Govt should ramp up contact tracing
The government must scale up its efforts to trace and quarantine all the people who might have come in contact with the coronavirus patients to contain the spread of the virus, say experts.
It had at least three months to prepare, but it could not act accordingly, they said, adding that a lack of proper screening at the airports and the failure to keep the returnees from abroad in isolation have made things difficult.
Experts now warn that the highly contagious virus might spread to the community level if the government does not immediately take measures such as contact tracing and strict quarantine.
Contact tracing is a front-line public-health strategy that involves identifying and following up with people who may have come into contact with an infected person.
"The goal is to contain the outbreak and break the transmission channels. But we don't know which method the government is following for contact tracing," said Mahmudur Rahman, a former director of the IEDCR.
According to WHO protocol, every suspected case and its contacts should be monitored for 14 days, he said.
"The main aim of contact tracing is to detect the patient and the vulnerable group in the earliest possible time. It is because early detection will help slow the spread and give the authorities time to take preparations."
The first confirmed cases of Covid-19 in Bangladesh was reported on March 7. With three new cases reported yesterday, the number now stands at 20.
Of the 20, nine travelled from countries badly affected by the coronavirus pandemic, while the others are their family members who came in contact with them. Three of the patients went home after recovery.
The number of those identified through contact tracing is hard to come by.
The Daily Star contacted at least three top officials of the Institute of Epidemiology, Disease Control and Research (IEDCR) yesterday, but none of them could give any exact figures.
Between March 1 and 18, 2,36,620 people arrived in Bangladesh from various countries, and most of them were not placed in strict quarantine.
Stressing on the importance of contract tracing in the fight against coronavirus, experts said the government could not afford to act slow now since there was a "gaping hole" in the quarantine arrangements.
They said contact tracing is relatively painstaking, but it is potentially life-saving in the fight against viral epidemics. It was handy in containing previous outbreaks of Ebola in Western Africa and the SARS scare of the early 2000s.
The experiences from Hubei province, Covid-19's ground-zero in China, and Italy, which has so far more than 4,000 deaths, showed that failure to act quickly could turn disastrous, they warned.
They pointed out that some Asian countries, including Hong Kong, Singapore and Taiwan, appear to have brought the coronavirus situation under control, using heavy disease surveillance, including effective contract tracing.
Contract tracing is also a key part of the United States' coronavirus containment strategy, they said.
Muzaherul Huq, a former regional adviser of WHO's South East Asia region, said contact tracing in Bangladesh had so far been a "complete failure."
"Who is monitoring the people? In our cultural and social context, contact tracing is very tough," he said, adding, "Those supposed to be in quarantine are mixing with people and those people are mixing with others."
He claimed that the virus has already spread to the community level, going beyond the "family remission level".
Replying to a query, Be-Nazir Ahmed, former director (disease control) of the DGHS, said there were some attempts of contact tracing at the beginning and that the authorities must intensify its efforts immediately.
"I cannot say that it is happening in a good way. A huge number of people arrived in Bangladesh from abroad in the last two months, but we don't seem to have details of all the returnees.
"If we do not know the contacts, then how will we trace them?"
Contacted, Prof Abul Kalam Azad, director general of the Directorate General of Health Services, said, "Whenever we get a positive patient, we ensure contact tracing to find those who might have come in his or her contact. We talk to them and try to reach out the last person."
He could not say how many people have exactly been tracked down so far.
"If you see, you will find that the corona positive cases have remained limited to the families of those previously infected. We repeatedly told them to follow quarantine rules within the families. But it's not possible for us to monitor everything at the family level."
THE BHUTAN CASE
Talking about the contract tracing method, experts lauded Bhutan for its efforts in this regard.
On March 6, the country announced its first positive case of the novel coronavirus -- a tourist from the US. Until yesterday, the country did not report any new case.
Soon after the first patient was detected, Bhutan authorities created a map of his contacts, tracking down at least 90 people who might have come in his contact.
Three of the patient's close contacts -- his partner, the driver of a car and the tourist guide -- are now in quarantine. Eight Indian nationals on board his flight from Guwahati were also put in quarantine.
Experts believe these measures helped Bhutan slow the spread of the virus.
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