According to the World Health Organisation (WHO), for the first wave of COVID-19 to be over, the number of people testing positive for COVID-19 has to drop below 5%. Bangladesh's present data says the infection rate is still above 10%. So the first wave of COVID-19 in Bangladesh is continuing and the rate of infection is increasing to some extent.

Why is the infection rate still increasing? The answer probably is we have become relaxed, or exhausted, or both. Unfortunately, nine months of COVID-19 infection has gone, yet we are not accustomed to using masks and hand washing. The question of social distancing is far away.

More than 50% of people who are outside the home do not use a mask. Out of which more than 50% do not know how to use the mask properly, most of their nose is exposed, so inappropriately using mask does not give them any protection. Soap and water are easily available in our country but we are reluctant to wash our hands. During winter most of the social events occur, like marriage, travelling for tourism, and in every occasion, there is a large gathering of people so the virus transmits easily. Another cause of the spread of infection in winter probably is, the novel coronavirus can remain in the air for a long period inside enclosed rooms and the people keep the doors and windows shut during winter.

 The number of infections is rising in many cold countries as the winter approaches. So we can assume that the outbreak may surge here in the coming winter. Washing hands with soap and water are one of the key hygiene rules to reduce the risk of infection, but people tend to avoid water during winter, so that may also facilitate the spread of viral infection.

Fortunately, winter usually is relatively brief in Bangladesh, but even then brings different sorts of diseases, such as fever, cold, cough, pneumonia and respiratory infections, cold diarrhoea, eye inflammation and dermatological problems.

To tackle the coming situation, the government of Bangladesh has taken some positive steps like those who are coming from abroad must have a COVID-19 negative certificate otherwise they will be quarantined for two weeks. Strong and strict monitoring is mandatory. Masks must be used properly while outside the home, otherwise, they should be penalised.

For COVID-19, data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infections, requiring oxygen and 5% are critical infections, requiring ventilation. The cause of death due to COVID-19 are either lung damage or coagulopathy. Occasionally sepsis or septic shock is also responsible.

The older population with comorbidity succumb to death more frequently. Bangladesh is lucky enough to have a lower death rate in comparison to other countries but unfortunately, the death rate of doctors, nurses and paramedics are very high, probably the highest in the world.

The author is a Professor of Paediatrics at Community Based Medical College, Mymensingh.

E-mail: mmukkhan@gmail.com