Is it time for Bangladesh to reform health screening systems at ports?

It is a matter of concern whether the measures taken to screen travellers entering the country have been adequate.

Bangladesh procured seven thermal scanners in 2014 for screening travellers at the ports of entry as part of Ebola control and treatment in the country.

The purchase and instalment of the scanners were made through maintaining the standard operating procedure (SOP) prepared by the National Ebola Monitoring Committee.

Prof Dr Be-Nazir Ahmed, Line Director of the Communicable Disease Control division of the Directorate General of Health Services (DGHS),  was the member secretary of the committee.

Sources at the DGHS and the Institute of Epidemiology, Disease Control and Research (IEDCR) said that the screening process commenced in line with recommendations from the World Health Organization (WHO).

WHO started emphasizing travel screening back in 2005.

In response to the changing patterns observed in the global spread of several infectious diseases, changes were brought about in the 1969 International Health Regulations aiming to prevent, control and provide a public health response to the global spread of diseases without unnecessary interference with international traffic and trade.

WHO’s interim guidance for Ebola virus disease, published in November 2014, which included exit screening at airports, ports and land crossings, was initially adopted for the coronavirus situation.

Three of the screening procedures of the protocol were commonly followed -- travellers with symptoms consistent with coronavirus would not be allowed to travel unless for an appropriate medical evacuation; temperature would be measured and identification data of the travellers would be recorded.

Among the three activities temperature was somewhat screened, but the other two screening procedures were not followed properly.

That is why incidents of returnees hiding and running away from home took place, said an official linked with the procedure.

Probable next steps

While talking about possible measures following the lockdown, Professor Be-Nazir Ahmed said as the lockdown would be eased, many more people would be allowed to enter the country.

“So, there is no alternative to strengthening travellers’ screening procedure,” he added. 

He said the system existing in the country’s ports was introduced when he was the director of Disease Control in the country.

Unfortunately the system did not see any progress in the last few years.

The present situation might be an opportunity to reform the system as necessary, he added. 

He said people should be screened not only by having their temperature taken but also by conducting viral infection tests on them.

If necessary, the authorities can arrange a quarantine space to conduct the tests. The Basundhara convention centres might be chosen as the quarantine spot as they are situated at an isolated place.

Those who have no viral infection would be sent to home quarantine either under the observation of law enforcers and the local administration or by contacting their local guardians, who would be held responsible if the person was found roaming outside the house.

Those who have viral infection would be put under institutional quarantine. If they show no symptoms within 14 days they will be released.

Testing should be done within a day, and for this at least three labs could be dedicated at places near the major airports of the country, the professor said.

We have 41 institutions in the country that could be used as laboratories and some of them could be made available in this regard.

This process will help in tracing, identifying and providing isolation with treatment to the possible Covid-19 sources in the country, the professor opined.