A sub-inspector (SI) with Covid-19 symptoms went to Bhairab Upazila Health Complex in Kishoreganj on April 9 when he met a resident medical officer (RMO) there.
Observing his condition, samples were collected from the police official and he tested positive for the disease.
This result prompted the RMO to be tested for the coronavirus infection, and the result came negative. On the other hand, a close contact of the doctor was found positive in the test.
However, the RMO was not quarantined, rather he was carrying out his duties regularly at the health complex.
A few days later, the RMO was found positive for the disease and samples from some 36 people, including doctors, nurses, supporting staff, and patients, were collected and of them, 20 were found positive, said one of the doctors who tested positive.
He said if the RMO had been sent to quarantine at the first stage, the infection rate could have been lessened and that was proved in case of Bhairab police station as all the members of the station were sent to quarantine after the first detection.
According to Bangladesh Doctors' Foundation (BDF), some six doctors of the upazila health complex were later found positive for Covid-19 owing to a little mistake.
An association of nurses' rights said at least 10 nurses were infected at the health complex.
Nurses, supporting staff are in worse state
While talking to the nurses at Dhaka Medical College and Hospital (DMCH) and Narayanganj 300-bed Hospital, they said they have been provided with partial personal protective equipment (PPE) and are concerned about the quality of the safety gears as well.
They said other healthcare professionals, who are working outside the coronavirus isolation unit, have hardly been provided with the protective equipment.
The nurses at the private hospitals, working at the emergency unit, said they are also at high risk now.
A nurse from DMCH said they are in fear as they do not know who would be posted at the workplace that deals with coronavirus patients with the incomplete set of PPE.
Besides, the nurses, including those who carried out their duties at the coronavirus unit, share the same dining space posing a risk for all to be infected with the virus.
However, such fear exists among nurses at the private hospitals as well.
A nurse at Dhaka's Ad-din Medical College Hospital, which mostly deals with expectant mothers along with children, said the authorities have been forced to relocate their emergency unit twice as two patients were found positive for Covid-19.
Now the unit has been transferred to the sixth floor and they are in fear of being infected as they were provided with poor quality of PPE, better to say raincoat without any protective mask, she said.
"We have been forced to buy face shields on our own."
The nurse also pointed out the mismanagement of the hospital authorities saying: "They took the nurses to the hospital from the hostel in an overcrowded bus which also poses risks of infection.”
A support staff of the hospital said the doctors got a complete set of PPE while the nurses got something of that, but they were scarcely provided with any protective equipment.
Similar situation was found at the government hospitals as well.
An online cross sectional survey under the supervision of Bangladesh Basic Graduate Nurses' Society (BBGNS) Joint General Secretary Sabbir Mahmud Tihan, using the google docs form, was conducted on April 19-20 when 575 nurses around the country provided data about their PPE practices.
Among the participants, 294 nurses (51.58%) work in government hospitals.
The survey said a total of 85.66% claimed that they did not have a minimum of one complete PPE set and 34.11% bought the PPE on their own.
Around 65.55% nurses did not wear PPE, while 75.57% did not wear eye protective glasses. Even 25.61% of them did not use qualified masks, it said.
Grim condition of healthcare professionals
According to the Bangladesh Doctors' Foundation (BDF), the total number of infected doctors now stands at 352, a six-fold increase from just 54 on April 14.
This means over 29 doctors were being infected per day over the 12-day period.
Bangladesh reported the first death of a doctor diagnosed with Covid-19 on April 15.
However, the foundation said eight doctors have recovered till now, while around 250 doctors have been kept under facilitative quarantine. Moreover, more than 300 doctors are in self-quarantine at home.
Bangladesh Basic Graduate Nurses' Society (BBGNS) said some 189 nurses in the country have been infected.
Among them, some 112 were from government hospitals with 79 from private hospitals. Till now, three nurses recovered from the infection and more than 350 nurses are under quarantine, it said.
Bangladesh Medical Technologist Association (BMTA) President Almas Ali Khan said more than 20 medical technologists have contracted the virus.
The healthcare professionals' rights-based associations collect information about the infected individuals by their members assigned in each district while the Bangladesh Medical Association (BMA) communicates with the directors of hospitals for updating the numbers, officials said.
Reasons for growing number of infections
BMA Secretary General Dr Md Ehteshamul Huq Choudhury and BDF Chairman Dr Shahed Rafi Pavel mentioned that hiding of detailed information by the patients and provision of low-quality PPE or lack of PPE are the major causes of the spread of infection among healthcare professionals.
Dr Shahed said the government has recently issued a circular that asked the hospital authorities to form three separate teams for the smooth operation of their health facilities in order to minimize infection rate among doctors.
But the directive has not been implemented in any stage, he lamented.
Besides, quarantine is another major issue, he said.
As the hospitals are following the regular routine, the doctors have very little scope to be kept in quarantine for the sake of running the regular operation of the hospitals, Shahed continued.
This causes the spread of infection, which happened in the Bhairab hospital, the BDF chairman added.
Meanwhile, BBGNS President Nasimul Haque Imran said the nurses are not getting proper food with nutrition at the hospitals dedicated for Covid-19 treatment.
Besides, poor management -- arrangement of their residences and changing rooms -- also plays a major role in spreading the disease.
What the authorities say
The Directorate General of Health Services (DGHS) has repeatedly denied the allegation of not being able to provide PPE.
DGHS Additional Director General (Administration) Prof Dr Nasima Sultana, in a daily online health bulletin on Friday, said they have managed some 1,516,190 PPE and of those 1,242,008 have been distributed.
They are collecting more PPE to continue the supply of the safety gears to the government hospitals, she said.
Meanwhile, the Hospital and Clinic Unit of DGHS on April 18 sent a circular to the medical college hospitals, specialized, and Sadar hospitals, along with upazila health complexes, to form three teams for running the operation of the healthcare facilities.
The circular also ordered that quality PPE for the healthcare professionals are ensured.
However, till last week none of the hospitals, except Shaheed Suhrawardi Medical College and Hospital, ensured the revised routine for operation.
Director of Mitford Hospital Kazi Rashid Un Nabi told the Dhaka Tribune on Friday that they did not introduce the shifts as they did not feel it necessary.
The same reply was obtained from the hospitals' authorities in and outside Dhaka.
Bangladesh Private Clinic and Diagnostic Owners' Association President Prof Dr Maniruzzaman Bhuiyan said: "We asked our members to ensure proper safety measures, including PPE, for the healthcare professionals.
"No official or staff of the member facilities brought any complaints over the matter to us. If we get any complaints, we will work on it."