While Dhaka and Chittagong are seeing a comparatively slower rate of coronavirus transmission, rising infection rates in the southern and northern part of the country have been a cause of concern.
After analysing Directorate General of Health Service’s (DGHS) data of 10 days growth factor from June 1 to July 10, it was observed that Dhaka, Gazipur, and Narayanganj – the first epicentres of Covid-19 in the country – are seeing a decline in number of new infections.
The data also shows that another epicentre Chittagong is still in an upward trajectory of Covid-19 cases as it is seeing a slow but steady rise.
On the other hand, the recent spikes in Khulna and Rajshahi drew the attention of the Directorate General of Health Services (DGHS) and public health experts.
Public health experts are saying that the government’s failure to stop transmission at the rural level has brought the country into an even longer crisis. The transmission rate was low before June in these rural areas.
Ayesha Akhter, assistant director of DGHS emergency control room, also the member secretary of the information committee for Covid-19, told Dhaka Tribune that it is a relief to see that the growth of transmission is apparently at a stable rate. This indicates that the transmission rate will go into decline soon.
However, the transmission rate is still surging in several areas outside Dhaka that has already drawn the attention of the authorities, she added.
Seeking anonymity, a mid-level officer at DGHS who is involved with Covid-19 testing told Dhaka Tribune that it seems like Dhaka is at plateau with Chittagong while Khulna reached its peak in terms of transmission. Meanwhile Rajshahi is heading towards the peak.
What the data says
Health Directorate data shows that the infection rate in Khulna and Jhenaidah is 20 times higher than that of May 31 despite there being a huge backlog in coronavirus testing facilities in the division.
On May 31, Khulna had some 72 confirmed cases but the number since then has tripled in the first 10 days of June and then doubled in the last ten days of June.
The first 10 days of July can be decisive as the number seems to be lower. DGHS officials said the number of confirmed cases is lower during this period as there is a deadlock in testing facilities.
When contacted, Ayesha confirmed that there is indeed a deadlock in testing facilities of the region.
Jhenaidah also reported 20 times more cases during the period. On May 31, there were only 49 cases in the district but that increased to 1063 on July 10. The major increase was reported in the first ten days of July when some 868 cases were reported during the period.
In Jessore, the confirmed cases are constantly rising in every 10 days interval and the number reached 892 from 104.
The southern part of Dhaka division, considered as the regional belt of Khulna division also showing a new spike of confirmed cases.
Among the districts, Faridpur reported around 10 times more cases in the last 40 days, turning the number of cases to 2,973 from 280.
However, the division that catches the most attention is Rajshahi.
Rajshahi district saw a gradual rise in Covid-19 cases in June which suddenly jumped in the first 10 days of July. The number of infections in the first 10 days of July (859) is higher than that of in the whole month of June (559).
On the other hand, Bogra is seeing a declining trend in new cases since the last 10 days of June.
The rest of the districts in Khulna and Rajshahi show a constant rise in the number of confirmed Covid-19 cases.
Meanwhile, the infection rate in Rangpur and Dinajpur is increasing.
In Chittagong division, Chittagong, Noakhali, Comilla, and Cox’s Bazar were the most affected areas in terms of Covid-19 cases.
Of those, Noakhali and Cox’ Bazar is seeing a declining trend in new infections although the total number of cases has increased.
The transmission rate in Comilla has grown steadily till July 10.
Among the rest of the districts in Dhaka Division, only Tangail has a gradual growth of infection while the rest are reporting a decline in transmission.
Public Health expert Prof Shah Md Monir said the growing cases in Faridpur region has become a matter of grave concern.
It would be wise if necessary measures had been taken before the virus spread further in the area, he added.
Declining test number raising questions
While the public health experts and infectious disease specialists are emphasizing on conducting more tests, the DGHs see no issue with it.
According to DGHS, there are seven reasons that contributing in declining number of Covid-19 tests – charging for the test, testing facilities requiring to see a doctor’s prescription for the test, discontinuation of follow up tests to announce recovery of patients, getting used to the virus, flood submerging different areas of the country, health workers who are Covid-19 positive going off duty, and lesser requests from the government’s higher officials or local representatives.
Former DGHS DG Prof Shah Md Monir said in recent times, the number of tests decreased while the rate of confirmed cases against tests increased. But there is nothing to worry as the tests are being conducted on symptomatic infected patients only.
However, Dr Nazrul Islam, noted virologist and former vice chancellor of Bangabandhu Sheikh Mujib Medical University (BSMMU) termed it as discouraging for the general people and said as the number of infection is still high, without conducting tests we won’t be able to learn about the real situation of the country.
Associate Professor of Institute of Health Economic, Shafiun Nahin Shimul said from a global perspective, the average test positivity rate is around 7%. So, around 20% in the country is not a low number.
According to worldometer, only Brazil has more number of tests-confirmation ratio in the top twenty countries with most covid-19 cases.
So, there is no reason to support the lower number of tests. If the authorities find the current method of Covid-19 tests expensive, they could introduce rapid antigen tests, he added.
Moreover, this will push Bangladesh into a long term infection cycle and can cause further economic losses as well, he suspects.