COVID-19: More data and analysis essential

There is a lack of adequate data and analysis concerning the state of coronavirus in the country. The health directorate is providing partial information. There is an absence of information required for policy making and planning. Public health experts and economic researchers have said this must be addressed immediately.

There are innumerable questions with no answers - which class or profession is most affected by COVID-19? Which cross section of the population has the lowest incidence of contagion? Among whom are the death rates highest? Is immunity developing among the affected patients? Which section of society is more conscious about maintaining social distancing? No genome sequencing of the virus has been done in the country to determine the coronavirus’ transmission strength. The general public as well as public health experts and researchers are in the dark about all this.

The main source of government information is the Institute of Epidemiology, Disease Control and Research (IEDCR). In the past this institution had provided the public with information and analysis on various disease outbreaks and epidemics such as the Nipah virus, anthrax, chikungunya and bird flu. Even during the dengue outbreak last year, IEDCR has presented information as well as analysis to a certain extent. However, this institution has not been providing any significant analysis concerning the coronavirus pandemic or its present state in the country. IEDCR presently does not even have the responsibility of coordinating the COVID-19 tests. Experts feel that there is no clear central hub for data and analysis regarding coronavirus in the country.

Convenor of the health ministry’s national technical advisory committee and professor of Bangladesh Medical and Dental Council (BMDC), Mohammad Shahidullah, told Prothom Alo, “We get to know how many people are being affected from the daily news bulletin of the health directorate. But we also need to know more details such as how many of the affected are garments factory workers, how many are slum dwellers and such. Such data can be analysed to change strategies or take up new programmes.”

Dhaka University’s Institute of Health Economics Institute, BRAC University’s James P Grant School of Public Health, and Bangladesh Health Watch have carried out, on a limited scale, certain studies concerning the social and economic impact of coronavirus. They have published the results of some of these studies.

Additionally, a private laboratory in Bangladesh has begun work on coronavirus gene sequencing. Dhaka Medical College and Mugda Medical College have also begun research. Those involved in such research said that it is essential to analyse the data of the coronavirus cases.

Research is being carried out globally. Public health experts, epidemiologists, pharmacists, geneticists, social and economic experts, everyone is involved in experiments, studies and research. From February all sorts of scientific research articles have been published in this regard. Every day new information and analysis is cropping up. This should have been so in Bangladesh too, experts say.

Government data

According to the health ministry, till Monday, samples of 129,865 persons have been collected. Of these, 15,691 have tested COVID-19 positive and 293 have died. Experts say that important socioeconomic information can be found in these figures and this is important.

Economist and former caretaker government advisor Hossain Zillur Rahman, speaking to Prothom Alo, said, “It is being said that there is community transmission, but there is no information about in which level of the community this transmission is higher.”

The health directorate has not clarified any such information.

Not a complex task

IEDCR personnel would go to people’s homes initially, to collect samples. They would fill in a form with the patient’s name, address and other details. An official of IEDCR on Monday told Prothom Alo, the form has been prepared on the lines of the World Health Organisation (WHO) form, with space for certain additional information.

Concerned persons said that the form used to collect samples is a huge resource of information for analysis. And, to an extent, the health directorate is giving some information based on these forms.

IEDCR publishes certain information on its website. This includes the number of samples collected and the number of results, the daily number of cases, the number of cases based on gender and age, number of deaths and number of deaths based on gender and age. It also has information of the district-wise number of cases and also the area-wise number of cases in Dhaka city.

Public health experts say that this gender, age and location-wise information is helpful in their work.

More data required

In its 14 April update, WHO stated that in 40 per cent of the cases, the symptoms are mild and in 40 per cent the symptoms are medium. In 15 per cent of the cases, the symptoms are acute and in the remaining 5 per cent the symptoms are complicated. Public health experts say this is a global average. However, this can change from country to country due to demography, climate and other reasons. That is why data is important to understand the actual state of the COVID-19 contagion in Bangladesh.

There is no specific treatment for coronavirus patients. The physicians prescribe drugs on the basis of the symptoms. Sources in several hospitals in Bangladesh have said that almost all patients are being given antibiotics. Two patients undergoing treatment at home has said they have been prescribed high dosage antibiotics.

Public health expert Abu Jamil Faisal said, “The death rate so far has been relatively low in our country, but no one can explain why. There can be a study on the drugs being administered to the patients in hospital and at home after testing positive.”

Attempts were made to speak to the director general of the health directorate, Abul Kalam Azad, and the IEDCR director, Meerjady Sabrina, in this regard, but they could not be contacted over cell phone.

Additional secretary (services division) of the health ministry, Habibur Rahman, was then contacted and he said, “When talking about the garment factory workers or slum dwellers, there should be specific data, not assumptions. I will bring the matter up in a future meeting.”

Gene sequencing important too

New information about the virus is emerging every day. Many feel that the transmission of the virus is not the same in all parts of the world. Geographical local, climate and other factors could create genetic changes in the virus.

An official of a private laboratory in the country said they have begun work on genome sequencing. It has been heard that IEDCR is also preparing to do so. Results for such research will be able to determine the characteristics of the virus in the country. It may help in tackling the virus.

Vice chancellor of Bangabandhu Sheikh Mujib Medical University, Kanak Kanti Barua, speaking to Prothom Alo, said, “The coronavirus pandemic is an enormous issue. Data and scientific analysis is essential to understand the extent of the virus. This is essential to determine what is to be done and also for the sake of posterity.”

* The report has been rewritten in English by Ayesha Kabir