet Infect.
Zhang, S., Wang, Z., Chang, R., Wang, H., Xu, C., Yu, X., Tsamlag, L., Dong, Y., Wang, H.,
Cai, Y., 2020. COVID-19 containment: China provides important lessons for global
response. Front. Med.
M. Shammi et al. Heliyon 6 (2020) e04063
... The evidence obtained from all over the world, even in developed countries, shows that hospitals are not sufficiently prepared for biological events [8][9][10][11]. The severe lack of resources and facilities in the recent global pandemics of SARS, MERS, and Covid-19 proves this unpreparedness [12,13]. Previous research has emphasized the significance of temporary medical centers to effectively use the limited resources for saving more patients. ...
... Depending on the type of accident, the establishment of health care centers has an important effect on reducing the impact of disasters as well as saving human lives. For, active hospitals may lose their efficiency during disasters due to the high number of referrals in a short period [12]. Therefore, temporary medical centers should be established as vital tools in times of crisis. ...
... An acute scarcity of resources and facilities has also been experienced at the global level in the SARS, MERS, and COVID-19 epidemics and pandemics [4,5]. Outbreaks of diseases can have destructive consequences, such as high mortality and social/economic dysfunction, paralyzing health system infrastructures. ...
Background: Temporary medical centers can properly compensate for the shortage of hospitals during biological emergencies. They bolster the capacity of medical centers regarding patient admissions, provide efficient care, and mitigate the progression of critical situations. This study aims to identify the advantages of setting up temporary medical centers in responding to the COVID-19 pandemic. Materials and Methods: This qualitative study engaged 25 people involved in managing temporary medical centers during the COVID-19 pandemic. The participants included patients, construction experts, and specialists who equipped and set up temporary medical centers in Tehran City, Iran. All had possessed a history of responding to biological agents. Considering the maximal diversity, the participants were selected based on work experience, age, gender, education level, and managerial background. The inclusion criteria comprised willingness to participate, ability to communicate with the interviewer, and informed consent. The exclusion criterion included the inability to continue the research. The study data were analyzed by MAXQDA-2020 software using the Graneheim and Lundman method. The results were validated against the Guba and Lincoln criteria. Results: Based on the results, the advantages of temporary medical centers were classified into 8 sub-themes: human-centered care, quick performance and response, helping the health system, preventing the burnout of treatment staff, saving the costs, justice and equality, leveling and providing classified services at various levels, and timely patient transfer. Conclusion: With specific criteria for accepting patients, temporary medical centers ensure their safety in care, help to break internal transmission, and pay attention to patients’ social and emotional needs. As a rapid response mechanism, they can answer to the current COVID-19 pandemic and other epidemics in future disasters. The result of this study can help manage biological emergencies in the future, as it presents a clear picture of the advantages of temporary treatment centers.
... The extensive Covid-19 mitigation actions nationally had resulted in slowing down of the agrarian activities like input availability, restricted labour movement, delay in timely field operations, disruptions in normal supply chains creating hardship environment for the farming community along with other sectors. [1,3,14]. Covid-19 pandemic apart from its major impact on physical health, also created great distress regarding the mental health and well being of the individuals and the dryland farming community is no such exception to it. ...
The inadequate planning and preparation by governments before the sudden imposition of lockdowns to tackle the COVID-19 pandemic have inflicted a severe blow to India's economy, causing immense hardships, particularly to the working people and the informal rural economy. The peak of the Rabi crop harvesting season in March 2020 coincided with the nationwide lockdown, leading to significant losses for farmers in the north-western regions. The rural areas, heavily reliant on agriculture and allied sectors, faced disruptions in input availability, labor movement, and supply chains, impacting the livelihoods of nearly 50% of the workforce. This study focuses on the adaptation strategies employed by dryland farmers in Andhra Pradesh and Karnataka during the pandemic. The research explores various dimensions, including health and psychological adaptations, farming practices, financial adjustments, and marketing strategies. The findings reveal that farmers, facing dual challenges of health and economic crises, resorted to diverse adaptation measures to mitigate the impact. At the individual level, farmers prioritized precautionary measures, government regulations, and engaging in productive work to cope with anxiety. Families emphasized maintaining hygiene, avoiding discussions about the pandemic at home, and sharing financial difficulties equally. At the village level, preventive measures, social distancing in markets and agricultural operations, and making masks compulsory were widely adopted. In terms of farming adaptations, farmers faced disruptions in the availability of quality seeds, fertilizers, and pesticides, leading to increased expenditures. Financial adaptations included increased borrowing from financial institutions and private money lenders, utilization of long-term savings, and involving family members in agricultural activities to reduce costs. Marketing strategies saw a shift towards selling to retailers and exploring mobile agricultural marketing, while some farmers faced challenges due to low prices and transportation issues. Despite the immense challenges, farmers exhibited resilience by implementing various adaptation strategies to protect themselves and their farming activities. The study underscores the need for a comprehensive understanding of the impact of the pandemic on Indian farmers, addressing research questions related to adaptation strategies at different levels.
