Bangladesh Slipping Into Grave Crisis, Fast Emerging As One Of Worst Covid-19 Hotspots

Bangladesh has gone over the edge of the Covid-19 precipice and is hurtling fast down the steep slope to an imminent and grave crisis.

The densely populated country of 16.8 crore people, a large percentage of them impoverished, registered 57,563 Covid-19 positive cases till Thursday (June 4) morning.

Public health experts say that the actual number of Covid-19 positive cases in Bangladesh will be much higher. “The testing rate is abysmally low and so most cases are undetected. We fear many deaths due to the coronavirus are also going unreported,” said an epidemiologist at Bangladesh’s premier Institute of Epidemiology, Disease Control & Research (IEDCR).

Bangladesh has so far tested only about 3. 5 lakh people, and that too in major urban centres. That translates into just 0.2 percent of the country’s population being tested till now. This is lower than even Pakistan’s testing rate, and given the country’s poor laboratory infrastructure and lack of testing kits, there is no way the number of tests will be ramped up appreciably in the next few weeks.

Public health experts say there are only 49 testing laboratories in the country and since there are no plans to increase this number, the testing rate will continue to be very low. Bangladesh’s Covid-19 positive cases--and experts point out that these are only cases being tested; most of the infected are not being tested at all--is growing exponentially now. The country is now ranked 9th in terms of rate of rise of Covid-19 positive cases. It was ranked 46th less than a month ago.

Bangladesh now ranks 21st globally in the number of Covid-19 positive cases. As per mathematical models, it will rank among the top 10 (in terms of number of cases) by the end of this month.

Epidemiologists say that the widely expected spike in the number of positive cases will happen due to the lifting of lockdown even before the country has had a chance to gain a modicum of control over the pandemic. Enforcement of the lockdown was extremely lax to begin with, and even in the country’s capital Dhaka, tens of thousands thronged the markets and crowded the streets and public transport.

“Now, with Bangladesh having chosen livelihood over lives, the virus will surely have a free run and infect millions. There is simply no way a disaster can be averted,” warned the IEDCR epidemiologist who did not want to be identified.

Also, Bangladesh’s health infrastructure is in shambles. Bangladesh has just 1267 ventilators--520 in state-run hospitals and 737 in private hospitals. This is grossly inadequate, say experts.

WHO figures say that about 15 per cent to 20 per cent of Covid-19 positive patients require hospitalisation, and 15 per cent of them require ventilator support for an average of two weeks.

Bangladesh has, at present, 44,621 active cases (of the country’s 57,563 cases, 12,161 have recovered and 781 have died).

Going by the WHO’s figures, more than 6,500 of the active cases in Bangladesh would be severe and requiring ventilators.

“That means most of the critically ill patients are not getting ventilator support. As the number of positive cases rise (and the number of ventilators remain static), the death toll due to lack of proper medical care will go up,” said a senior professor at  the Dhaka Medical College Hospital.

Despite public assurances by the country’s health authorities, Bangladesh has failed to import ventilators over the past three months and attempts by local manufacturers are still in the trial stages.

There seems to be no urgency to improve the country’s healthcare infrastructure, and that can only result in the case fatality ratio (percentage of deaths) going up alarmingly in the coming weeks.

Virologist and Bangabandhu Sheikh Mujib Medical University’s former vice-chancellor Nazrul Islam says that the virus has spread everywhere due to lax enforcement and observance of lockdown and, now, its lifting.

Experts say Dhaka’s decision to lift the lockdown at a time when it should have been extended and enforced very strictly will cost Bangladesh very dearly.