“Pandemic of COVID – 19 Infections in Bangladesh”--Our experience and challenge to this serious condition in Okamoto Medical Center.
Dr. Mohammad Selim Reza
Prof. Shingo Okamoto
Introduction:
The COVID-19 pandemic in Bangladesh is part of the worldwide pandemic of corona virus
disease 2019 (COVID-19) caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2).
The virus was confirmed to have spread to Bangladesh in March 2020. The first three known cases werereported on 8 March 2020 by the country's epidemiology institute, IEDCR. Since then, the pandemic has
spread day by day over the whole nation and the number of affected people has been increasing.

District wise Covid-19 Epidemiological Map
Of Confirmed cases. (As of 03 October 2020)

Disease
Virus strain
LocationFirst outbreak
Arrival date
Confirmed cases
RecoveredDeaths
Fatality rate

COVID-19
SARS-CoV-2
Bangladesh
Wuhan, Hubei, China
8 March 2020
9,77,568 (8 July 2021)
8,50,502 (8 July 2021)
15,593
2%
Government website
corona.gov.bd12000
11162
10000
8000

7666

7462

6000
5042
4000

4014
2523

200002695
1897 1488

3525251320

1710
1014369385

Pandemic Covid 19 highest infection statistics in Bangladesh (Per Day)

In order to protect the population, the government declared "lockdown" throughout the nation from 23
March to 30 May 2020.The infection remained low until the end of March. But saw steep rise in April andhighest infection was June 2020.Since then the infection was low & minimum was January 2021. In
March 2021 the infection was gradually increased and it was called second wave of Covid-19 infection inBangladesh. Maximum infection was in July 2021.

 Government Response
On 23 March 2020, when Bangladesh had 33 confirmed cases, the government declared a ten day
nationwide holiday. People have been asked to practice social distance and stay at home. Public & private
offices will be closed with the exception for emergency. Public transport would be limited & advice wasgiven to avoid them. This measure is described as lockdown.

• Most crowded road & highway during lockdown.
The lockdown was extended nationwide and regionally many times in thisCovid-19 infection time. Lockdown has severe economic impact. Bangladesh is economically poor
country. Most of the people live from hand to mouth. So during lockdown people lost their source ofincome. They cannot buy food and essential goods for their daily living
 Testing and Monitoring
Bangladesh has consistently shown one of the lowest test rates per capita in the world. So the levelof testing is insufficient to understand the spread of infection. Bangladesh is doing on an average 12,000
to 15,000 Covid-19 test per day for a population of 168 million. Public health expert in Bangladesh haveexpressed concern about the government decision to charge people for Covid-19 test. After taking thecharge for test suddenly decreased the number of test being done.

Patients are waiting for covid-19 test
In June-2020 Government decided to charge 200 TK (£1.80) for testing done at government facilitiesand 3500 TK (£32) for private facilities. The government facility is limited and not available. Almost one
in four Bangladeshi live in bellow the national poverty line. Charging people for the test is really creating

problem. It is creating barriers, especially for the poor. During the pandemic people don’t have work, theydon’t have money. They don’t have enough food, how they will do test. There is also lack of confidenceof our health care system. People don’t want to get tested because they don’t trust the result of testing.
Another problem is delay in getting the test result. It takes a week. Sometimes people don’t get the resultat all. In Bangladesh people are 168 million. That is performing a maximum 15,000 test per day. This
number of test is nothing for this huge population. So we must have to increase the number of test
everyday in the whole countrywide.
 Vaccine Trial & Vaccination
On 5th November 2020, a agreement was signed between the government of Bangladesh andSerum Institute of India. Under the agreement Bangladesh order 30 million doses of Oxford-Astrazeneca
vaccine form Serum institute. On the other hand Indian government has given 3.2 million doses toBangladesh as a gift which was also produced by Serum institute. But Serum Institute supplied only 7
million doses in the first two months of the year. Bangladesh was supposed to receive 5 million doses permonth but not received shipment in March and April 2021, due to severe covid-19 infection in India.

Indian government is not allowing export vaccine for their crisis. As a result rollout of vaccine has
been disrupted by supply short fall. Most people who have received the 1st dose are not getting the 2nd
dose on time. Not getting the 2nd dose at the right time is likely to reduce the effectiveness of thevaccination program. Bangladesh is looking for alternative vaccine source. Because India isn’t supplying
the vaccine according to the agreement.
 Medical Facility for Covid-19 Patient
In our country there are no proper medical facilities for a lot of patient. After pandemic of covid19, a lot of covid-19 patients were crowding in every private & government hospital. Hospital &management was not prepared for management of the huge patients of covid-19 at the first wave. Some
private hospital was closed for fearing the covid-19 infection for few days. All the patients were crowdingin the government hospital only. It was very difficult to manage covid-19 & non-Covid-19 patients in thesame hospital separately. Many Doctors & staffs were affected by covid-19. Then the government
declared some hospital only for covid-19 patients. Bangladesh has only 1,169 ICU (Intensive care Unit)
beds in government & private Hospital. On an average 0.72 beds per 100,000 citizen.