... It is necessary to mention and adopt methods for the separation, collection, storage, transportation, and disposal of waste produced with regard to the BMW management guidelines [32,33]. Investment in healthcare facilities and the recruitment of trained health workers are critical to increasing treatment capacity [34,35]. Different methods of disinfection such as hydrogen peroxide steam, washing, ultraviolet (UV) disinfection lamps, humidifiers, gamma radiation, alcohol solutions of 75%, and ethylene oxides can be considered [36][37][38][39][40][41]. ...
Full-text available
Biomedical waste (BMW), encompassing hazardous medical materials, poses environmental and public health risks if not correctly managed. The Central Pollution Control Board (CPCB) in India is a statutory organization that oversees BMW disposal standards, aimed at mitigating these hazards. BMW mismanagement is a major problem and potentially poses threats to the environment as well as public health. During the coronavirus disease 2019 (COVID-19) pandemic, increased use of personal protective equipment (PPE) and other medical equipment was witnessed which led to a marked raised BMW generation. To ensure proper and optimized BMW management, CPCB established guidelines and rules to be followed by the medical facilities as well as the common BMW treatment facilities (CBWTFs). The challenges in implementing proper waste management practices were lack of awareness and inadequate infrastructure. Strategies for better BMW management were proposed, including color-coded bins, improved infrastructure, advanced technology, and awareness campaigns. Highlighting CPCB's vital role, this emphasizes healthcare facilities' proactive role in implementing and evolving regulations for sustainable BMW disposal, ensuring both public health and environmental well-being through compliance and responsible waste management partnerships.
... Some developing countries have also successfully controlled the virus through effective governance measures, such as China and Vietnam (Earl & Vietnam, 2020). Conversely, Bangladesh failed to effectively assess the pandemic's effects, making it challenging to control the spread of the virus before it took hold of thousands of citizens (Shammi et al., 2020). ...
Full-text available
This paper draws upon a theoretical framework for resource allocation to examine the differences in resource allocation capabilities of city governments that result from harnessing intelligent urban systems, also known as smart city construction. By analyzing data from 141 Chinese cities in 2020, we demonstrate that smart city construction has a positive influence on government resource allocation capacity. Moreover, we find that this positive relationship is strengthened when there is sufficient regional resource stock and weakened by the complexity of regional pandemics. This study highlights the critical mechanism of harnessing intelligent urban systems to optimize government resource allocation, contributing to the literature on resource allocation in public sectors, and providing clear practical implications for effective crisis management.
... (9). There were only a few Covid-19 dedicated hospitals initially and unavailability of the fundamental needs for the health personnel arguably resulted in mental stress for healthcare personnel (10). Hospital administration was unable to provide a good number of Personal Protective Equipment (PPE) and at some point, doctors had to manage their PPE at their own expense. ...
