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Coronavirus fears grip Bangladesh amid doubts over preparedness

Manzur H Maswood | Published: 01:14, Mar 13,2020 | Updated: 22:07, Mar 13,2020

 
 

Following the first cases of coronavirus infection in Bangladesh, sale of face masks and hand sanitisers soared. The photo shows people out on a Dhaka street at Gulistan with their faces covered, though experts prescribed such a measure only for the infected. — Indrajit Kumer Ghosh  

The novel coronavirus, which the World Health Organisation later named as Covid-19 giving it a specific identifier, finally entered Bangladesh on last Sunday as the first coronavirus cases in the country was confirmed after three people tested positive for the infectious virus in Dhaka.

The virus that believed to have started spreading from a market in the Wuhan city of China that sells wild animals in late December has already become a global health concern with 129,167 cases around the globe. New patients are being identified in new countries every day.

Bangladesh was at high risk of coronavirus spread since its outbreak in China for its global connectivity. Italy, Iran, South Korea and Japan appeared to be the new hotspots of the novel virus, and thousands of Bangladeshis live in those countries.

The three people who were identified in Bangladesh came from Italy. They reportedly mingled with families and neighbours after their return and later developed the symptoms.

Later, they were tested at the Institute of Epidemiology Disease Control and Research and tested positive on Saturday.

The disclosure about the coronavirus infection came hours after prime minister Sheikh Hasina on Sunday morning urged the people not to get scared of the virus.

In recent weeks, people were in doubt that the country was free from coronavirus while the authorities were saying that Bangladesh was at a high risk of the novel virus spread.

The screening of the incoming travellers at the ports of entry was also in question. People were in doubt as to whether the screening was being done properly or not.

Though the virus finally entered Bangladesh, many questions about the preparations for controlling its spread remained unanswered.

The government on Monday said it widened measures to tackle the novel coronavirus from spreading.

But panic gripped the nation after identification of three Covid-19 patients.

What brought relief to the worrying multitude is the news that two out of the three infected patients recovered and the remaining one infected case was doing well and no new cases were detected as of Thursday, officials said.

The movement of people decreased on the streets and to the schools and markets after the Covid-19 patients were identified.

Many people were seen coming outdoors wearing masks, and shops and drug stores witnessed a rush for masks and disinfectants.

The government on Monday said it increased the number of hospital beds across the country, installed five more thermal scanners at the ports of entry, made it mandatory for the returnees to register their names with upazila hospitals and opened nine new call centres besides the previous four for coronavirus support.

The government, however, said that it did not have any plan right now to close the schools and colleges and suspend flights to and from the coronavirus-affected countries.

The outbreak of the new coronavirus in China has put the entire health system of Bangladesh on high alert while its facilities are already struggling to handle regular patients in the capital and elsewhere.

Health experts said that the health system here was not prepared to tackle the situation if people en masse were found infected with the virus.

Health minister Zahid Maleque at a press conference at the secretariat on Monday said, ‘We’ve arranged a 100-bed facility at each district and 400 beds in the capital for coronavirus-infected patients.’

‘We have now scanners at all the ports of entry to screen the passengers as five new thermal scanners have been installed,’ he said.

He also added that the novel coronavirus was not dangerous like Ebola and SARS, but contagious, assuring people that the government had been prepared for dealing with the virus since January and people should not get panicked about it.

Zahid Maleque urged people to avoid gatherings and take precautionary measures like maintaining personal hygiene by washing hands with soap and by using alcohol-based hand rub and hand sanitizers to keep the virus at bay.

On the government measures, he said that control rooms were opened at all the district and upazila hospitals across the country so that the care-seekers could easily get the necessary information and treatment.

Health Services director general Abul Kalam Azad on Monday advised people not to get panicked and urged them to call the national health call centre at 16263 and the hotlines of the IEDCR if they needed coronavirus treatment.

‘We have the preparations to take the patients for tests and to hospitals if needed,’ he said.

IEDCR director Meerjady Sabrina Flora said that anyone coming from abroad should go for the mandatory home quarantine for 14 days.

All who are coming from abroad also must register their names with the upazila health complex for monitoring by the government, she added.

If any of the returnees has symptoms of the coronavirus infection like fever accompanied by coughing, sneezing and breathing difficulty, they have to contact the IEDCR through its hotlines, she said.

Meerjady said that one particular area of the country was clustered based on the identification of the three infected patients while surveillance sites were set up across the country for the early detection of the patients and controlling the spread of the virus.

Besides, laboratories outside the capital have been identified for testing the coronavirus infection if the number of patients continues to increase.

The IEDCR added eight more numbers as its hotlines in addition to the previous four numbers. Now the hotline numbers are: 01937000011, 01937110011, 01927711784, 01927711785, 01401184551, 01401184554, 01401184555, 01401184556, 01401184559, 01401184560, 01401184563 and 01401184568.

Besides, people could get information about the coronavirus from the national health hotline 16263.

Speaking at the press conference at the IEDCR, World Health Organisation country representative Bardan Jung Rana said that how fast Bangladesh could detect the new cases was the objective and the challenge now.

‘This [coronavirus infection in Bangladesh] is at the moment still epidemiologically linked, there are people who are coming in from infected countries,’ he said.

