(Bloomberg) -- As the biggest cyclone to hit South Asia in two decades loomed over the Bay of Bengal, emergency relief officials realized they were facing a nightmare: They needed to evacuate more than 5 million people to safety at the risk of spreading Covid-19.

Right after the weather office elevated the cyclone warning to the maximum on Wednesday, Najmul Alam, a government official in Bangladesh, had the onerous task of evacuating hundreds to storm shelters while at the same time attempting to keep social distancing rules in place. He’s one of many that struggled with the same problem.

Alam ordered his team to evacuate residents to safety, but many initially decided to stay home assuming the storm would dissipate. As rain and wind gathered strength, thousands rushed out for help, overwhelming the facilities. By the end of the week, millions across the region took shelter in relief centers as Cyclone Amphan caused widespread damage in India and Bangladesh, killing about 100 people.

“I was struggling with what to do. Too many people came in such a short space of time,” said Alam, chief executive of Bhandaria, a coastal sub-district in Bangladesh. The number of people seeking shelter surged to 50,000 before dark and it became tough to maintain social distancing in an area that has already reported eight positive cases of the coronavirus, he said. “The biggest challenge was to prevent them from blending into the crowd.”

His battle during the cyclone illustrates the complicated task of saving lives during a natural disaster at a time when the coronavirus pandemic is hitting one of the most densely populated regions in the world. The pandemic has been spreading in India at the fastest pace in Asia, so far infecting more than 100,000 people in the second most-populous nation, while Bangladesh has seen about 28,500 positive virus cases.

“Disasters wreak havoc on fighting the pandemic,” said Bhuputra Panda, associate professor of Public Health Foundation of India.“ The possibility of increasing the rate of transmission rises sharply” as it becomes almost impossible to maintain social distancing, personal hygiene, wearing mask and even quarantine centers are converted into cyclone shelters.”

Virus Risk

Of the initial plan to evacuate more than 5 million, Bangladesh ended up evacuating about 2.4 million people while eastern Indian states of West Bengal and Odisha moved about 700,000 people before the cyclone hit the region.

“We are battling a pandemic on one hand and there is a cyclone situation in some parts,” India’s Prime Minister Narendra Modi said in a Twitter Post.

The storm has now dissipated, but not before leaving a trail of disaster. An airport and several low-lying areas were flooded, power supplies to millions of homes were snapped, and trees and buildings were left damaged. Relief operations and efforts to restore power supply are continuing in the affected areas.

“At relief centers, we are providing masks and some food to people,” Kolkata Mayor Firhad Hakim said. “We have arranged beds for them. There are so many people that it’s difficult, but we are trying to maintain social distancing as much as we can. We will make sure that nobody catches coronavirus at the relief centers.”

Pradeep Gooptu, secretary at the Bengal Initiative, a Kolkata-based liberal think tank, said he’s worried about the disaster relief force, who don’t appear to have the necessary protective equipment such as masks to give to people inside the shelters. The cyclone has “severely compromised” the fight against Covid-19, he said.

“Evacuated people, or those fleeing their ruined homes, are in no position to maintain social distancing,” Gooptu said. “At this juncture, relief without preventive health measures or safety appears to be a severe lapse.”

The natural disaster has also added to the pain of about 1 million Rohingya refugees, who are staying in crowded camps in Bangladesh. The nation has evacuated many of them to various mosques, but the risk of the spread of the virus has intensified. At least four refugees have been tested positive for the virus.

“Saving lives comes first,” said Mahbub Alam Talukder, refugee relief and repatriation commissioner of Bangladesh. “It’s difficult to maintain social distancing when a threat like Cyclone Amphan appears. We’ll think about social distancing later.”

©2020 Bloomberg L.P.