Covid-19: Testing was inadequate from the beginning, study finds

According to studies by Bangladesh Health Watch (BHW), Covid-19 testing in Bangladesh has been inadequate from the very beginning of the pandemic. Furthermore, sample collection tools were not standardized, not adequate and not correct either.

According to one report, experts revealed that possible reasons for inadequate testing of COVID-19 were lack of testing facilities and kits, deficiency of testing skills and technicians, lack of monitoring of testing quality, reporting delays, and fear of infections from testing sites.

Another report found that on average, Covid-19 patients spent Tk12,000 on medicines, food, etc. during their illness. Also, specific medicines were not available in pharmacies and had to be procured from different sources at high prices.

BHW conducted three research studies on sample collection, testing, medicines and other food items used by COVID-19 patients, and challenges of handling COVID-19 cases in Bangladesh.

One of the research initiatives, titled 'A Quick Assessment of Medicines and other Food items Used by COVID-19 Positive (+ve) Persons at home,' was conducted by Dr Muntasir Faisel; Dr Maksudul Islam; Nuhad Raisa Seoty; Dr Sayeda Shabnam Malik; Nusrat Jabin; Prof. Saidur Rahman (Khasru), and Dr Abu Jamil Faisel. It was conducted from 04 June 2020 to 30 August 2020.

For this study, in-depth telephone interviews (IDI) were conducted of confirmed COVID-19 positive patients, post-recovery.

The report said 71% of the respondents reported fever as the most frequent symptoms, followed by general weakness, body ache, cough and sore throat. About 17% had a loss of smell and 23% suffered from Aguesia (loss of taste).

All the patients interviewed took Paracetamol, followed by several vitamins, such as Vit. C, B and A. Antibiotics, particularly Azythromycin, have been taken by almost 70% of patients, followed by Doxycycline in 10%, and Chloroquine and Hydroxychloroquine in about 9% of cases.

In addition to taking therapeutics and a regular diet during their illness, all the recovered patients took precautionary measures and supplementary food. 84% gargled with hot water, 79% inhaled steam and 76% drank hot water.             

The report said while many of the precautionary measures used by the respondents are helpful in respiratory exercises, people should be made aware that most of the medication taken is unnecessary, have not been proven to be effective in treating COVID-19, and have side effects.

Another study titled 'Opportunities and Challenges of COVID-19 case handling in Bangladesh,' found that testing has been inadequate from the very beginning. The study was conducted from June to August involving different COVID-dedicated health care facilities across the country. A total of 51 in-depth telephone and in-person interviews were conducted with service users, service providers and experts.

The report said that about 80% service users were unaware about the locations of testing sites, and about testing procedures. Over half were not interested in being tested owing to the social stigma and fears of isolation from the community and family members.

Moreover, few of the service users lost interest in testing due to the delayed and repeated false negative results. Some mentioned lack of testing facilities in their areas.

The third research study titled 'Sample Collection and Sample Testing for SARS-Co-2 in Bangladesh,' assessed the quality of sample collection and the safety of rT-PCR testing procedures for SARS-CoV-2. A survey was carried out using information from 24 Directorate General of Health Services officials. The researchers also studied four daily newspapers and four TV channels.

The study found that IEDCR, the national referral center for surveillance, failed to train relevant officials and monitor the quality of sample collection methods and tests, because it claimed it was too busy with single-handedly driving home sample collections and tests for about a month.

According to the report, this resulted in poor training quality. The quality of sample collection methods and safety of some lower-tier laboratories has suffered. In the beginning, sample collection tools were not standardized, leading to false negative results.

The report added that even now, some district hospitals do not possess any PCR machines.

Also, for some time in the beginning, sample collection sticks were even made of even broom-sticks and hair clips with cotton tips, and samples were transported in non-laboratory-grade normal saline, occasionally in polyethene bags or in tubes with loosely fitting caps, which would fall off during transportation, the report further added.