COVID-19: Physicians' mortality rate in Bangladesh ‘highest in the world’

Although healthcare workers on the frontline of the coronavirus battle are falling victim to the virus across the world, experts say the pandemic seems to turn deadly for Bangladeshi physicians in terms of mortality rate.

Over the past two weeks, the deaths of physicians from coronavirus have been reported almost every day in the country, taking the total tally to 43 as of 18 June, said Bangladesh Medical Association (BMA) president Mostafa Jalal Mohiuddin.

Besides, Doctors Safety, Rights and Responsibility said six other physicians died with coronavirus symptoms.

According to various organisations, coronavirus has claimed the lives of about 50 physicians, which is around four per cent of the nation’s total COVID-19 fatalities.

BMA president Mohiuddin said 3,301 health workers, including 1,040 physicians, 901 nurses, and 1,360 technicians and others engaged in different roles at the hospitals were also infected during the same period.

But the number is much higher as per the data of other bodies of physicians, nurses and healthcare employees.

Health experts have attributed the high mortality and infection rates of health workers to mainly lack of infection control measures, monitoring, proper management at the hospitals, inappropriate use and disposal of safety gears, lack of training for dealing with patients, coronavirus patients’ tendency to hide information, and carelessness of physicians and nurses.

Data from the Directorate General of Health Services (DGHS) show that the total number of confirmed cases stood at 108,775 and deaths at 1,425 on Saturday.

Former World Health Organisation (WHO) regional advisor Muzaherul Huq said the rate of coronavirus infections among health workers is very high in Bangladesh compared to other countries.

He said nearly 4,000 health workers, including physicians, nurses and pathologists and technicians, have so far been infected.

Huq said around 50 physicians have died in the country from the virus over the last two months. Sylhet MAG Osmani Medical College Hospital’s assistant professor Moyeen Uddin Ahmed was the first physician to die of coronavirus on 15 April.

“The coronavirus mortality rate in doctors in Bangladesh is around 4 percent, the highest in the world,” he added.

Huq said the average standard mortality rate in doctors in the world is 2.5 percent. “Italy witnessed the highest number of deaths of physicians, but the mortality rate of physicians in that country is also less than three percent.”

He thinks the main reason behind the growing infections among health workers is that they are directly coming in contact with patients and their attendants without proper protective gears.

“Lack of quality PPE was the main reason behind the infections of the doctors at the initial stage, but this problem has now been resolved to some extent,” he said.

The expert said many physicians are not properly trained to handle COVID-19 patients and using and disposing safety gears.

He said physicians have been working long hours under serious pressure and suffering from distress and fatigue. “That’s why sometime they lose their mind and wrongly handle patients, causing the infection.”

Former director (disease control) of DGHS Be-Nazir Ahmed said the health workers are being infected with the coronavirus in a greater number for lack of effective infection control practice at the hospitals.

Besides, he said physicians and health workers have not been trained enough to face the coronavirus situation and keep them protected from the virus.

“A small number of physicians and nurses were given training through video conferencing which is not enough,” he noted.

Be-Nazir said some physicians are still not taking adequate precautionary measures in dealing with patients. “Some are making mistakes under pressure while some are not properly maintaining health safety rules.”

The expert said all hospitals should ensure effective and quality infection control measures.

“Good guidelines should be prepared for infection control and there should be a trained team at every hospital to monitor the infection control measures.”

“Chinese team members, who arrived here also told us that they’re not seeing infection control measures at Bangladesh’s hospitals and this is the main reason behind the high infection and death rate in the health workers,” he said.

Besides, sufficient logistic support should be ensured for the health workers.

“They should be given quality safety gears. Sufficient and separate washrooms, basins should be ensured for doctors and nurses with available sop and sanitiser. They should be given comfortable accommodation so that they can stay separately from their family members after performing their duties.”

Bangabandhu Sheikh Mujib Medical University (BSMMU) vice-chancellor Kanak Kanti Barua said majority of the physicians who have died so far are senior ones who have comorbidities.

He said most physicians are getting infected while dealing with patients who come to them hiding information about their symptoms.

“Many patients, along with their attendants, come to the physicians without masks. They also hide their infection. Even, many patients who come to BSMMU for tests visit my room without any reason. Sometimes patients become aggressive if they are barred. It’s a big problem,” he said.

He said many senior and retired physicians are getting infected as they are doing private practice. “All physicians, including the senior ones, should handle patient very carefully and take all precautionary measures.”

They also should know how to safely put on PPE and put it off and the masks, and dispose of them, the BSMMU VC added.

“We’ll face dire consequences if we can’t protect our physicians and health workers from the virus. The deaths of senior physicians are irreparable loss to the nation,” he observed.

Kanak Kanti said all the hospitals should focus on infection control measures to protect the physicians and other health workers.