Reopen? Increase testings first

Epidemiologists, economists and businesses in Europe and USA are recommending their respective governments to increase the large scale testing capacity and further for coronavirus suspects to gradually reopen their economies shuttered by the lockdown required to slow the spread of the virus.

But we are still lagging far behind in ramping up our testing capacity. As of Friday, our health care system had conducted only around 17,003 tests in the last two months, a very low number vis-a-vis the extent of tests suggested by global experts to reopen economic activities. 

Only 103 people are being tested per one million in Bangladesh, whereas, the number is many times higher in European countries. In Italy, over 18,000 people were tested per million, around 21,000 in Germany, around 14,000 in Spain and around 10,000 in the USA. 

To get a perspective of where we stand, let's have a look at the population number in different countries. 

Germany has a population of 83 million, Italy has 60 million, Spain has 46 million and the USA has 331 million, a country about 66 times bigger than Bangladesh. 

With A population of 165 million, Bangladesh is lagging far behind in testing capacity. Due to the low number of tests we cannot have a realistic picture of our situation and mobilise accordingly to tackle the health crisis and then decide when to lift the shutdown. 

Our testing rate is also the lowest in South Asia. 

South Korea and Taiwan have already proven the effectiveness of a large-scale testing immediately after detection of the first case and the protocol to trace the contacts of infected people to fight the coronavirus. Therefore, unlikely China, they have not placed their countries under lockdown. Their economies were not shut down either. 

In spite of the ongoing pandemic, the European countries are now trying to ease the strict restrictions they imposed last month to gradually reopen their economies adopting the model of enhancing further the testing capacity. 

In fact, Spain cautiously relaxed its lockdown on Monday, April 13 to let 3,00,000 non-essential workers return to work.

The situation in Germany is a little different from Italy, Spain and the UK, the three worst hit countries in Europe. The country has not really been able to keep infection numbers at bay better than some of the hardest-hit nations.

But Germany has been able to keep the death rate relatively low. More than 3,400 people have died from the virus in Germany, around four people in every 100,000 across the country. That is well below Italy's 35 and the UK's 18.

As German Chancellor Angela Merkel announced last week that the country would begin gradually scaling back its lockdown, the country is planning on carrying out even more tests, in case the increased contact leads to a second wave of infections.

In such a development, the European Commission have laid out a set of conditions for lifting the lockdown gradually in an effort to mitigate the economic devastation. 

Widespread testing is a precondition for lifting social distancing measures in the future. It also depends on a large scale capacity to monitor the spread of the virus and contact tracing and quarantine the carriers. Moreover, hospitals must have enough beds, intensive care units, medicines and equipment. 

The European Commission, however, says companies and workers won't get back to business-as-usual until there's a vaccine or a cure for Covid-19.

The commission has warned that the easing may be temporary as it will "unavoidably" lead to a spike in new cases that could threaten healthcare systems again and lead to a reinstatement of the confinement rules.

Though Donald Trump announced that the US economy would reopen on May 1, the country is not ready for this.

Medical experts and businesses have advised the Trump administration to enhance further testing capacity first before taking a decision. 

"The USA would have to be able to run at least 500,000 tests per day before the current social distancing rules could be relaxed. That would be more than three times the current level, according to data from the COVID Tracking Project, which has been gathering state-by-state testing data.

"Right now, we are preventing the spread of the disease by extreme social distancing, by keeping people away from each other," said Dr Ashish Jha, director of the Global Health Institute at Harvard University.

"If we want to end that and let people interact with each other, we need to make sure infected people are not interacting with uninfected people. And the only way to know who is sick and pull them away from the uninfected is testing," he said.

We don't exactly know the extent of our crisis due to the low number of tests being done so far. Our medical experts have long been urging the health directorate to enhance the capacity of testing in line with the advice of the WHO. 

But the situation has not improved in the last two months. In the first one month, since it started testing people for coronavirus, the daily test number was below one hundred. The number remained below 500 for many more days. 

Only in the last one week, the number of tests per day have surpassed the one thousand mark. On Friday the IEDCR said it ran the maximum number of 2019 in the previous 24 hours.   

Director General of Health Directorate Professor Abul Kalam Azad on Wednesday also acknowledged that the overall situation of the spread of the virus in the country could be understood by increasing the collection of samples for tests. 

However, it is not possible to increase the number of tests anytime soon due to mainly the shortage of testing kits. According to the health directorate it has a stock of only 71,000 kits for a country with a population of 165 million.

Initially, only the IEDCR in the capital conducted the tests. Since the beginning of this month, some more labs have been pressed into service to run the tests. Currently, 17 labs are doing the job with their cumulative capacity of conducting 4,500 tests per day.  

The ministry and the health directorate have been blamed for lack of preparedness to increase the testing capacity. 

The low testing capacity, according to epidemiologists, remains the main reason for the country's poor response to fight the coronavirus. Moreover, we have failed to ensure quarantine of people who returned to the country from the countries affected by the virus. We were late to cut flights with affected countries too. 

And all these may now delay the country's move to reopen the economic activities after the lockdown ends on April 25.