Full-text available
Background COVID-19 is a new infectious disease with a high rate of transmission and morbidity. In Bangladesh, the first COVID-19 patient was detected in March 2020, and the number of COVID cases was close to 800,000, and nearly 12,000 deaths have occurred. The number of efficient doctors and other healthcare workers was relatively low to adequately cater to the daily new cases of COVID-19. Coping with new situations has been a source of psychological issues among frontline physicians, and working under limited resources has added more stress. This study synthesizes the results of 74 online surveys and 10 interviews as part of a case study. A quantitative online study using Microsoft form was conducted among a sample of 74 medical doctors, and whom 47 were frontline doctors and 27 doctors had not been exposed to the COVID ward or patient. The purpose of the Microsoft form was to maintain the confidentiality of the study participants. Participants included in the study were the doctors who worked in a COVID-dedicated hospital and the participants were chosen by snowball technique. All the participants were anonymous; interviews were taken online, and no personal information was asked during the interviews. Interviews were audio recorded, transcribed, translated from Bangla to English, and then hand-coded for content analysis. SPSS-23 has been used to analyze the statistical part. Result: This study investigates the mental health issues brought on by encounters with explanatory models, the impact of resource constraints, challenges, and consequences, as well as coping techniques among frontline doctors during the early pandemic wave. Only 10.8% of workers received proper PPE, yet 64.9% lacked sufficient safety gear. Furthermore, a lack of PPE caused 77% of the 74 respondents to become fearful. During the COVID-19 pandemic, 50% of frontline doctors experienced moderate depression, 62.16% experienced moderate anxiety, and 48.65% experienced moderate stress due to their workload, lack of sleep, and the unpredictability of the COVID scenario. The current survey reveals that 45.9% of doctors felt a strong desire to leave their positions during the first wave of the COVID outbreak. Physicians' depression has also been linked to the underappreciation of the general public and the administration's disregard for actions. As part of the analysis, it was also discovered that there was workplace aggression against doctors, including harassment, as well as job dissatisfaction, which put them into stress and depression. Among the psychological problems, participants frequently reported having trouble sleeping, sleeplessness, losing their appetite, and having panic attacks. Discussion: Participants who worked in a COVID-dedicated hospital experienced higher stress levels than those experiencing anxiety or depression. Other factors, such as a lack of PPE and witnessing infected coworkers, demonstrated a high correlation with anxiety. In spite of the study's documentation of the multiple challenges faced by front-line doctors, they persisted in providing care, assistance, and treatment in specialized institutions, usually in challenging circumstances. However, some said that the emergence of issues was the fault of accommodation facilities during the susceptible scenario. Because of the lack of personal protective equipment, these personnel were also more likely to experience mental health problems, and they also had a higher risk of getting the disease due to their close contact with patients who had been diagnosed. While doctors normally work in shifts, many frontline doctors had to put in more or longer hours than advised during the pandemic. The respondents used a variety of coping mechanisms, with self-motivation being the most successful one. The most prevalent coping techniques among the participants were believing that being a doctor is a noble career and that caring for patients is a good deed. Conclusions: As a matter of fact, with a high percentage of moderate to severe depression, anxiety, and stress during the first wave of the pandemic, a large incidence of psychological distress was noticed among Bangladeshi frontline COVID-19 doctors. It is clear from the worsening of almost all workplace-related physical, psychological, and social stresses that the COVID-19 pandemic increased the burden on an already difficult profession.
... Such financial and occupational uncertainties [141] has given rise to mental stress and anxiety which further exacerbated severe health impacts among the population during the second and third wave. Moreover, the lower supply of commodities combined with shops and marketplaces' closure led to price hikes putting severe economic and mental pressure on certain classes [142]. ...
Full-text available
The ongoing pandemic COVID-19 caused by Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) has wreaked havoc globally by affecting millions of lives. Although different countries found the implementation of emergency measures useful to combat the viral pandemic, many countries are still experiencing the resurgence of COVID-19 cases with new variants even after following strict containment guidelines. Country-specific lessons learned from the ongoing COVID-19 pandemic can be utilized in commencing a successful battle against the potential future outbreaks. In this article, we analyzed the overall scenario of the COVID-19 pandemic in Bangladesh from Alpha to Omicron variant and discussed the demographic, political, economic, social, and environmental influences on the mitigation strategies employed by the country to combat the pandemic. We also tried to explore the preparedness and precautionary measures taken by the responsible authorities, the choice of strategies implemented, and the effectiveness of the response initiated by the government and relevant agencies. Finally, we discussed the possible strategies that might help Bangladesh to combat future COVID-19 waves and other possible pandemics based on the experiences gathered from the ongoing COVID-19 pandemic.
