Two months have already passed but Bangladesh is still in a perilous situation due to the mounting amount of allegations from patients against the health service system of the country.
Bangladesh had a long time to find a way to deal with the crisis, including an option to explore the best practices adapted across the world. However, the country failed to reap those opportunities which lead to a situation that can now leave the health system in a vulnerable state.
Being frontline service providers, it is very common that the health care professionals would be at high risk of contamination, experts and professional said.
However, delay in taking protective measures, which are also not foolproof, are dragging health care professionals to a desperate situation, they added.
Hospital accounts for 41% of infections in China, despite having taken huge disinfection measures, while Bangladesh is nowhere near to them, said Bangladesh Medical Association (BMA) Secretary General Ehteshamul Huq Chowdhury.
Health authorities took delayed steps to solve the personal protective equipment’s (PPE) problems and by the time they did, the hospitals had already became vulnerable to some extent.
When they took the first measures to make the hospitals a bit safer, another issue came along and finally they shifted from one initiative to another (triage), which was advised in early March.
Because of this, a huge number of physicians, nurses, medical technologists and others have been infected and more are under quarantine or isolation facilities, making the situation even more complex, he added.
Over a thousand health care professionals infected
Bangladesh Medical Association said they have a list of 1,090 health care professionals infected by the coronavirus till Tuesday.
Among them, 463 are doctors, 275 nurses and 352 are other health care professionals.
The number accounts to around 10% of the total infections in the country.
However, an estimate of Bangladesh Doctors’ Foundation (BDF), a platform of local physicians, said on Tuesday the total number of infected doctors now stands at 574, up from merely 54 on April 14.
The majority of the infections are in Dhaka, followed by Narayanganj, Gazipur and Kishoreganj. Most cases were at government hospitals. Interestingly, no cases were found in private hospitals outside Dhaka.
BDF Chairman Dr Md Shahed Rafi Pavel said more than 100 doctors are staying at home awaiting testing while a further 400 doctors went into self-quarantine as they came into contact with infected ones.
Some 113 health care professional have recovered from the infection so far, he added.
Meanwhile, Bangladesh Basic Graduate Nurses Society informed that some 350 nurses have already been infected, while more than 500 others are in quarantine as they came into contact with the infected patients.
According to Bangladesh Medical Technologists (MT) Association some 30 MTs have been infected till Tuesday.
Meanwhile, Bangladesh Diploma Pharmacists Association reported eight infected cases in government hospitals while Bangladesh Pharmacists Forum said they are yet to make the list but were informed of around 30 such cases.
Much more to do
The upward trend of infections among doctors continues amidst widespread discontent from healthcare professionals regarding the quality and distribution of personal protection equipment (PPE).
Improper hospital management, lack of training for wearing and disposal of PPE are making for a complex situation which is leading towards an alarming state of affairs.
BDF Chairman Dr Md Shahed Rafi Pavel said despite several attempts, they have not seen any visible result from the initiatives taken by the health authorities.
It took months to issue the directive to maintain the three routine based duty in a month, however, it is yet to be implemented strictly as many doctors have already got infected, said Dr Md Shahed.
BMA Secretary General Ehteshamul Huq Chowdhury said PPE have already been provided but as the professionals did not get the required training on how to wear and dispose the PPE, it is also becoming a source of infection.
Regular disinfection process should be carried out in the hospitals as well, he added.
“DGHS (Directorate General of Health Services) yesterday (May 4) have just provided the directive to introduce the triage system which will need another 10 to 15 days. Till then the situation will continue,” said the secretary general.
This is demoralizing for the doctors and the other healthcare professionals, he opined.
Will setting up triage system at hospital entrance be a savior?
BMA has proposed three immediate measures for safeguarding healthcare professionals on April 28. According to the leaders of BMA, they have been advising for it since March, soon after it showed its efficiency in Italy.
Along with the required quality PPE, a triage system should be initiated at the entrance of non-covid hospitals and proper equipment should be supplied to the staff in time, said Dr Ehteshamul, secretary general of BMA.
The most infected countries received maximum benefit from this system, he added.
In the triage system, there should be a specific place at the hospital where all the patients first go and in accordance to the patients’ required treatment they would be sent to yellow, green and red rooms, where they will receive the treatment.
The best part is, not all doctors will be exposed to the risk of infection every time an infected person enters the hospital premises.
Italy frst introduced the system in early March, in a form of emergency field hospitals, outside hospitals, to fight the virus. USA and France also implemented the system to safeguard their health care professionals as well.
On March 8, the health authorities in Bangladesh reported the first case of Covid-19, a severe acute respiratory illness caused by a new strain of coronavirus, Sars-CoV-2.
The country reported 186 deaths and 11,719 cases of Covid-19 till Wednesday.
Till now, the fast spreading coronavirus has claimed more than 265,080 lives and infected more than 3,823,010 people across the world, according to worldometer.
As many as 1,303,018 people have recovered from Covid-19, a disease caused by a new strain of coronavirus, which has spread to 212 countries and territories across the planet.