Waiting for a silent outbreak? 

Even though the current number of coronavirus cases in Bangladesh appear low, the situation may very rapidly go out of control, experts have said. 

And when the outbreak happens nobody will know the real numbers because tests are done on an extremely low level. 

The first three cases of the flue like Covid-19 was reported on March 8 and the three latest cases were declared in just a week. But experts are apprehensive that a full blown outbreak is just around the corner.

Prof Muzaherul Huq, former adviser of the World Health Organisation's Southeast Asia region, said Bangladesh was not adequately prepared to tackle the coronavirus outbreak. 

"Apart from local transmission, there is the risk of community transmission. The government did not track the eight patients. They voluntarily came for testing.

"Bangladesh is taking some ad hoc measures but the situation at present is just the tip of the iceberg. We can predict nothing before at least two weeks but like the rest of the world, cases are rising in Bangladesh," he said.

Muzaherul said the eight patients in the country had already transmitted the virus to many people. 

He said he would not be surprised if the number of cases made a big leap now. 

"This shows the government's Covid-19 tracking mechanism is really weak," explained Muzaherul.       

Infected people without symptoms might be spreading virus

It has so far been said that the virus spreads mainly by people who are already showing symptoms. 

But more than half a dozen studies have shown that people without symptoms are causing substantial amounts of infection, CNN said on Monday. 

Experts said it had become clear that transmission by people who are asymptomatic or mildly symptomatic is responsible for more transmission than previously thought. 

"It is absolutely clear that asymptomatic infection surely can fuel a pandemic like this in a way that is going to make it very difficult to control," said Michael Osterholm, director of the Centre for Infectious Disease Research and Policy at the University of Minnesota. 

Coronavirus test not for all despite symptoms 

The IEDCR said it would not test a person for coronavirus if he or she does not fulfill two criteria.

First, the person has returned from abroad in the last two weeks. Second, the person has come in contact with a returnee.    

Wishing anonymity, a Lalmatia resident in the capital told The Business Standard he was asked these two questions when he had called the IEDCR hotline to request a coronavirus test. 

"They told me not to worry because it might be a seasonal flu, and also asked me to go to a nearby doctor. If I had fulfilled the two criteria, they would have come to my house to collect samples," he said. 

The IEDCR told him that they had the list of people who had been infected through local transmission. 

"They told me they would not test me because I was not on that list," he added. 

However, IEDCR said if the hospitals referred patients with atypical pneumonia cases, then they would be testing them for Covid-19   

Everyone showing symptoms should be tested

Experts are saying everybody showing symptoms should be tested. Prof Muzaherul said everyone should be tested for the virus because not every returnee was following the home quarantine measures properly and there had been local transmissions. 

Analyses of data from the world's worst-hit countries from Covid-19 show that the number of cases appears small in the initial stage – typically two to four weeks –  after which cases explode and the situation goes beyond control, resulting in an almost unmanageable health crisis.  

For instance, the first two cases in Italy were reported on January 31. In a week, the number rose to three. 

In three weeks, there were still three cases     

But in the fourth week, the number leaped to 650 and Italy was in the middle of a full-blown coronavirus outbreak. 

The same script played out in Spain which declared the first case on February 1. Four weeks later, on February 26, the number was only two. 

From the following day, cases began to rise fast and in two weeks, there were 1,639 cases.     

Even though there are only a few cases of the disease in the country now, eight at last count yesterday evening, the number of infected might see a steep rise in the coming weeks, according to experts. 

Outbreak in two weeks?

Prof Dr Nazrul Islam, former vice-chancellor of Bangabandhu Sheikh Mujib Medical University, told The Business Standard on Monday there was a risk that the virus would break out in two to three weeks. 

This is because those who are supposed to be in home quarantine are not following the health guidelines properly, he said. 

"Thus, if they are carrying the virus, they might transmit it to others," he added. 

"The number is now increasing from two to four. Two to three weeks later, it could jump from 32 to 100," explained Nazrul.

Diplomats ask about quarantine effectiveness

Diplomats meeting with Foreign Minister Dr AKM Abdul Momen at the State Guest House Padma, enquired about the steps the government was taking to quarantine Covid-19 suspects. The foreign minister assured them that adequate measures have been taken to prevent the spread of the coronavirus and the Rohingya camps are also being monitored adequately.

Legal action against non-compliance with home quarantine steps

The cabinet yesterday decided that all those arriving from abroad must stay in 14-day quarantine or else face legal action.

"All local or foreign nationals must follow the 14-day quarantine rule or else legal action will be taken against them," Cabinet Secretary Khandkar Anwarul Islam said this while briefing reporters after the weekly cabinet meeting at the secretariat yesterday, reports UNB.

A notice issued by the health ministry on Monday said committees have been tasked with monitoring whether the expatriate Bangladeshi returnees are following the home quarantine measures properly. To handle the coronavirus situation, the government has formed committees at national, divisional, city corporation, municipality, district, upazila and union levels.    

They will take help from local health complex officials and the officers-in-charge of the local police stations if returnees breach home quarantine guidelines.

Also, not following quarantine measures will result in action under the communicable diseases law 2018.        

"We have so far been lenient about the returnees' 14-day home quarantine directive. Now the local authorities will take action in case of non-compliance," said Institute of Epidemiology, Disease Control and Research (IEDCR) Director Professor Dr Meerjady Sabrina Flora.