Is the virus hotline helping right? NO

If you call the IEDCR coronavirus hotline today, the responder will ask you, did you return from abroad or come in contact with anybody who returned from abroad in the last 14 days? 

If you say 'no' to both parts of the question, the responder will advise you not to be worried. Yet, if you feel feverish, you will be advised to see a doctor at your local hospital for flu treatment.   

If any of your answers is 'yes', you will be advised to let them know if you start to have breathing problems, high temperature and coughs. 

In that case, the disease control agency will send somebody to collect samples from you for testing. 

This correspondent today called the hotline and received the above health advisory.

Earlier this week, The Business Standard called the hotline number on two separate occasions and received the same advisory showing their testing protocol remained unchanged even in the face of growing risks of the pandemic spreading in the country. 

They seem to be oblivious to the fact that people who have never gone abroad or met foreigners can also get infected.

As of yesterday, five out of 10 patients detected so far were infected through local transmission. It conducted only a few tests, 268 so far. It has a stock of 1,732 kits as of now, a minuscule number in this densely populated country of 170 million. 

Disregarding the evolving risk, the Institute of Epidemiology, Disease Control and Research (IEDCR) has been following the same test protocol for around the last three months. It is the lone authority to determine if a person needs to be tested for the virus and if needed, it runs the tests. 

Its approach to fight the pandemic remains unchanged even after it had detected cases of local transmission of coronavirus. 

The most effective ways to fight virus is testing as many as possible.

The way the IEDCR is handling the virus outbreak currently does not match the WHO advisory.

The global health organisation once again on Monday night asked the health authorities of the countries affected by the virus to conduct extensive tests. 

"We have a simple message to all countries - test, test, test," WHO Director General Tedros Adhanom Ghebreyesus told a news conference in Geneva, calling the pandemic "the defining global health crisis of our time".

"All countries should be able to test all suspected cases, they cannot fight this pandemic blindfolded."

Without testing, cases cannot be isolated and the chain of infection will not be broken, he said.

Global experiences show that the most effective way to fight the virus is testing as many people as possible for infection. 

China and South Korea successfully fought the virus by conducting extensive testing. 

Italy, on the other hand, is now struggling to cope with the situation mainly due to scanty testing at the beginning of the virus outbreak.    

Current definition of infection must be expanded

Experts, however, is of the opinion it is time for IEDCR to take a more vigorous approach to meet the Covid-19 outbreak. 

Professor Mahmudur Rahman, member of the Advisory Council of the WHO Preparedness Committee on Epidemic, told The Business Standard yesterday the current definition of the infection must be expanded to bring more patients under the testing protocol. 

He also said even apparent pneumonia cases have to be considered as suspected Covid-19 cases and tested. 

However, talking to this newspaper yesterday, Dr Aminul Hasan, a member of the government's technical committee on coronavirus, said the IEDCR approach may be changed if the number of patients went up. 

Complicating the situation is the fact that more than one lakh expatriates have returned in last one week. According to reports, most of them are freely mingling with people in their localities, thus increasing the risk of local transmission manifold. 

The quarantine system in Bangladesh is also largely ineffective. In this densely populated country, most homes do not have enough space to dedicate to quarantine one or more persons.

Prof Muzaherul Huq, former advisor of the WHO, had said in an earlier comment to The Business Standard, "Apart from local transmission, there is risk of community transmission." He also criticised the government's poor tracking mechanism of Covid-19.

Even though experts so far have been working on the assumption that the virus spreads mainly by people who are already showing symptoms, strong proof has emerged from more than half a dozen studies that people without symptoms are causing substantial amounts of infection, CNN said on Monday referring to a latest study by experts. 

Experts said it had become clear that transmission by people who are asymptomatic or mildly symptomatic is responsible for more transmission than previously thought. 

Returnees from China, Italy, Greece and other virus infected regions, who are mingling freely in their areas, have the potential to be carriers without any symptom. The IEDCR could not test them all before letting them go home because of its limitations. 
Meanwhile, testing and isolating patients have been stressed by US experts. 

"No matter how your health systems or political systems are organised, the keys to epidemic control remain the same - test, trace, isolate and inform," Jessica Justman, a professor of medicine in epidemiology at Columbia University, has said.

Bangladeshi experts are also of the same opinion. In an earlier comment to The Business Standard about returnees mingling with locals, Prof Muzaherul had said all returnees should be tested for the virus because not everyone was following the home quarantine protocol properly and there had been cases of local transmission.