Deaths with symptoms go unrecorded

Manzur H Maswood | Published: 00:19, Sep 18,2020 | Updated: 16:49, Sep 18,2020


Many people dying with COVID-19 symptoms across the country are remaining out of the ambit of testing, giving a wrong picture of deaths from the novel coronavirus.

Bangladesh still could not ensure testing facilities in all districts as 37 districts out of 64 are yet to get COVID-19 testing facilities even six months into the epidemic after it had emerged in March 2020.

Bangladesh’s COVID-19 mortality rate — calculated by the number of deaths per 100 confirmed cases — is 1.41 per cent now, but experts said that the ‘surprisingly low’ mortality rate does not represent the actual scenario due to the absence of widespread testing.

They blamed an unorganised COVID-19 testing system, which leaves many ailing patients inaccessible to tests even after their deaths.

Bangladesh so far confirmed 4,859 deaths and 3,44,264 cases.

But the country’s biggest hospital, Dhaka Medical College Hospital, alone reported 1,178 deaths with COVID-19 symptoms since May 2 to September 7, but during the time the confirmed COVID-19 deaths was around 400 at the hospital.

‘The deaths are reported to the Directorate General of Health Services as COVID-19 deaths only when they are dying after obtaining a COVID-19 positive certificate,’ said DMCH medicine professor Robed Amin.

‘Those who are admitted with symptoms but died at the hospital before undergoing testing or before arrival of their test reports, they are not reported as COVID-19 deaths,’ he told New Age.

‘Many died before being tested while some died after providing samples, but as the test reports are sent to the families of the deceased, DMCH does not update the lists after releasing the bodies,’ he added.

According to the data of a Dhaka University-based research group Centre for Genocide Studies, at least 2,180 people died in the country with COVID-19 symptoms between March 8 and September 5.

Among the 2,180 cases, highest 728 people died in Chattogram, 393 in Dhaka, 342 in Khulna, 243 in Barishal, 218 in Rajshahi, 101 in Sylhet, 95 in Rangpur and 60 in Mymensingh divisions.

The researchers usually took account of the newspaper reports of deaths with COVID-19 reports.

The number of burials in the capital’s two city corporations has increased by 24.82 per cent between March and August.

According to statistics of both the city corporations, on an average 1,750 bodies were buried in the capital’s graveyards every month since March after the first COVID-19 infection had been detected.

The average number of burials per month was 1,402 between March and August in 2019.

Health minister Zahid Maleque claimed that Bangladesh’s lower death rate is a sign of success in handling the virus.

National Technical Advisory Committee on COVID-19 member and virologist Nazrul Islam, however, said that the government’s claim of 1.41 per cent fatality rate does not represent the actual fatality rate.

‘It [1.41 per cent fatality rate] is surprisingly low,’ he said, adding that the rate is a misrepresentation of the actual scenario.’

‘People are dying every day everywhere with symptoms of COVID-19 but all of the deaths are not included in the government’s tally,’ he said. 

‘All the deaths should be reviewed for the sake of our planning, but the government has taken a counterproductive position and have been hiding the actual COVID-19 picture since the outbreak,’ said Nazrul, a former vice-chancellor of Bangabandhu Sheikh Mujib Medical University.

The government initially issued a protocol to bury COVID-19 deceased in a number of selected graveyards for such burials need utmost precaution to prevent the spread of the virus.

But the protocol was relaxed since June 3 after the number of deaths started to increase.

Many COVID-19 patients are staying at home instead of going to hospitals and many are dying also at homes.

The DGHS in daily updates announces the number of daily deaths, including the deaths at homes, but many such deaths also remained unreported as over 84,000 COVID-19 patients are missing from the DGHS database.

According to the DGHS, since May 17, at least 645 COVID-19 patients died at homes and 33 were brought dead at hospitals.

World Health Organisation former regional adviser Muzaherul Huq said that he was pretty sure that many COVID-19 deaths remained unaccounted while many patients also remained out of the ambit of testing.

‘People are struggling to access the test facilities as still 37 districts do not have any labs for testing COVID-19, let alone the testing of the people who died with symptoms,’ he said.

Muzaherul said that the review of all the deaths should be done to know about the virus and to take policies and actions to lower the number of casualties.

Health minister Zahid Maleque on August 20 said that Bangladesh had been ‘generally successful’ in fighting the coronavirus outbreak.

As the evidence shows, he said, the COVID-19 death rate is lower in Bangladesh than in other countries.

Officials, however, did admit that many deaths with COVID-19 symptoms are not being reported due to red-tape and the unwillingness to test the deceased.

Director of the Institute of Epidemiology, Disease Control and Research, the disease monitoring arm of the government, Tahmina Shirin said that the deaths with COVID-19 symptoms are not counted and those deaths are not even reviewed later.

Replying to a question she said that officially they did not take any policy not to test the deceased with COVID-19 symptoms, but the limited testing resources and indifference of the families usually lead to the lower rate of testing the deceased.

Bordering India’s COVID-19 mortality rate stands at 1.7 per cent, but their scientists dispute the rate since their scenario is as same as in Bangladesh.

The rate is about 3 per cent in the USA, 11.7 per cent in the UK, and 12.6 per cent in Italy, according to Johns Hopkins University.

The global rate of COVID-19 deaths is about 3.3 per cent.

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