Among the beds only 432 beds are in the government hospital and 737 in private hospital. About
5% of covid-19 patients required ICU & mechanical ventilators. Bangladesh has managed to secure only
1267 ventilator machines for its population. There is one ventilator for every 317300 people of thecountry. We also need covid-19 dedicated hospital. Bangladesh must increase the ICU bed and ventilator
very soon. Many Covid-19 patients are not getting ICU bed and ventilator support.
 Socio-Economic Impact

People are waiting & receiving relief from government & Organization.
The Covid-19 pandemic has heavily impacted household & individual level of earning. InBangladesh around 13 % people have become unemployed. Due to several time lockdown many people
have lost their work. People don’t have enough money to buy food & essentials. A lot of people of ourcountry work in the foreign country especially in the Middle East, Europe & America. Many of them havelost their job because of pandemic covid-19. Most of the country don’t allow Bangladeshi worker to enter
their country after covid-19 infection. So Bangladesh is not getting proper remittance. Government
support for the people isn’t sufficient. Some rich citizen & non-governmental organization is supporting
the poor people.

 Death by Covid-19

Janaza Salah & burial process
At the end of the June 2021 total about 15,000 deaths by covid-19 infection. On an average 30 to35 people are dying per day after the infection. After passed away, victim family is facing the crisis ofIslamic Funeral (Janaza Salah Prayer). Chief of mosque we called Imam is not willing to perform theJanaza Salah. Family members & community members are also not willing to attend in Janaza Salah due
to fear of infection. A few charitable organizations along with the international committee of Red Cross
are taking measure for proper handling dead body in Bangladesh. All families want to bury their loves
one. The Charitable Organizations collect the body from the hospital and other place & bury them in thecemetery. It was challenging at first because the volunteers feared to bury the dead body for covid-19
infection. Though, the dead body was safely covered.
 Okamoto Medical Center is serving the village people in this pandemic

In this pandemic of covid-19, it is very risk to visit patients. In our center we have no proper
personal protective equipments. So our staff’s are in very dangerous situation. Every day we have to face
many patients suffering from fever, cough & cold. Those kinds of patients are very suspicious of covid19. All patients are first time come to us before going to government central hospital. As a doctor we
can’t refuge the patients to give treatment. We maintained physical distance, wear mask-hand gloves &frequently hand wash. In last march I was suffering from fever, head ache & malaise. My mother was also
suffering from the same symptoms along with dry cough. We suffered fever for about 10 days. After
subsiding fever I was suffering from fatigue, weakness & anorexia. My mother was also suffering fromvertigo, fatigue & dizziness. I & my mother suffered about 1 month with fever complication. Definitely
we were infected by covid-19. Almighty God saved us with the prayer of Dr. Okamoto & other kind
contributors along with our relatives and village people. Thanks a lot to professor Okamoto & othercontributors for their kinds support.

 Present Situation of Covid-19 (Indian variant)

Now in July 2021, the covid-19 situation is getting worse. Indian variant of covid-19 infection israpidly spreading in our country. Bangladesh surrounded by Indian borders. So this virus can easily
spread here. Now more than ten thousand people are infecting every day. The infection is increasing
every day. Death is also highest about 165 per day by this Indian type corona virus. The health specialists
are worried that the infection and death will much more in coming day. Now in our government & private
hospital fulfill by covid-19 patients. There is no extra bed for new covid-19 patients, also shortage ofoxygen supply. Our hospital service management will breakdown, if covid-19 infection increasing in thisway.
 Conclusion
Covid-19 pandemic is a global problem. Only one country by itself will not be able to control it.
World leaders will have to work together. Every day we are losing precious live. Every people have
responsibility from his position to do something for this pandemic. Bangladesh is developing country. We
have no proper healthcare system. I hope co-operation & support from the developed countries;
Bangladesh will overcome this serious covid-19 infection. In our village where Okamoto Medical Centeris situated, a lot of people are infecting & passing away by this pandemic. I want to help the poor infected
people of our village through Okamoto Medical Center. I hope Japanese contributors will support us.