Covid test disparity reigns in Bangladesh

Dhaka, Ctg account for over 43pc tests done so far in August

Covid tests are not being carried out according to needs but rather are concentrated in major cities, increasing further the disparity in healthcare access in Bangladesh, official data show.

More than 53 per cent of the tests done in the first 10 days of August took place in laboratories of eight divisional cities although the ongoing wave of coronavirus infections apparently impacted all 64 districts. and Chattogram districts accounted for more than 43 per cent of the tests in the 10 days, highlighting the healthcare access disparity even among major cities.

The areas with access to most Covid tests are home to less than 30 per cent of the country’s population, according to the latest population census data.

‘Initially, Covid tests were concentrated in cities because of the disease’s high prevalence there but the situation has changed,’ said epidemiologist AM Zakir Hussain.

The highly infectious Delta variant of coronavirus has apparently spread rapidly in villages since its emergence in May as reflected in the huge influx of patients with Covid symptoms to Dhaka hospitals for treatment.

These patients are mostly in critical condition and testing positive for Covid-19 in an advance stage of the disease with their lungs and other organs severely malfunctioning.

A review of the Directorate General of Health Services of patients admitted at four dedicated Covid hospitals in Dhaka found that 85 per cent of the patients were from villages.

‘Timely diagnosis is crucial for all treatment, especially for diseases like Covid-19 capable of seriously harming health in a very short time,’ Zakir explained to New Age.

The current surge in Covid tolls in Bangladesh is apparently caused by the Delta variant, the most ferocious of the variants emerged so far fuelling the Covid pandemic, which has left even the most vaccinated countries dreaded.

Scientists have already confirmed that the Delta variant has reduced the incubation period of coronavirus, causing symptoms among vulnerable infected population in a short time.

In severe cases, scientists said, the disease may lead to death in just eight to 10 days.

‘Covid-19 has spread to almost every village but people are either unwilling to get diagnosed or do not have the means to do it,’ said Abu Jamil Faisal, a member of the public health expert group of the DGHS.

‘What is going to happen is that Covid patients with strong immunity will survive while the rest die with disparity lingering the pandemic,’ he warned.

Apart from deaths from fever that reported to have been surged in villages, dozens of people are dying with Covid symptoms every day at government hospitals.

The cause of such deaths will never be known for the health sector with its limited capacity can carry maximum 50,000 tests a day.

The case fatality analysed from official data of confirmed deaths and confirmed cases is higher in areas with lower tests.

The analysis has been done among the eight most tested areas with data from the first 10 days of August.

As per the analysis, the case fatality was 1 per cent in Dhaka, Chattogram and Rajshahi, the places with higher tests, against 3 per cent case fatality in Rangpur and Khulna, where tests were relatively lower.

Rajshahi counted for 2 per cent of tests done in the  10 days while Rangpur and Khulna for 1 per cent each.

Case fatality was 2 per cent each in Mymensingh, Barishal and Sylhet while

the districts accounted for 3 per cent, 1 per cent and 2 per cent of the overall tests in the 10 days respectively.   

‘The high case fatalities are likely the result of only critical patients getting tested,’ said Institute of Epidemiology, Disease Control and Research adviser Mushtuq Hossain.

Getting tested is generally time-consuming across Bangladesh, often taking days irrespective of the condition of patients, with 24 districts lacking RT-PCR laboratories, the main diagnostic means.

Even districts with RT-PCR laboratories require their inhabitants travel long distances from rural areas to towns, where the laboratories are situated.

If the overall tests done ever since Covid-19 emerged are counted, Dhaka accounts for 65 per cent of the tests while Chattogram  15 per cent, Rajshahi and Khulna 4 per cent each, Sylhet 3 per cent, Rangpur  2 per cent and Barishal 1 per cent.

A total of 82,12,041 tests have been conducted in the country with one of the lowest test figures in the world.

Some 13,76,322 cases have been detected in the tests.

DGHS director Nazmul Islam said that the government was trying to reduce disparity, especially in testing, by increasing rapid antigen tests but found people reluctant.

‘Taboo against getting tested prevents people from getting diagnosed for Covid-19,’ he said at a routine virtual press briefing when asked about the testing disparity.

Still, people generally seek Covid diagnosis when symptoms turn severe for escaping the trouble they need to go through for getting tested.

The government does not keep a list of people dying with Covid symptoms as well although many hospitals are recording their death.

The Centre for Genocide Studies of Dhaka University has so far counted deaths of 4,435 people with Covid symptoms based on media reports.

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