Bangladesh falls behind in COVID-19 tests, ahead in death rate in South Asia

In around a month after reporting its first coronavirus case, Bangladesh has far fewer number of deaths and infections than many other countries, but the mortality rate is comparatively higher.

But the densely populated country lags far behind most other countries in testing for COVID-19, the respiratory illness caused by the virus.

The total known number of the infected in Bangladesh is 56, among whom six have died, according to data from the Institute of Epidemiology, Disease Control and Research or IEDCR until Thursday.

The death rate in the country stands at 10.71 percent, the highest in South Asia. No other country in the region reported more than 3 percent deaths from the disease.

The rate is 2.85 percent in India, 1.35 percent in Pakistan, 1.67 percent in Afghanistan and 2.03 percent Sri Lanka while no one is known to have died from COVID-19 in Nepal, Bhutan and the Maldives.

According to Worldometers, a reference website that provides counters and real-time statistics for diverse topics, Angola and Sudan have the highest rate of deaths - 28.57 percent. They have seven cases with two fatalities each.

The global death rate due to the virus is 5.08 percent, according to Worldometers.

Among the countries with most deaths from COVID-19, Italy has the highest fatality rate of 11.89 percent, Spain 9.01 percent, the US 2.37 percent, China 4.03 percent and France 6.99 percent.

In Bangladesh, the government has faced criticism for a lack of coronavirus tests.

The government’s disease control agency IEDCR, which had the lone facility to conduct the test until last week, said it received a little over 1 million calls related to coronavirus on its hotlines.     

It ran tests on specimens from 1,900 people, which means the rate of COVID-19 test is a little over 11 people among every 1 million in Bangladesh.

According to calculations by Our World in Data, a scientific online publication that focuses on large global problems, the rate of tests among every 1 million people was 222.3 people in China until Feb 24, 3,422 in Italy until Mar 20, 118 in Japan until Mar 19, 429 in Malaysia until Mar 20, 4,456 in Australia until Mar 20, 314 in the US until Mar 19, and 10.5 in India until Mar 20.

Facing criticisms, the Directorate General of Health Services said on Thursday it was widening the range of tests as more facilities have already been set up.

bdnews24.com asked Mushtuq Husain, a former IEDCR chief scientific officer whom the agency is consulting now in its efforts to stem the outbreak, why there was a lack of tests in Bangladesh.

 “Everyone is talking about test. Many anxious citizens had called initially, but the virus could not be detected in most of them. Now we need to choose them though the sample collection criteria have widened,” said the member of Bangladesh Medical Association’s executive committee.

The IEDCR had initially been conducting the test on only overseas returnees who had symptoms of COVID-19, such as fever and cough.

Later, it started testing close contacts of the returnees with COVID-19 symptoms and the patients who had been hospitalised with respiratory problems, but were not recovering through normal treatment.

As a patient tested positive, the doctors, nurses and staff members of the hospital also underwent the test.

The lists of close contacts of the confirmed cases are long and the authorities collected specimens from every one of them even if they showed no symptoms, Mushtuq said.

“Now we are getting more negatives. The number of patients will rise when there is wide transmission,” he said.    

“Community transmission in Bangladesh is very limited. But if the rate of community transmission increases, the number of positive results will increase even if we conduct tests randomly,” he added.

FEWER TESTS, HIGHER DEATH RATE?

A researcher believes the death rate appears higher in Bangladesh because of fewer tests than other countries.

“We had been conducting tests on only severe cases. The rate of patients with morbidity was higher among them. So, the death rate was high. The number of patients would have appeared higher if we had conducted tests on mild and moderate cases as well,” the former IEDCR official said.

He requested anonymity considering the sensitivity of his estimation.

Mushtuq said the death rate in Bangladesh is high because not all the patients are able to get admitted to hospitals.

“This actually happens in the initial stages. In following stages this sees improvement. When these people can be admitted… then the true picture will be apparent,” he added.

Is it the hospital management or is it the patients’ mentality, what is responsible for this disorder?

To answer this question, Mushtuq said, “Patients are always willing to get admitted. But private hospitals have completely barred patients with respiratory problems.

“The government hospitals can’t do that. Everyone has masks and Personal Protective Equipment now. I think the situation on admitting patients has improved.