Coronavirus Infection Curve: For now, the only way is up

Thursday's test results were a turning point with the number of detected coronavirus cases crossing a hundred (112) for the first time in a single day. The authorities yesterday said another 94 people tested positive for the virus.

Together, this number (206) is more than the total number of cases for the entire last month.

If one assumes March 8 -- the day when the authorities reported the first Covid-19 case in Bangladesh -- the beginning of Week 1 of the crisis, then by the end of the fourth week, on April 4, the country had only 70 cases.

This week, that number stands at 424. This is a 505 percent increase from the figure of Week 4.

What can the nation expect in the coming weeks? What will Bangladesh's epidemic curve look like? Experts say one should look at the countries already into the crisis to search for the answer.

"The number of positive cases may increase by a lot. We can learn from our neighbouring countries," said Dr Mushtuq Hussain, consultant, National Action Plan for Health Security at the Institute of Epidemiology Disease Control and Research (IEDCR).

India's turning point occurred in Week 8 of the crisis -- between March 20 and March 26. The total number of positive cases stood at 694, which was a staggering 359 percent increase from the previous week.

Two weeks later, at this current moment, the cumulative number of positive cases is 6,771, which is 10 times more than the number from their watershed week.

Unlike India, Pakistan did not have much time in hand before things went south. Bangladesh and Pakistan reported their first cases approximately around the same time, but Pakistan's case numbers have seen a meteoric rise from the first week.

From a total of 16 cases the first week, it had 187 cases at the end of Week 2, and all very suddenly that number shot up to 887 by Week 3. As of April 10, the country has 4,489 positive cases with 63 people dead.

United States of America saw its first sharp jump in Week 7, with 647 cases reported. Today at Week 13, the number is over seven hundred times more at 463,619. Over 16,000 people are dead.

Malaysia also saw its number of positive cases skyrocketing from one week to the next at a precise point of the pandemic. On March 13, which was the end of Week 7, the country had a cumulative total of 200 cases. By Week 8, the total number stood at 1,030. At the current moment, three weeks after its watershed week, Malaysia's total positive cases have risen four-fold.

Dr Meerjady Sabrina Flora, director of IEDCR, was asked whether Bangladesh could see a rise in cases the way its neighbouring countries did. "There is a fear of that happening," she answered.

"The number of positive cases has increased and will continue increasing," she stated.

"In fact, to get a proper sense of how much the number of positive cases has increased, one should look at the tests done at the IEDCR laboratory today. We conducted 196 tests today and results of 53 of them were positive. This is a big proportion when comparing to the numbers of the previous days," she added.

Approximately a thousand additional tests were done in other labs across the country yesterday, of which another 41 tested positive. This was the first time the government managed to test more than a thousand samples a day.

Essentially, Flora warned that even as testing has been ramped up, the percentage of samples found positive is on the rise because there are more infected people than there were before.

Statistics from other countries, which have experienced a meteoric rise in coronavirus cases, shows that an increase in the percentage of samples testing positive is an indication that the country is climbing up the curve.

For example, after India ramped up testing, the percentage of cases found positive has gone up from 0.88 percent in Week 5 to 5.17 percent right now. Bangladesh is now showing a similar figure -- 5.76 percent of the samples tested positive as of yesterday.

Requesting not to be named, a senior infectious disease researcher, involved in the government's response to Covid-19, said this could only happen because the rate of infection is also increasing. "If rate of infection did not increase, and only testing increased, then we could not see such an increase in the percentage testing positive," she said.

WHAT NEXT?

Experts said a lack of containment has been a key to how the country has come to this point.

"Narayanganj is a big hotspot. We have failed to keep positive cases in Narayanganj and now they are all over the country," said Flora.

Experts warned that the numbers would increase well into the next few months and all efforts should be made to flatten the curve.

"We are facing a very difficult time ahead and this situation will prevail for the next couple of months," said Dr Mushtuq Hussain.

"We have to ensure active surveillance among the community and test all with flu-like symptoms. The government alone cannot do that. Communities like housing societies can take the responsibility of making sure that their residents are getting tested," he said.

"Lockdown of neighbourhoods is not the only answer. We have never asked the police to start marking homes with positive cases with red flags. This [marking homes] is creating stigma and resulting in people hiding their disease status, or refusing to get tested," he said.

He added that the way the pandemic has been handled has resulted into social stigma against families of those testing positive. "That is why people are leaving and going to their village homes," he said.

"We have to make sure people have enough to eat. Otherwise, they will get out into the streets looking for food," he said, adding it will only increase the chances of coronavirus transmission.