THE World Health Organisation has emphasised aggressive testing, isolation of the infected and identifying transmission sources as the three important preventive steps against COVID-19, but the government is yet to establish a mechanism to ensure that the steps are effectively followed. Until very recently, the Institute of Epidemiology, Disease Control and Research was singularly responsible for the tests. Since January 21, Bangladesh has tested 2,547 cases, which is considerably small for the population size. There are now 14 laboratories with the capacity to handle 4,000 samples a day, but the authorities are using 12 per cent of the capacity. Testing outside Dhaka reportedly lacked guidelines on sample collection. The institute has claimed that it can run at least 1,000 cases a day, but has so far managed up to 200 tests. The number of tests has increased, but it is still too low to give a picture for a better management of the issue.
Authorities also lag in identifying transmission sources. Of the nine new cases confirmed on Friday, five were infected locally, coming in contact with known infected person and two had travel history, but in the remaining two cases, the source could not be traced. Twenty per cent of the total confirmed cases, infection sources could not be established, which suggests a community transmission. In most the deaths with COVID-19-like symptoms, the issue of infection has remained unresolved, suggesting a greater risk of community transmission. It is unclear whether in all such cases, samples have been collected and chain of their infection has been established. The government too does not rule out the possibility of a cluster-level community transmission. It did not, however, ensure tests through sentinel samples either. Public health experts and virologists have expressed concern that the government had time to prevent the community transmission by identifying the cluster of infection, but it did very little to stop the outbreak from reaching such a stage of transmission.
The government decisions to decentralised testing facilities to Chattogram, Rajshahi, Rangpur, Mymensingh and Cox’s Bazar and plans to expand the services to other cities is welcome. The establishment of testing facilities will not, however, do much unless they are used to their full capacity and an increased number of tests are done for a better understanding of the prevalence of the infection. Otherwise, as many public health experts say, the government will be attending the outbreak rather blindly, with partial knowledge of what is happening. An increased number of tests with an effective mechanism to identify infection sources could still turn things around and prevent the COVID-19 outbreak from turning worse.
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