Bangladesh Health Watch (BHW), a citizens’ platform for improved accountability of country’s healthcare system through evidence based policy review and citizen feedback, cordially invites you to a Webinar on the occasion of the dissemination of findings from three research studies:
The dissemination event was held on 15th October 2020. A total of 50 participants from different sector i.e. WHO representative, health experts, Civil Society leaders, academicians, NGO leaders, journalists, donors representatives including Swedish SIDA were present. The webinar was moderated by Dr. Ubaidur Rob, Country Director, Population Council and the working group member, BHW. The presenters were:
Dr. Muntasir Faisel, Dr. AM Zakir Hussain and Palash Chandra Banik.
Presentation 1: A Quick Assessment of Medicines and other Food items Used by COVID-19 Positive (+ve) Persons at home
The research 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.
The second research study conducted by Dr. AM Zakir Hussain . This survey was carried out using information from 24 Directorate General of Health Services officials as well as from four daily newspapers and four TV channels. This 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.
Presentation – 3: Opportunities and Challenges of COVID-19 case handling in Bangladesh
The third study conducted by the Department of Non-communicable Diseases, Bangladesh University of Health Sciences (BUHS) on COVID-19 case handling. This 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.
This study found that testing has been inadequate from the very beginning. The report also 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 findings of the studies that shared with journalist during the online press launch got some media attention. A snapshot of the media coverage are as follows:
English Newspaper
| SI | Newspaper | Headline | Link |
|---|---|---|---|
| 1 | The Business Standard | Covid-19: Testing was inadequate from the beginning, study finds | https://tbsnews.net/coronavirus-chronicle/covid-19-bangladesh/covid-19-testing-was-inadequate-beginning-study-finds |
| 2 | Daily Star | Covid patients have to spend Tk 12,000 each for medicine | https://www.thedailystar.net/backpage/news/covid-patients-have-spend-tk-12000-each-medicine-1978769 |
| 3 | Daily Observer | BHW finds inadequacy in C-19 testing from the beginning | News clip |
Bangla Newspaper
| 1 | Prothom Alo | বাসাথেকে সুস্থহকে বযয়১২ হাজার টাো | News Clip |
Question & Answer
Q: Does the WHO have guidelines for positivity rates for testing?
Dr. AM Zakir Hussain: WHO uses 5% positivity rate as a bench marker for assessing the sufficiency of tests though but if we test 200,000 samples today based on the fact that more than 85% samples today test negative, test positivity in all probability will be less than 5%. So the cut-off 5% has to be considered in that light. If we do not test, the reported number of cases give people a sense that COVID-19 is not so serious in Bangladesh. Besides, if you don't know people is infected or not, you cannot do contract tracing. The ratio of number of confirmed cases to contacts traced/quarantined in BD is among the highest in the world. In other countries, for every confirmed cases, in other countries, more than 10 to more than 100 contacts were traced and some of them were quarantined. In BD, it was only about 1 to 3. That has been the reason the disease spread wildly in the country.
Q: In the residence of slums and low income group people the isolation is impossible.
Comment: It is challenging. You can put the people in stadiums, etc. this has been used in other countries. We did it in more resource challenged countries Sierra Leone, and Liberia during EVD outbreaks in 2014/15. Nothing is impossible.
BUHS: It was the study at the initial phase when the national plan was not implemented so well as now.
Q: What is about old aged people (62+)? Who tested positive had they gone to hospitals?
Dr. Muntasir: Old aged people (62+) who tested positive didn't complete their treatment at home, they need to go for hospital treatment so that they are not included in our study.
Closing remarks:
The moderator sum-up the session in requesting to look at the BHW website https://bangladeshhealthwatch.org/role-in-covid-crisis where all the study reports will be available soon. Finally, he concluded the session by giving thanks to all the presenters and guests.
Participants of the webinar as per their online ID
| SI | Name |
1 |
Nowshin Fahim |
2 |
Maya, UNICEF |
3 |
Daniel, SIDA |
4 |
Palash Chandra Banik, BUHS |
5 |
Pradip Sen Gupta |
6 |
Prof. Dr. Rowshan Ara Begum |
7 |
AMR Mushtaque Chowdhury, BHW |
8 |
Rafiqul Islam |
9 |
Raihana Kamal |
10 |
Sajjad Zohir |
11 |
Samar Roy, MPG |
12 |
Shaikh Masudul Alam, BHW |
13 |
Shiyong WANG, World Bank |
14 |
Zahirul Islam, SIDA |
15 |
Sharmin Mizan |
16 |
Shusmita |
17 |
Yasmin H Ahmed, BHW |
18 |
AISD’s iPhone |
19 |
Dr. AM Zakir Hussain, BHW |
20 |
Prof. Dr. Md Nazrul Islam |
21 |
Dr. Muntasir Faisel |
1. |
Dr. Zahir Uddin Ahmed |
2. |
Atia Hossain |
3. |
Dr. Md Maruf Haque Khan, BSMMU |
4. |
Dr. AJ Faisel, WG member, BHW |
5. |
Dr. Rezaul Haque |
6. |
Fardina Omi |
7. |
Fazlul Haque (SF) |
8. |
Bazle Razee |
9. |
Dr Ubaidur Rob, WG member, BHW |
10. |
Abdul Karim |
11. |
Country Director, HOPE foundation |
12. |
Fojila Khanom |
13. |
Iftekhar Rashid |
14. |
Iqbal Masud |
15. |
Jamal Uddin |
16. |
Madu Mita |
17. |
T Anika |
18. |
Tareq Mahamud |
19. |
Mr. Aumio |
20. |
Mahbubur Rahman |
21. |
Maleka Banu, Mohila Parishad |
22. |
Md. Abdur Razzak, JICA |
23. |
Mithila Faruque, BUHS |
24. |
Mofakhar Hussain, Canada |
25. |
Mohammad Abul Faiz |
26. |
Morshed Chowdhury, BHW |
27. |
Muhammad Shafiullah |
28. |
PD Urban Primary Health |
29. |
Dr. Khairul Islam, WG member, BHW |
30. |
MA Sabur |
31. |
Aneela Perveen |
32. |
Prof. Dr. Anower Hussain |
33. |
Dr. Jahir Uddin |
34. |
Mahruba Khanam, BHW |
Citizen's Voice