We have recently learnt about the government's readiness to face the possible second wave of the Covid-19 pandemic during the approaching winter. Admittedly, it is a commendable move on the government's part.

Western public health experts first raised the possibility of a second wave of the pandemic. Naturally, they were planning their response measures ahead of the less privileged nations.

In fact, in the face of a fresh surge in the pandemic cases (number of the infected crossing five million), the European countries' response has been the reintroduction of the strict containment measures including shutting down of parts of major cities as in Madrid of Spain or ensuring stringent observance of social distancing or wearing face masks as in France, in the UK and elsewhere.

The governments or their health departments in Europe, in the USA or in Canada have a more or less clear picture of the pandemic situation in their respective countries. That helped them to adopt an effective strategy against the pandemic.

But are we adequately informed about our own pandemic status?

Let us have a cursory look at the situation. As of September 27, 2020, the number of confirmed cases stood at 357,873, while the number of fatalities was 5,129. Of the infected, 26,777 recovered from their medical conditions. Evidently, the figures give but a notional representation of the actual pandemic situation in the country. That is so for several reasons. First, the number of tests. At present, on an average, between 12,000 and 15,000 tests are being done daily, a figure rather low for a country with around 168 million people. The test number was higher before, but declined since late June when the government decided to charge for tests to avoid what it said, 'unnecessary tests.' It has actually acted as a disincentive, especially, for the less conscious and economically vulnerable section of the population to get tested for Covid-19. Hence is the recent fall in test numbers giving the questionable impression of a reduced infection rate!

However, one needs also to keep in mind our limitations as a developing nation with such a population size and a fragile healthcare infrastructure which is now stretched to the limit. 

 Second, our obvious limitations regarding test facilities and other logistics. Initially, conducting diagnostic tests for the Covid-19 was the job of the Dhaka-based Institute of Epidemiology, Disease Control and Research (IEDCR) alone. However, so far across the country some 77 laboratories are operating for the tests. Capacity-wise, this looks like a notable improvement.

Third, inherent limitations of the diagnostic tests. As for example, the RT-PCR

test, which looks for the virus's genetic material in the test sample and is universally accepted as the 'gold standard' of the Covi-19 test, is also not 100 per cent error-free. Studies have shown that in about 30 per cent cases, the PCR tests come up with incorrect results. In such cases, false negatives far outnumber the false positives. In PCR tests, quality of the reagents and test kits used matter. And those are in short supply, globally. So, Bangladesh cannot be an exception here.

Of other kinds of tests, Antigen test gives results very quickly. But in 50 per cent cases the test gives inaccurate results (mostly false negatives). Rapid tests like this, despite high error margin, can at least help increase test numbers phenomenally. Given our condition, rapid Antigen tests can be an answer to the low test numbers, but, of course, with a qualification.  Anti-body tests, on the other hand, tell us if a person was infected in the past. Scientists do not give much credence to these as a diagnostic test.

However, despite the limitations having to do with the tests and other constraints, the government would still require a workable strategy to face the looming second wave of pandemic attack.

We believe the government has a strategy.



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