Coronavirus: Is Bangladesh following its national plan?

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Bangladesh is now possibly heading towards Country Level 4 situation

For an effective national preparedness against coronavirus infection, Bangladesh government last month planned for a few measures needed to be followed to control the outbreak in the country.

The measures includes prevention of mass gathering, ensuring social isolation and countering disinformation.

With its “National Preparedness and Response Plan for Covid-19, Bangladesh”, prepared by Ministry of Health and Family Welfare, the government also emphasized on expanding laboratory network and testing capacities.

As per the plan, the health directorate said a total of eleven testing facilities are functioning now and in total at least 28 facilities will be functioning by the end of April.

The number of tests conducted in Bangladesh to detect Covid-19, a disease caused by a new strain of coronavirus, patients is alarmingly low, therefore there are doubts on the real number of coronavirus infected people in Bangladesh. 

Preparedness to control the pandemic seems to be like fumbling in the dark, when very few people -only 10 in one million- are getting tested.

However, Directorate General of Health Service (DGHS) Director General (DG) Prof Dr Abul Kalam Azad said a total of 14 institutions, including nine in Dhaka, are conducting sample tests across the country to ensure quick confirmation of Covid-19 cases.

On April 2, Prof Dr Abul Kalam told BSS that within the first week of April, all the divisions will have at least one polymerase chain reaction (PCR) laboratory and at the end of the month “we expect to set up and get running a total of 28 laboratories all over the country.”

Categories of the plan

The national plan categorized the situation in four levels. Country Level 1 is when no case is detected in the country, Country Level 2 is when imported cases and limited human to human transmission will be reported, Country Level 3 is when there is a cluster of cases and Country Level 4 is when community transmission is reported.

The Bangladesh government published the plan when no patient was tested positive for Covid-19. However, Institute of Epidemiology, Disease Control and Research (IEDCR) is now hinting on a limited scale community level transmission, which means Bangladesh is now possibly heading towards Country Level 4 categorization.

The Bangladesh government on Monday announced that 35 people were tested positive, which is so far the highest number of Covid-19 infected patients since March 8.

The plan stressed on the importance of screening passengers at the airport a couple of times. However, it stirred criticism when a few thermal scanner machines were reported to be faulty.

The DGHS DG Abul Kalam Azad said the government started screening the suspects at the airport, along with the arrangement of dedicated quarantine zones for people arriving from the affected countries since January.

As of Sunday, Bangladesh has screened a total of 6,67,777 passengers, data compiled by DGHS shows.

Major highlights of the plan

The plan has a chapter on risk communication which says misinformation on all relevant channels, including traditional media and social media, will be countered.

The government has done some work on that front, however, it stirred criticism when the information ministry assigned some of its officials to monitor broadcast media to check whether the media is spreading rumors and misinformation.   

Preventing mass gathering was one of the highlights of the national plan but the government received a lot of criticism because right after announcing the general holiday, thousands of people rushed to home in crowded public transportation. 

The government requested people to stay at home but it did not halt the public transportation.   

The plan states that religious leaders would be sensitized to fight the Covid-19 outbreak. However, the plan does not mention anything clearly about halting religious gathering in mosques, temples, churches or any other place. 

Bangladesh made international headlines when at least 25,000 people performed a prayer named Khatme Shifa or Ayat ash-Shifa (Six Quranic Verses of Healing) to seek the containment of the pandemic Covid-19 at the Central Eidgah of Lakshmipur’s Raipur on March 18.

Till Sunday, there was no government instruction to halt religious gathering, although the plan states that mass gathering should be prevented if Bangladesh reaches to level three.  

However, Islamic Foundation issued a guideline where they requested Imams to continue five-time prayers and Jummah prayers at mosques with limited number of people.

On Monday, the Religious Affairs Ministry issued an emergency notice, suspending prayers at mosques across the country in a bid to stop further spread of Covid-19.

Quarantining, isolating suspects

As for quarantined people, the plan says: “According to guideline provision of accommodation, food and other necessary supplies will be provided. The Ministry of Disaster Management and Relief will be responsible along with other stakeholders for this.”

However, it did not really elaborate anything about providing supplies for people in home quarantine. It did say, people who have come from abroad must quarantine themselves at their home for 14 days.

However, several media reports revealed that a number of people were not following government instructions and socializing outside before completing their home quarantine period. Lax monitoring of the government was criticized.  

The plan states: “Prepare the isolation wards at the designated health facilities — Kurmitola General Hospital, Infectious Disease Hospital (IDH) and Bangladesh Kuwait Moitree Hospital–for isolation and treatment of suspected Covid-19 cases.

“Prepare isolation units in all governmental hospitals; Ensure all private hospitals and clinics are instructed to prepare isolation units at their respective premises.”

However, it did not say how many isolation units are needed if the situation gets worse. It is not clear if those facilities are sufficient for Bangladesh, a country with 167.2 million people.  

The plan also suggested to establish intensive care capacity at the divisional and district levels.

Currently, hospitals in Bangladesh have only 1,169 ICU beds (432 govt, 737 private) in total against a population of 161,356,039 people.

At present, only around 34 ICU beds are ready to be used at Bangladesh Kuwait Moitree Hospital and Sheikh Rasel Gastro Liver Institute & Hospital. Besides, 11 more ICU beds are prepared at three private hospitals.

Health and Family Welfare Minister Zahid Maleque earlier said the government has prepared 200 ICU units for Covid-19 patients, while 11 labs have been set up for testing samples of suspected coronavirus cases.

 “As many as 28 more labs will be set up as part of our effort to expand the Covid-19 test facilities across the country,” he said.

‘Bangladesh is now on right track to curb the outbreak’

Amid the allegations by some quarters regarding prior preparation to combat novel coronavirus, DGHS DG Prof Dr Abul Kalam Azad claimed it is not true as the government acted very seriously from the very outset of this global crisis to halt the outbreak of the lethal disease in Bangladesh.

On April, the DG said Bangladesh is now on the right track to curb the outbreak of the Covid-19, reports BSS.

“We prepared designated hospitals, and equipped our health professionals with necessary facilities,” he claimed.

Prof Abul Kalam Azad said the government closed down all educational institutions in the country, locked down infection-prone areas to prevent community transmission and advised the people to stay at home.

The DG said six hospitals have been prepared in Dhaka for coronavirus patients, while arrangements are underway to treat coronavirus patients in five more hospitals of the capital.

“Separate beds have been kept ready for such patients in district and upazila level hospitals,” he added.

As of Monday, Bangladesh has reported 12 deaths and 123 infections of Covid-19.

The fast spreading coronavirus, which was first reported in China’s Wuhan, has claimed above 69,501 lives and infected more than 1,275,000 people across the world till date, according to Worldometers.

As many as 265,887 people have recovered from coronavirus infection, a pandemic declared by World Health Organization (WHO), which has spread to 208 countries and territories across the planet.