Coronavirus in Bangladesh: First death amid sloppy response

Bangladesh yesterday confirmed the first death from the novel coronavirus, the victim being a man in his early seventies, amid growing public anxiety over the government's preparations to contain the spread of the virus. 

The man had underlying health conditions and was infected by one of his relatives who returned from Italy recently, said the Institute of Epidemiology, Disease Control and Research (IEDCR).

The death comes 11 days after the country recorded first coronavirus cases.

The IEDCR yesterday reported four more cases, raising the number of Covid-19 cases to 14.

"It is indeed bad news for us that we have lost a life due to Covid-19 for the first time in the country," IEDCR Director Prof Meerjady Sabrina Flora said at a press briefing at her office in the capital.

The patient was in the ICU at a private hospital in the capital and had multiple pre-existing complications such as chronic obstructive pulmonary disease (COPD), hypertension, heart disease and diabetes, she said.

He also had a stent implanted in his heart, Flora said.

Those who came into contact with the man are being traced and quarantined, claimed the IEDCR director.

Of the four new cases, three are men and the other is a woman. They include two returnees from Italy, one from Kuwait, and a family member of one of the returnees.

All four have underlying health conditions, she said.

Flora further said 10 coronavirus patients are now receiving treatment in isolation in hospital. The first three patients who tested positive early this month already returned home after recovery.

A total of 16 people have been kept in isolation while 42 are under institutionalised quarantine, she added.

The IEDCR tested samples from 49 people in 24 hours till 8:00am today. It has so far tested 351 samples.

Flora said they would ready some labs -- both inside and outside the capital -- within a week to carry out coronavirus tests.

"The labs will work under the direct supervision of the IEDCR."

The director urged everyone not to hide information, especially about travel history and coming into contact with returnees from abroad, while consulting doctors.

"Covid-19 is highly contagious but not deadly."

She said the IEDCR is working on a mobile app to ease pressure on its hotline numbers.

"Apart from this, we will provide an email address and open a Facebook page."

She requested people to use these means to contact the IEDCR and to call on the hotline numbers only if they are unable to use the alternatives.

CURRENT SITUATION

Though the government insists that it has taken all-out preparations, there is concern about whether the country is fully equipped to prevent an outbreak and treat the infected.

The IEDCR claims there has been no community transmission yet. But experts say the reality could be different as the authorities don't have a complete picture of the crisis that is unfolding.

To know about community transmission, the World Health Organization (WHO) has advised testing all the cases of atypical pneumonia in the country.

National Influenza Centre at the IEDCR has surveillance centres in 19 hospitals across the country. The IEDCR chief claimed that they are testing all atypical pneumonia cases.

The experts, however, said those tests must be done through an active method -- a planned and targeted way to select and test the cases.

"If we systematically test some cases of atypical pneumonia and suspected cases who have not travelled any virus-affected countries, we could be able to know whether there is any community transmission," Prof Mahmudur Rahman, former director of the IEDCR, told The Daily Star yesterday.

However, no tests have yet been done on such suspected cases, he said.

According to experts, the failure to enforce home quarantine of the suspected cases across the country is also an issue of concern.

A total of 631,538 passengers from different parts of the world entered the country from January 21 till yesterday, according to the IEDCR.

The majority of them were from the virus-hit regions. This week, around 400 Bangladeshis returned from Italy and were allowed to go home on condition of self-quarantine.

Media reports show that many of them were not following the instruction to remain in self-quarantine, putting the community people at risk of infection.

Prof Saif Ullah Munshi, chairman of virology at Bangabandhu Sheikh Mujib Medical University, said, "Since the outbreak went out of control in China, we got more than two months for preparations. But we failed to understand the gravity of the crisis."

The first major lapse on the part of the government was a lack of proper screening of inbound passengers at the international airports in Dhaka, Sylhet and Chattogram, and at the land ports, he noted.

Experts pointed out that even when Covid-19 turned pandemic in Europe, the government allowed expatriates from Italy, Germany and other countries to enter the country without proper screening.

And then instead of keeping those expatriates in strict quarantine, the authorities allowed them to go home, they said.

WHAT SHOULD BE DONE?

"The government must take drastic measures. We need strict monitoring to ensure proper quarantine. There should be arrangements to treat patients at facilities. The intensive care units [of hospitals] should be ready," said Prof Muzaherul Huq, former regional adviser (Southeast Asia) to the WHO.

He suggested that the government should put the entire country under lockdown immediately.

"All health staffers should be equipped and trained for Covid-19 patient management. There should be arrangements for their [staffers] accommodations near hospitals, away from their families," he added.

He also suggested that Covid-19 patients should not be admitted to general hospitals as this could lead to transmission of the virus.