Epidemiological surveillance yet to be in place

Bangladesh is yet to conduct an epidemiological surveillance which experts say is very important to understand the gravity of the coronavirus situation and will help take any policy decision in this regard.

They said such surveillance would have allowed health officials to suggest the government about the next course of action like when and how the ongoing shutdown should be relaxed or withdrawn, which area is highly vulnerable and what measures to be taken.

Epidemiological surveillance is the discipline of continuously gathering, analysing, and interpreting data about diseases, and disseminating conclusions of the analyses to relevant organisations.

In Bangladesh, the Institute of Epidemiology, Disease Control and Research (IEDCR) was supposed to do the surveillance on Covid-19.

Contacted, IEDCR officials said they had started the surveillance and it would be completed in about three weeks.

"We have been conducting epidemiological surveillance in and outside Dhaka. We are hopeful that we will be able to complete it within two to three weeks," said ASM Alamgir, principal scientific officer at IEDCR.

Asked when did they start the work and what was the sample size, he declined to provide any details.

Bangladesh entered into its 61st day yesterday ever since the first case of the coronavirus was detected in Dhaka on March 8. The surge in infections continued with 636 new cases reported yesterday, taking the total to 13,770.

Yesterday, the authorities also reported eight Covid-19 deaths, bringing the death toll to 214.

Amid the worsening coronavirus situation, the government has reopened factories and decided to reopen businesses and shopping malls on May 10 on a limited scale, apparently in a desperate attempt to bring the economy back on track, but without an epidemiological surveillance report from the IEDCR, the reference body of WHO in Bangladesh.

"Policy makers are not public health experts. So, the health officials should suggest them based on evidence. We are yet to hear about such epidemiological surveillance," said Prof Be-Nazir Ahmed, former director (disease control) of the DGHS.

Without epidemiological evidence, which is needed to check the infection rate and help generate immunity in a particular community, relaxing the shutdown may be dangerous and may expedite the spread of the virus, Be-Nazir warned.

Expert also said an epidemiological surveillance can decipher how many of a representative group of people of a community have generated antibodies to fight the virus despite been infected.

Scientists then may extrapolate from there the magnitude of the pathogen's spread in the broader population, experts said.

Such surveillance could also shed light on how the virus transmitted among people, including what role seemingly less-affected groups, like children, have played in its dispersion, they said, adding that the IEDCR should focus more on surveillance.

"IEDCR needs to concentrate more on the ongoing epidemiological surveillance of Covid-19 for analysis, which is very important for epidemic control. It will give us a clear idea about the Covid-19 situation of the country," IEDCR consultant and epidemiologist Mushtuq Husain told The Daily Star.

Abul Kalam Azad, director general of the Directorate General of Health Services (DGHS), also acknowledged it.

'It is important and we have asked the IEDCR to concentrate more on research," he said.

He also said currently their projections are based on the trends of the identified cases.

"But to give an accurate picture, we need epidemiological surveillance."