Our puzzling daily death toll

The curve of deaths from novel coronavirus has depicted a peculiar trend, especially in the recent months.

Deaths totaled 84 on April 18, grew four times every month until June 18, then nearly doubled on July 18.

The daily death count crossed 50 for the first time on June 16.

June 30 saw the highest single day deaths of 64 persons – marking an abrupt jump from 45 of the day before and dropping to 41 the next day.

The trend of falling daily death toll on the following few days after a very high count gave hope that the infection and death from the virus perhaps finally started to drop. However, another high single-day death figure just a few days later diminished that hope.

The daily death count varies so widely that the curve points to nowhere – for a business to plan for the near future or for a school to decide about asking pupils to return

Infection figures are also unpredictable, leaving no clue even for an expert to understand the behavior of the virus and forecast when it will start waning.

"It is a riddle, a puzzle indeed. We do not have any clear idea," says Professor Mushtaque Chowdhury, a public health expert. He referred to the claims made by well-placed government officials that the infection had reached a plateau. "If that were true, the rate should have started declining by this time, but this has not happened," he said, expressing his reservation about the numbers released.

"I doubt whether we are getting the real data based on which we can make some projections," said Prof Mushtaque, founder dean of Brac University's James P Grant School of Public Health.

Many countries in Europe and Asia have overcome the first shock and started reopening in a planned way – keeping in mind that a second wave could strike at any time.

Bangladesh is still navigating its first wave with no idea how long it will continue and when the second blow may come.

Prof Mushtaque sees "zero surveillance" as the only way to have a broader idea of where the country stands now in Covid-19 cases. He explained, "If we can conduct random testing at the community level among people with both with and without symptoms, we can have an idea of the spread of the virus."

Zero surveillance involves a system that covers the entire country without getting details of individual cases of disease when infection rate is high.

Why does the Covid-19 death rate fluctuate so widely?

Former Vice Chancellor of Bangabandhu Sheikh Mujib Medical University and noted virologist Professor Nazrul Islam finds, "Those who are aged and have co-morbidities are more likely to die from Covid-19. The day which sees a higher number of critical patients may register a higher death toll." 

After 66 days of general holidays, businesses and offices started reopening – while the virus curve showed no sign of waning.

Authorities went for "stricter" lockdowns in selected places in Dhaka and some other districts – a decision that seemed to have lost steam with no follow-up assessment.

The number of tests is declining, but the infection rate is hovering above 20 percent of the cases tested – meaning one in every five tested is infected.

The numbers are raising confusion and uncertainty, taking a further toll on the economy and businesses.

Dr Ahsan H Mansur, executive director of local think tank Policy Research Institute, said the rate of infection in our country is higher than in any other country. "Test numbers have been kept low to show lower number of infections, leading to confusion in the public's mind."

"Real statistical data is a must during a tough time like the novel coronavirus pandemic. People could have been more aware had they known the real situation. Facing the crisis could have been easier," he said.

The unusual ups and downs in the numbers of death and infections have eroded people's trust in data and raised uncertainty about the reduction in the infection rate. "As a result the economic recovery will definitely be delayed," said the economist.

"A lack of credible data about infections is limiting the potential for new investment and external trade," says Shams Mahmud, president of Dhaka Chamber of Commerce and Industry.

"The number of tests has declined drastically. So the real number of Covid-19 patients remains unknown. Amid such uncertainties, one cannot say when the economy may see a rebound," he said.

"If the virus is not tamed, nobody will come from abroad to invest here. Similarly, businesspeople will not be able to tour abroad to bring in new business and investment," the business leader said, expressing his fears that Bangladesh might lose the opportunity to get investments relocated from China.

He said the budget for the new fiscal year was framed with the hope that the crisis would be over rapidly. If the situation does not improve, the budgetary projections of growth, investment and employment will remain largely unmet, he fears.

Global practice

From Italy to New Zealand, irrespective of how well the virus was contained, governments acknowledge that fresh waves of the deadly novel coronavirus are likely and that the policy tools to mitigate the damage are limited. The hope is that localising quarantines to towns, cities and regions will be enough to snuff out bouts of infections as they come.

Spain is taking new measures to cut a spike in novel coronavirus cases, amid fears of a more widespread second wave, according to Bloomberg's analysis.

Catalonia has closed its nightlife for two weeks but cities outside the north-eastern region are also seeing a surge in cases.

Europe's hardest-hit country, Britain, reopened pubs and is now finding spikes in virus cases. Johnson, who aims to return to "significant normality" by Christmas, on Friday said his government is preparing the health service for a second wave of infections over the winter.

In Australia, residents of Melbourne have been ordered to stay home for six weeks and South Africa ordered schools to be shut again. Israel declared victory over the virus only for Prime Minister Benjamin Netanyahu to warn that another shutdown could be ahead.

The US economic outlook has darkened in the past month amid renewed lockdowns in some states due to surging novel coronavirus cases, according to economists in a Reuters poll. The economists warned of the high risk if the job recovery underway reverses by the year's end.

"The current situation presents two risks – some states might need to shut down more consumer activity to get the virus under control, and the stall in the reopening process might cause longer-term damage to businesses and the labour market," said David Mericle, chief US economist at Goldman Sachs.