'Mismanagement' mars COVID-19 sample collection, testing as Bangladesh sees cases surging

When the work to control the coronavirus outbreak should gain pace amid a rising trend in the number of infections and deaths ahead of a possible second wave in winter, experts bemoan alarming mismanagement in sample collection and testing.

They now doubt sincerity of the government which had been saying all along that it was taking measures to prevent a surge in infections.

A number of government and private laboratories in Dhaka are not collecting or testing swab samples for a day at regular intervals when the situation is feared to be taking a turn for the worse.

But the reason for the failure to collect the samples remains unknown due to a lack of monitoring.

The Directorate General of Health Services, the civil surgeon of Dhaka, and the labs have conflicting stories to tell about the issue.

The number of daily confirmed coronavirus cases hovered around 1,500 for a long time after the initial surge, but it has been over 2,000 for quite some days.

The number of deaths reported daily has also increased from below 25 to over 30.

Amidst the alarm, more than half of the 66 labs in Dhaka did not collect or test samples for at least one day in the two weeks until Nov 22, according to the daily data published by the DGHS.

The trend of no collection or testing is usually seen on Thursdays and Fridays, even at large government facilities like Bangabandhu Sheikh Mujib Medical University and Shaheed Suhrawardy Medical College Hospital.

The Ad-Din Medical College Hospital and Ahsania Mission Cancer and General Hospital disagreed with the government data that they did not collect or test samples for at least one day.

Crowds of people lining up to get tested for the coronavirus at the Mugda Medical College Hospital in Dhaka as the number of cases has begun to rise ahead of winter. Photo: Mahmud Zaman Ovi

Jahangir Alam, the marketing manager of CRL Diagnostics, said when the number of samples collected in a day goes very low, they test these with the next day’s samples.

“This is why the number of tests is shown zero some days,” he explained.

“The workers need holidays,” said Nazmul Karim, the additional director of BSMMU, defending the decision to stop testing on Fridays.

Moinul Ahsan, the civil surgeon of Dhaka, admitted that most of the labs are not collecting samples, but he could not say why.

Nasima Sultana, the additional director general at the DGHS, claimed the labs have never stopped testing samples, but the private ones are not testing regularly as fewer patients opt for testing there due to high fees.

She could not explain why the BGB Hospital did not conduct any test for 14 days in a row.

Only a handful of people came to Dhaka’s Mugda Medical College Hospital for coronavirus tests on Wednesday. Photo: Mahmud Zaman Ovi

Nasima acknowledged a lack of monitoring. “We have given the private labs permission to conduct the tests. Now it’s up to them how they will manage the tests,” she said.

Dr Be-Nazir Ahmed, an advisor to the World Health Organization, criticised the government for the lack of monitoring.

“We are failing to control the outbreak because we are not conducting and managing the tests properly,” he said.

The former director of disease control at the DGHS believes the people have a lack of confidence in the Health Services Division, leading to their unwillingness in undergoing tests.

He also emphasised contact tracing after testing to control the outbreak.

Professor Nazrul Islam, a member of the national technical advisory committee on COVID-19, said there must be some effects if samples collected in a day are tested the next day.

The former vice-chancellor of BSMMU alleged the DGHS does not provide data to help the public and the committee of experts assess the situation.

“There are many sorts of mismanagement,” he said.