Bangladesh does not have focus on stemming the sources of novel coronavirus infection. Instead, the officials and healthcare practitioners are more interested in treating the patients. This was said by a visiting team of medical experts from China.
Aside from identifying the weaknesses, the team of experts also made a six-point recommendation to curb the infection in the country. That include increasing the number of tests by setting up more labs and ensuring their quality, treating patients at hospitals, and strengthening the hospitals’ infection control management system.
Bangladesh diplomats working in Dhaka and Beijing told Prothom Alo on Sunday that the China delegation returned in the last week of June and gave the report to the Bangladesh government in the second week of July.
Speaking to Prothom Alo on Tuesday, deputy chief of China mission in Bangladesh, Yan Hualong said the report by the team of Chinese experts has already been handed over to Bangladesh. He, however, declined to comment on the subject of the report.
In response to a question of Prothom Alo, Hualong said China is ready to help Bangladesh if they seek any help to implement the recommendations.
The 10-member Chinese medical expert team arrived in Dhaka for two weeks on 8 June. They discussed with experts from Sylhet and Chattogram through videoconferencing from Dhaka.
Treatment of infected person
The China delegation said Bangladesh has appropriate facilities for treating the COVID-19 patients with medium and acute symptoms. But patients with mild symptoms have been advised to stay in quarantine at home. As a result, source and spread of the disease could not be stemmed at the outset for lack of effective and quality observation. This has increased the chance of infection.
In this context, the Chinese experts made some recommendations for patients with different types symptoms.
Prothom Alo on Tuesday evening contacted the director general, an additional director general, and director of concerned department of the Directorate General of Health Services (DGHS) to know their steps to implement the recommendations made by the Chinese experts. All of them said they know nothing of the report
Firstly, to observe the symptoms of the patient very closely and provide oxygen therapy as soon as possible.
Secondly, to ensure that a patient does not deteriorate from medium to critical condition, if his disease is detected in the primary stage.
Thirdly, appropriate detection of patients is necessary. Patients with medium symptoms can be treated at makeshift hospitals but those with critical condition have to be sent at specialised hospitals.
Fourthly, highest use of primary healthcare at hospitals has to be ensured. A ventilator has to used for two patients and help with medical equipment should be sought from the international community.
Fifthly, emphasis should be on multidimensional treatment for critical patients. Team of specialists has to be formed taking physicians from ICU services for treating various diseases. The goal would be to decrease the death rate.
The China delegation thinks, the source of infection could be uprooted keeping patients at temporary hospitals. This can also curb the rate of infection and death.
Boosting lab capacity
The China experts evaluation is, the number of RT-PCR tests for detection of coronavirus in Bangladesh is insufficient. During the time of their visit, around 15,000 tests were being done at 60 labs. The process Bangladesh follows in collecting samples from a patient’s home also increases the spread of infection. The lab workers are at risk of contracting the infection because of lack of quality bio-safety training.
Several recommendations were made to get over the weaknesses of labs as per the light of experience from Wuhan.
Firstly, the number or testing capacity of labs has to be increased. The quality of labs across the country has to be same. Professional labs alongside the medical educational institutions have to be encouraged to conduct tests.
Secondly, regular training has to be organised for the lab workers alongside ensuring their bio-safety.
Thirdly, quality of tests at labs has to be ensured and steps have to be taken to decrease the rate of false positive and negative.
Fourthly, labs should be run scientifically. Machines should be kept functioning for 24 hours through shifts. As a result, the number of tests will increase in a short time.
Fifthly, specialised places have to be selected for collection of samples.
Infection control management at hospitals
The Chinese delegation found that there is no specialised department at medical colleges for teaching infection prevention, control and safety. No one has been appointed for monitoring the infection situation for 24-hour. In this situation, they have made a few recommendations for decreasing the infection of physicians and healthcare providers.
Firstly, increasing the number of all-time workers by increasing supplies for them and arranging training for them on how to control the infection.
Secondly, specialised infection control department could be opened at quality medical colleges.
Thirdly, people with strong sense of responsibility have to be employed and their working time has to be fixed. The front-line fighters have to be kept at one place. There should be enough rest and nutrition for them. At the same time, there should be monitoring of the health condition of those who assist in healthcare.
Fourthly, proper detection of disease, treatment and PPE should be ensured.
Fifthly, isolation wards should be installed at totally detached areas, probable infected areas and at infected areas. The walkways of patient will be different from that of the healthcare providers.
Prothom Alo on Tuesday evening contacted the director general, an additional director general, and directors of concerned departments of the Directorate General of Health Services (DGHS) to know their steps to implement the recommendations made by the Chinese experts. All of them said they know nothing of the report while the secretary to health services division of the health ministry could not be reached.
Speaking to Prothom Alo, professor Mohammad Shahidullah, convener of National Technical Advisory Committee on coronavirus, said the committee is not informed about the report presented by the China delegation. If the government thinks, it can implement some of the recommendations directly and seek advice of the committee in some cases.
* The report, originally published in the print edition of Prothom Alo, has been rewritten in English by Shameem Reza