Cases may double by month-end

While the country's healthcare system remains under severe strain following record surge in coronavirus infections almost every day, a team of researchers warn that the total number of confirmed cases could double by the end of this month.

Having crossed the 50,000-mark yesterday, the number may jump to 87,000 by the middle and 123,000 by the end of this month, according to a projection by the team of experts, who are from University of Dhaka , Directorate General of Health Services (DGHS), and University of Toronto in Canada.

The projection is based on the current trend of the Covid-19 spread and epidemiological modeling, said head of the team, Shafiun Shimul, an associate professor of health economics at DU.

"With the reopening of everything, the spread of the virus is likely to accelerate and Bangladesh could be the next epicenter like Brazil or Russia, if not the USA," he told The Daily Star yesterday.

The team submits reports on such epidemiological model-based projection to the government on a regular basis, he added.

Epidemiologists and other health experts, however, said the number could be even higher as many cases remain not reported due to inadequate testing and contract tracing facilities.

The government has increased the number of daily tests. Still, only two out of 10,000 people in the country have so far been tested -- one of the lowest rates among the world's worst coronavirus-hit countries.

The reopening of the offices, transport services, and other economic activities ignoring experts' advice and warning would only make matters worse, said the experts.

The country recorded the highest daily spike in Covid-19 cases yesterday, two days after a shutdown to contain the spread of the deadly virus imposed on March 26 was relaxed.

As many as 2,911 people were reported coronavirus positive in 24 hours till 2:30pm yesterday. With it, the total number of cases hit 52,445, according to the DGHS.

Thirty-seven people died over the same period, taking the death toll to 709.

A total of 12,704 samples were tested in 52 labs across the country in those 24 hours.

Till yesterday, Bangladesh stood 21st in terms of total number of confirmed cases, surpassing Netherlands, a severely hit European country.

More than 50 percent of the cases in Bangladesh were detected in the last two weeks. Experts attributed the rise in infections to increased public movement linked to people swarming shopping malls, leaving the capital for Eid, and reopening of garment factories.

Before the shutdown was relaxed, the National Technical Advisory Committee (NTAC) on combating the coronavirus outbreak had suggested not to ease it unless the daily number of cases showed downtrend. But it was not heeded.

"We had suggested not to lift the shutdown until a declining trend starts. But the government has gone for the reopening because of disruptions in economic activities. Although it took some measures, we need to see how those measures are maintained," Prof Shahidullah, who heads the committee, told The Daily Star.

A member of the committee said, "We placed each recommendation in details on how to withdraw of the shutdown. But those were not taken into consideration. If they [the authorities] had read the full report, decisions would have been different," said the member.

According to the National Institute of Health, USA, and WHO, such shutdowns can be relaxed if the number of cases continues to go down for at least two weeks.

WHO says any government that wants to start lifting restrictions must first meet six conditions. Those are: Transmission of Covid-19 is under control; health systems and public health capacity are able to detect, test, isolate and quarantine every case and trace every contact; hot spot risks are minimised in highly vulnerable places, such as nursing homes; preventive measures such as physical distancing and hand washing in workplaces have been established; and populations are fully engaged and empowered to live under a new state of "normality".

'HERD IMMUINITY A FAR CRY'

Experts said because of inadequate data, it is not possible to predict when the outbreak will hit its peak and how long will it take to acquire natural herd immunity.

The concept of herd immunity is based on equipping 50 to 90 percent of a population (depending on how contagious an infection is) with immunity against an infectious agent by means of vaccinating or allowing people to get infected and recover.

This option, however, will take a heavy toll on people's lives and put a severe strain on the already overstretched healthcare system of the country, said experts.

They said the country saw relatively a slower rate of infections when the shutdown was underway, but with offices and road transport services open now, the transmission rate would go up if social distancing and other health safety measures are not maintained strictly.

Prof Nazrul Islam, a noted virologist and a member of NTAC, said reopening of shopping malls and other business and the rise in infections were related.

"We are expecting another rise in cases after June 9 because of movement of homebound people from and to Dhaka centring the Eid. Many of them may exhibit symptoms during the 14-day incubation period," Prof Nazrul Islam, told The Daily Star.

"Ultimately, we are heading towards [natural] herd immunity. But we cannot predict when it will be achieved," he said.

Prof Ridwanur Rahman, an infectious disease specialist, said, "Although we have no representative data, around 10 percent of the population might have already  been infected with the virus. So herd immunity is far away."

DANGEROUS CONSEQUENCES

Countries which reopened the economy without ensuring proper health safety measures faced a grave coronavirus crisis.

Take Brazil for an example.

The Latin American country was not even among the 10 worst hit countries till April 29. But situation deteriorated fast and as of May 31, it remained the second worst affected country, after the US, with about five lakh confirmed cases.

"The Brazilian president called the states to ease the lockdown considering economic fallouts. Now, the country is seeing a higher number of cases," said Shafiun Shimul. 

In Bangladesh, if the infections continue to spread, hospitals will not be able to treat a huge number of patients, said experts.

According to the DGHS, there were 13,984 general hospital beds, 399 intensive care units, and 106 dialysis beds for Covid-19 patients across the country as of Tuesday.

The DGHS, however, has a plan to increase the number of Covid-19 beds to 21,439 at different private hospitals. It has recently directed all hospitals to treat Covid-19 patients which experts said would make it tough to keep general patients and healthcare staffers safe from the infection.

"I fear the crisis would not be over soon," said Prof Nazrul Islam.