... The high prevalence of anxiety in the current study may be due to numerous sociodemographic and academic factors, which may differ across continents and countries. The other possible explanation is that the expectation of completing clinical work in a healthcare system that has a high volume of patients with limited resources could predispose one to potential mental disorders [32,33]. As an illustration, the study found that nursing students attending College B were at a two-fold risk of exhibiting anxiety symptoms as compared to those in College A. College B is situated in the biggest township in South Africa, which means nursing students may be exposed to more patients in the midst of limited resources during their clinical work. ...
Full-text available
Background: Globally, mental disorders are common among nursing students; therefore, effective prevention and early detection are urgently needed. However, the prevalence rate of anxiety symptoms has not been investigated in South African nursing colleges. Aim: The study aimed to assess the prevalence of anxiety symptoms and their sociodemographic risk factors among nursing students in Gauteng province, South Africa. Methods: This cross-sectional descriptive study was conducted at Chris Hani Baragwanath and SG Lourens nursing colleges in the first week of June 2022. A purposeful sampling technique selected the third- and fourth-year nursing students aged ≥ 18 years registered at the two nursing colleges. The seven-item Generalised Anxiety Disorder scale was used to assess anxiety symptoms. Results: The prevalence of anxiety symptoms was 74.7% (95% confidence interval: 69.9–78.9). Being a student at nursing college B, being in the fourth academic year of study and use of substances were identified as predictors of anxiety symptoms in these nursing students. Conclusions: The prevalence of anxiety symptoms in this study is relatively high, with predictors of developing anxiety being a student at nursing college B, in the fourth academic year and current use of psychoactive substances were predictors of anxiety symptoms. These findings highlight the need to develop interventions and strategies to promote mental health assessments and management to prevent and reduce the problem of mental disorders among nursing students.
Full-text available
At present, Covid-19 pandemic creates a vulnerable situation for all over the world. This situation is highly effects on all of the social and economic aspects. Dhaka is the capital city of Bangladesh which is the world's six most densely populated city. The most of the people of Dhaka city are middle class who has been facing different types of challenges due to Corona pandemic situation. The objective of this study is to identify the challenges that has faced by middle class people at Dhaka city of Bangladesh. Questionnaire and interview techniques were used to collect the data of this study. Both descriptive and inferential statistics were used to analyze the data. Descriptive statistics were used to give details about the Corona virus as well as inferential statistics were used to identify the major challenges and show the significant relationship between Covid-19 pandemic and identified challenges which has faced by middle class people at Dhaka city. Factor analysis was used to identify the major challenges that are created by corona virus pandemic situation. Multivariate analysis of variance was used to show that the overall and individual significant effect of Covid-19 pandemic on identified major challenges. Findings of the study show that there are six challenges which are reasonably formed by this circumstance. The identified major challenges are Financial crisis that has led to increase child marriages and divorce due to increase family conflict, Failure to meet basic needs that led to increase child labor , Unemployment rates and occupational changes have increased, Decreased social interaction which led to increase psychological and physical complications among children and adults, Decreased financial ability to meet the cost of education and Frustration grows among the people that increased deviant behavior in the society. The findings of this study may help the concerned line organizations to take necessary steps to overcome the situation of middle class people of Dhaka city in Bangladesh.
Owing to global trade and travel, the recent novel coronavirus disease (COVID-19) pandemic has surpassed all geographical barriers and encompassed the entire world, impacting everyone in all spheres of life. Yet, it is evident that not every person was equally affected. In order to overcome this challenging ordeal, the World Health Organization (WHO) initially recommended washing hands with soap and maintaining hygiene as a first approach to fight against COVID-19. However, this seemingly simple instruction exposed inequalities that exist in terms of economic wealth, access to resources, urban-rural divide, and gender. The aim of this chapter is to establish how COVID-19 has made the achievement of sustainable development goal (SDG) 6, i.e., water and sanitation, of perhaps greater importance than ever before as the eradication of COVID-19 and achievement of SDG 6 are knotted. Focusing on the specific reality of the South Asian context, it is intended to analyze the social, economic, and other inequalities exacerbated by the COVID-19 and obstacles that these inequalities have brought to highlight in achieving SDG 6 and the intertwined SDG 3, i.e., health and population, in face of the current pandemic situation the world is currently experiencing.