‘We need to be able to contain this and it has to be done. It needs rigorous work and solidarity among everybody,’ he said.

General people also see with suspicion the screening of the travellers entering Bangladesh and the capability of the country to detect coronavirus cases as people from affected countries are getting into the country and mingling with people every day.

The government’s disease monitoring arm, Institute of Epidemiology, Disease Control and Research, installed a surveillance system and set up coronavirus sample collection points at the headquarters of all the 64 districts and 29 ports of entry.

Officials said that they had activated a surveillance system in accordance with the epidemiological outline.

The government has already set up coronavirus isolation centres at all the medical college hospitals and at the district hospitals for any suspected coronavirus cases.

The IEDCR has also formed health coordination committees across the country with the civil surgeons as the heads of the district committees. Doctors were also given training to handle coronavirus patients.

Though the screening of passengers entering Bangladesh at the airports is not the deciding factor in whether the virus would spread or not in the country, the screening has been activated as a precautionary measure.

On the average, around 15,000 people enter Bangladesh every day using the ports of entry. Bangladesh so far has not suspended any flight operation with the affected countries.

At the ports of entry, passengers fill out forms with their travel information and are checked for fever. Any passenger with symptoms that could match the coronavirus infection is being sent for quarantine.

The IEDCR has stationed medical teams at 29 ports of entry to determine whether a sick person should be isolated and tested for the virus, said IEDCR chief scientific officer ASM Alamgir.

‘We have the setups to collect samples to test any suspected person at the ports of entry and at the 64 district headquarters,’ he said.

‘There is nothing to get panicked about,’ he said, adding, ‘We have activated a surveillance system across the country in accordance with the epidemiological framework.’

The IEDCR has collected kits and reagents from the World Health Organization for testing coronavirus infection and the result can be obtained within two to three hours, he said.

There are limited numbers of thermal scanners at the ports of entry, officials admitted, but alternative scanners like hand-held temperature detectors were available at the ports.

The curb the spread of the virus, Bangladesh suspended visa-on-arrival for Italy, South Korea, Iran and China, health minister Zahid Maleque said in a press conference on Tuesday.

Bangladesh also asked to show medical certificates to seek visa from the countries, he said. The government also urged the Bangladeshi expatriates to avoid travel to the affected countries and requested citizens not to travel unless there was an emergency, the minister said.

Earlier, seven Bangladeshi expatriates were identified with the coronavirus — five in Singapore, one each in Italy and the United Arab Emirates — and three of the infected five in Singapore have already been released from hospitals after they recovered.

Currently, 23 Bangladeshis remained in quarantine in Delhi after their evacuation from China. Bangladesh also brought back 312 nationals from Wuhan, the epicentre of the virus, and released them in good health after a 14-day quarantine.

The World Health Organization’s COVID-19 Strategic Preparedness and Response Plan, which is aimed at providing a basis for action regarding coronavirus, consists eight ‘pillars’ including:

Pillar 1: Country-level coordination, planning, and monitoring

Pillar 2: Risk communication and community engagement

Pillar 3: Surveillance, rapid response teams, and case investigation

Pillar 4: Points of entry

Pillar 5: National laboratories

Pillar 6: Infection prevention and control

Pillar 7: Case management

Pillar 8: Operational support and logistics

A member of a technical committee formed for coronavirus in Bangladesh said that the country lacked organised preparation as suggested by the WHO.

IEDCR consultant Mushtuq Husain told New Age that their strategy now was to keep the information about the passengers, quarantine them at home, put those in isolation who were found with symptoms and track the people who have already mixed with them.

World Health Organisation epidemiology adviser Mahmudur Rahman said that it was not the scanning of the passengers but their follow-up in the later days, which proved most effective in detecting the coronavirus infection cases.

He, too, stressed the need for 14-day home quarantine for those coming from abroad and their follow-up by the government surveillance system.

Bangabandhu Sheikh Mujib Medical University virology professor SU Munshi said that asymptomatic coronavirus patients would easily come out of a thermal scanner.

‘Thermal scanner is not foolproof,’ he said.

‘Even those who are coughing and sneezing with no running fever, they would not be identified by a thermal scanner,’ he said.

There remain concerns over the preparations to tackle the coronavirus, public health experts said.

The management and control of the spread of the highly contagious virus in the country of 160 million people is also a challenge, they said.

It is very much likely that the virus has already spread to communities, said Dhaka Medical College principal Khan Abul Kalam Azad.

‘It will be challenging for the authorities if panicked people start thronging the hospitals,’ he told New Age.

The noted medicine expert advised people not to get panicked, but to stay home and use mask if they have fever accompanied by coughing and sneezing.

‘If they have breathing complications, they should go to hospitals,’ he advised.

Azad gave a number of advices for people, such as not going to the bazars or public places unless essential and maintaining personal hygiene like washing hands with soap at short intervals, particularly after coming from outside.

He also advised the guardians not to send children to school if they have fever alongside coughing and sneezing.

Bangladesh Health Rights Movement chairman Rashid-e-Mahbub said that the country’s health facilities were already overburdened and tackling the situation would be difficult if the number of the affected became high.

He expected all-out efforts by the government to prevent the spread of the virus and prepare the hospitals for such patients.

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