Detect, isolate and contain

As the number of Covid-19 deaths and infected patients keep going up, experts blame it on inadequate case detection and isolation measures taken up by the authorities.

They said although the ongoing shutdown has "slowed" the transmission rate of the coronavirus, the future might be "harsh" if there is no rigorous case detection and isolation measures put in place through the enforcement of a strict countrywide lockdown. 

"The lockdown has slowed down the transmission, but we see the authorities' decision to open garment industries without ensuring certain health measures. Such actions could increase the danger," Dr Mushtuq Hussain, consultant at the Institute of Epidemiology Disease Control and Research (IEDCR), told The Daily Star yesterday.

Earlier in the day, the Directorate General of Health Services (DGHS) reported that 552 new cases were detected and five more people died in 24 hours since 2:30pm yesterday.

With it, the total number of detected Covid-19 cases stood at 8,790 while the death toll hit 175.

Like other days, Prof Nasima Sultana, additional director general (administration) at the DGHS, informed about the country's latest Covid-19 situation in a bulletin through videoconferencing.

She said three more patients receiving treatment at hospitals recovered in those 24 hours, taking the total number of reported recovery cases to 177.

Among the five deceased, three were males and two were females. All of them were from Dhaka.

One of the deceased was over 60 years, one between 51 and 60, two were between 41 and 50 and one was between 31 and 40, said Prof Nasima.

The authorities had reported the first three Covid-19 cases in the country on March 8 and the first death on March 18.

Of all the 175 deceased, 73 percent were males, shows IEDCR data.

Some 42 percent of all the deceased were above 60, some 27 percent were aged between 51 and 60, some 19 percent between 41 and 50, some seven percent between 31 and 40. The rest were below 30.

No death has so far been reported from the age group 11-20, shows the data.

Dhaka city continues to remain the worst-affected region in terms of the number of cases and deaths caused by the deadly virus.

As of yesterday, a total of 4,309 cases -- 56.02 percent of all cases -- were detected in Dhaka city alone, according to the IEDCR website.

More than 83 percent of the total cases were from Dhaka division, it showed.

As many as 95 Covid-19 patients who died in hospitals were from the capital, seemingly the epicenter of the outbreak in Bangladesh.

During the last three days, the city saw more than 200 new cases daily -- a continuous upward trend compared to other regions.

Among other regions, Narayanganj saw the highest cases -- 987 --  followed by Gazipur with 322 confirmed cases.

Out of 342 confirmed cases in Chattogram division, highest 104 cases were detected in Cumilla district,  proved to be another epicenter outside Dhaka division.

Mymensingh saw 269 cases as of yesterday while 149 cases were detected in Rangpur division, 147 cases in Khulna, 135 in Sylhet, 123 in Barishal and 112 in Rajshahi.

A total of 5,827 individuals' samples were tested in 24 hours since 2:30pm yesterday, which is 4.56 percent more than the previous day, Dr Nasima said.

One hundred and sixty eight people were put under isolation across the country over the period, she added.

'CASE DETECTION, ISOLATION CRUCIAL'

Recently, thousands of readymade garment workers have returned to work from their village home after the government allowed to operate RMG factories with certain conditions.

Sources, however, said the decision was finalised without fixing any health protocol in coordination with the DGHS.

"Maintaining social distancing is the key to contain the transmission. Now the situation will depend on how we are maintaining it," Prof Nasima told The Daily Star, while replying to a query on the issue.

Asked whether the reopening decision was taken in consultation with the DGHS, she said, "You better ask it our high-ups."

Source said the government office concerned and the Bangladesh Garments Manufacturers and Exporters Association had sought suggestions from the DGHS and the IEDCR in this regard.

Later, the DGHS asked to ensure social distancing in the living places of the garment workers, while the IEDCR suggested keeping the workers in 14 days of quarantine before they would join work.

"There was a recommendation that those factories which will not be able to maintain the protocol will remain shut down," Dr Mushtuq Hussain told The Daily Star.

In a latest development, an inter-ministerial meeting on "reopening industries and commerce on a limited scale" will be held today . The meeting would be presided over by the health minister at his office, sources said.

Besides, the government is also planning to extend the ongoing lockdown until May 16, the media reported yesterday, quoting state minister for the ministry of public administration Forhad Hossain, as saying.

Experts, however, said the lockdown would not be fruitful unless every case was detected and isolated accordingly.

"Initially, Thailand and Singapore contained the outbreak successfully. But now we see they are on the brink of second wave of transmission. The virus has spread even to remote islands. So we have nothing to feel complacent," Dr Mushtuq Hussain said.

He thinks the DGHS should take prompt actions as it has the legal authority to take any measures to contain the outbreak. "The DGHS has the authority to inspect any place and take action accordingly. The question is whether they are doing or not."

"It is an unknown virus. So, if anyone says the virus will not wreak havoc here, it will be an unscientific statement."

Talking to The Daily Star, Prof Nazrul Islam, member of the National Technical Advisory Committee on Covid-19, said, "Reopening economic activity is a necessity. But we have to fix strategy for this. We don't know what the situation will turn after 8-10 days."

Both the experts suggested scaling up the daily number of tests, detecting and isolating the positive cases as early as possible.

The number of daily tests is still around 6,000. The authorities are now planning to increase the number to 10,000 within a week, according to DGHS sources.

However, the tests will be still inadequate, experts pointed out.