Full-text available
Background The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals worldwide. The present study developed the Fear of COVID-19 Scale (FCV-19S) to complement the clinical efforts in preventing the spread and treating of COVID-19 cases.Methods The sample comprised 717 Iranian participants. The items of the FCV-19S were constructed based on extensive review of existing scales on fears, expert evaluations, and participant interviews. Several psychometric tests were conducted to ascertain its reliability and validity properties.ResultsAfter panel review and corrected item-total correlation testing, seven items with acceptable corrected item-total correlation (0.47 to 0.56) were retained and further confirmed by significant and strong factor loadings (0.66 to 0.74). Also, other properties evaluated using both classical test theory and Rasch model were satisfactory on the seven-item scale. More specifically, reliability values such as internal consistency (α = .82) and test–retest reliability (ICC = .72) were acceptable. Concurrent validity was supported by the Hospital Anxiety and Depression Scale (with depression, r = 0.425 and anxiety, r = 0.511) and the Perceived Vulnerability to Disease Scale (with perceived infectability, r = 0.483 and germ aversion, r = 0.459).Conclusion The Fear of COVID-19 Scale, a seven-item scale, has robust psychometric properties. It is reliable and valid in assessing fear of COVID-19 among the general population and will also be useful in allaying COVID-19 fears among individuals.
Full-text available
The world must act fast to contain wider international spread of the epidemic of COVID-19 now. The unprecedented public health efforts in China have contained the spread of this new virus. Measures taken in China are currently proven to reduce human-to-human transmission successfully. We summarized the effective intervention and prevention measures in the fields of public health response, clinical management, and research development in China, which may provide vital lessons for the global response. It is really important to take collaborative actions now to save more lives from the pandemic of COVID-19.
Full-text available
Governments will not be able to minimise both deaths from coronavirus disease 2019 (COVID-19) and the economic impact of viral spread. Keeping mortality as low as possible will be the highest priority for individuals; hence governments must put in place measures to ameliorate the inevitable economic downturn. In our view, COVID-19 has developed into a pandemic, with small chains of transmission in many countries and large chains resulting in extensive spread in a few countries, such as Italy, Iran, South Korea, and Japan.1 Most countries are likely to have spread of COVID-19, at least in the early stages, before any mitigation measures have an impact.
The public governance of epidemic outbreaks faces great uncertainty. Successful governance is only possible with a competent early warning system, which hinges upon efficient production, sharing, and use of relevant knowledge and information. In this process, functional scientific/professional communities are critical gatekeepers. Analyzing China’s failed early warning for the COVID-19 outbreak, we show that an epidemic governance system dominated by bureaucratic forces is doomed to failure. In particular, we identify the lack of autonomy of scientific/professional communities—in this case, virologists, physicians, and epidemiologists—as one of the major contributing factors to the malfunction of the early warning system. Drawing upon the idea of community governance, we argue that only by empowering scientific/professional groups to exert efficient community governance can a state modernize its early warning system and perform better in combatting epidemics.
Lockdowns and closings proliferate, but virus testing and contact tracing are lagging.
Objective: Suicide has become the second leading cause of fatality among the 15-29-year-old age group. Bangladeshi statistics indicates 61% of suicides are within this age range. However, the nature of student suicides as well these issues concerning gender differences has been less studied inside the country. Consequently, the present study investigated students suicide cases using examples from the Bangladeshi news media. Methods: Bangladeshi student suicide press reports over an 18-month period were collated using Google search in the present study. After the removal of repeated cases, a total of 56 reported suicides remained for final analysis. Results: Most cases were male (n=40), Muslim (n=43), belonged to public university (n=17), graduated at upper level (n=37) and committed suicide at midnight (n=25). The most common suicide method was hanging (n=42). The most common reasons for suicide included relationship problems (n=11), exam failure (n=10), and family arguments (n=6). Gender differences showed that 9 out of 16 female suicides were medical students whereas male suicide cases were more diverse across educational types and levels. Limitations: This study only included student suicide cases reported by printed news media, so the total number of cases is unknown as because not all such deaths will have been reported. Conclusions: The results reflect global suicide trends (e.g. more cases of male suicide) although, the findings were not consistent with previous Bangladeshi researches which tend to proclaim higher rates of female suicide. Results suggest that suicide prevention programs are needed, particularly among male adolescents and young men.