As the COVID-19 pandemic gains momentum, fragile health systems in low and middle income countries will quickly become overwhelmed.
People who are suffering with serious illness like cancer, HIV/AIDS, heart or kidney diseases, COPD/asthma, compromised immune systems, or those who are over 60 years old with multiple disorders are extremely vulnerable.
Bangladesh has a population of over 160 million people, many living in cramped conditions in informal urban settlements, where social distancing is almost impossible. In this situation, coordinated community responses are essential to curbing the spread of the virus.
Many people do not understand how COVID-19 is transmitted and how to protect themselves and others.
To reduce the transmission of COVID-19, you need to wash your hands frequently or rub them with alcohol solution or sanitizer; maintain social distance at 6 feet, especially with anyone who is coughing or sneezing; avoid touching eyes, nose and mouth with unwashed hands, maintain respiratory hygiene such as coughing into the crook of your elbow; seek medical care early if you experience fever, cough or breathing difficulties and protect yourself if you have visited any area where COVID-19 is spreading.
In Bangladesh, social organisations have mobilized to raise awareness on COVID-19 through electronic and print media. At the same time, organisations are distributing face masks, plastic hand gloves and other personal protective equipment, as well as delivering food parcels to vulnerable people as the country goes into lock down.
Religious organisations are spreading awareness regarding safety measures to reduce COVID-19 transmission through songs and advertisements.
An essential item in slowing transmission of the virus is disinfectant alcohol solution or sanitizer. However, in Bangladesh, as in many countries, there is huge shortage of these essential items. Only a few local pharmacies are selling these sanitizers, many times higher than original trade price.
To overcome this shortage the medical, pharmacy, nursing and chemistry students from different universities and medical colleges of Bangladesh started producing hand sanitizer in their campuses.
These hand sanitizers (30ml/50ml/100ml) are then distributed free of charge among low income households who cannot afford to buy them.
The formulation used has been published by the World Health Organization:
Formulation of 100ml Hand Sanitizer
- Isopropyl alcohol 75 % v/v
- Glycerol 1.45 % v/v
- Hydrogen peroxide 0.125% v/v
- Lavender 0.1 % v/v
Preparation steps for local production:
- The alcohol for the chosen formulation is poured into the large bottle or tank up to the graduated mark.
- H2O2 and Glycerol are added using the measuring cylinder. Because of the glycerol’s viscous characteristics where it sticks to the walls of the measuring cylinder, it can be rinsed with some sterile distilled or cold boiled water to be added and then emptied into the bottle/tank.
- The bottle/tank is then topped up to the corresponding mark of the volume (10-litre or 50-litre) to be prepared with the remainder of the distilled or cooled, boiled water.
- The lid or the screw cap is placed on the bottle/tank immediately after mixing to prevent evaporation.
- The solution is mixed by gently shaking the recipient where appropriate (small quantities) or by using a wooden, plastic or metallic paddle (electric mixers should not be used unless “EX” protected because of the danger of explosion).
- After mixing, the solution is immediately divided into smaller containers (e.g.: 1000, 500 or 100ml plastic bottles). The bottles should be kept in quarantine for 72 hours. This allows time for any spores present in the alcohol or the new or re-used bottles to be eliminated by H2O2.
This collaborative initiative by the universities and teaching hospitals shows a rapid, effective response to a society-wide health threat. The authors encourage any institutions with the means of producing hand sanitizer to follow the WHO formula which can be found here: https://www.who.int/gpsc/5may/Guide_to_Local_Production.pdf
 Coronavirus disease (COVID-19): Vulnerable populations and COVID-19, Government of Canada, Canada. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/vulnerable-populations-covid-19.html
 UN working to ensure vulnerable groups not left behind in COVID-19 response, United Nations. https://www.un.org/en/un-coronavirus-communications-team/un-working-ensure-vulnerable-groups-not-left-behind-covid-19
 Coronavirus disease (COVID-19) advice for the public, World Health Organization. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
 WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care, WHO-recommended hand rub formulations (Section 12). https://www.ncbi.nlm.nih.gov/books/NBK144054/