The main purpose of the lockdown is to prevent the disease from spreading from one place to another. Lockdown is not everything – it is only a part. It is a step to curb the transmission of the disease.
If there had been no lockdown in the country, the many patients found in Dhaka these days would have spread all over the country because hundreds of thousands of people go to all over the country from Dhaka every day. Also, many healthy people from outside Dhaka would carry the disease from here. Lockdown has prevented these cases.
But lockdown is not everything. It is a policing system. It is necessary to analyse who are the people with whom the patient has come into contact with. It is necessary to know the places where the patient has visited and by which transport. Lockdown is an administrative matter, but the rest is the task of the public health department.
Contact tracing is not done properly. We need a team for each of the 5,000-6,000 patients that we have. Each team needs 10 to 12 members. Teams of public health experts, medical officers, volunteers, police, and local elected representatives should be there.
Contact tracing, quarantine and laboratory tests must be facilitated along with lockdown. Forget about 6,000, if we could form 1,000 or 500 teams, it would be enough for the moment. There are several teams. But they are not teams of experts. It is hard for a medical officer who has no degree in public health.
As a result, many people are being infected with the disease from one patient. The number of patients is not increasing because we cannot trace all the patients. The number of patients is supposed to increase by a hundred to 200 to 400 to 800 every next day.
All the countries are experiencing this. But here, the number was stuck between 300 and 400 in the last few days.
The reason is we have missed many patients, in many cases we were late to trace patients. The samples are not being collected properly. The people who are collecting samples are not skilled.
On the one hand, we cannot trace patients and we cannot stop the spread of infection from those who are being identified. The curve that we are seeing is not the true picture. It is recorded data. There are patients outside this. The garment factories are open. Now the number of patients will increase.
Once, the position of Bangladesh was at 112 in the world. Now it is 47. Probably the position will come down to below 40 in the next few days. Because other countries are not having new infections. If we fail to take the right actions, the peak of our situation will come out.
Garment factories and restaurants are being opened without any discussion with the health department. The risk will increase in the coming days because of these uncoordinated decisions.
We have been emphasising proper tracing of the patients from the beginning. But the tracing of infected patients is not being done, many patients are hiding themselves in fear and others are being infected from them.
We are being trapped in a vicious cycle. We have to pay the price. Because of the way the number of patients is increasing, we do not have enough space in our hospitals to keep so many patients.
Professor Be-Nazir Ahmed, former director, Communicable Disease Control, DGHS
Curve of rising patient numbers not real one
The curve of the number of rising patients that we are observing is not the real curve. This curve consists of only the patients who are being tested. People from all over the country are not being tested. Most of the patients are from Dhaka division.
The number of patients is higher where more tests are being done. The curve is rising in Dhaka as the number of tests is increasing here. The curve will rise more if more tests are done. If the number of tests does not increase, the curve will remain the same.
To make the curve rise and then come down, we need to test the people all over the country who have the symptoms of coronavirus and isolate them. If isolation can be done all over the country, the transmission of the virus will stop and the curve will also fall.
We need to do three things – lockdown, test and trace.
After detecting a patient, all the people who had come in contact with him or her in the previous three days must be kept in quarantine because they could also be infected. Those who will show symptoms after being placed in quarantine must be isolated.
After two weeks, those who will show symptoms should be tested and the others will be set free. If we can follow this procedure, the situation will improve.
The decision of opening the garments factories and markets is unscientific. It will lead to a dangerous situation in Dhaka city. The scientific decision is even the mosques should not be allowed gathering of more than 10 people.
The garment factories that have been opened will not be so for many days. They should be placed under lockdown within a few days. In every country, there is a task force who decide what to do. But we do not have any task force. Nobody knows who is making decisions for us.
Professor Ridwanur Rahman, head of Research Centre, Universal Medical College
Cannot control situation in Dhaka because lockdown is not maintained properly
Most of our patients are in Dhaka city. The number of patients is not increasing in other divisions apart from Dhaka. We cannot control the situation of Dhaka division because the lockdown is not maintained properly. It is only an official lockdown. As a result, the number of patients is not decreasing.
The number of patients has increased along with the number of tests. All the works are being done over the phone but nothing is being done properly.
The health department says they are not getting information about the patients when they call them. The patients are giving them the wrong numbers. But this is not any solution. The problem must be solved by involving the local administration.
Contact tracing is not being done properly. The infection is spreading by infected patients.
The garment factories have been opened again, which will increase the number of patients in Dhaka division. We will get the result in the next seven or eight days. The real picture will appear then.
Currently, the information we are getting will not include the information from the RMG factories. The current information is based on the patients who were infected earlier. The curve of infections after April 20 shows that the number is fluctuating. But there is a big jump in the curve after April 28.
The number of patients increased more on April 29 which suggests that the curve is rising high. This pattern of increasing patients is alarming. The curve will be clear after observing the number of infected patients of the next two to three days.
Professor Nazrul Islam, noted virologist and former vice-chancellor of Bangabandhu Sheikh Mujib Medical University Hospital
