Bangladesh does not have detailed records of over 100,000 patients who tested positive with Covid-19 since the pandemic made its way into the country.
The failure of the health authorities in identifying the location or compiling the details of these patients will adversely affect any research, contact tracing, and decision on the next course of action in combating Covid-19 in the country, say healthcare experts.
Bangladesh recorded 337,520 coronavirus positive cases till September 13 since the virus was first detected on March 8, data compiled by Directorate General of Health Services (DGHS) show.
However, the location-wise data updated every day by the Institute of Epidemiology, Disease Control, and Research (IEDCR) – the national institute for conducting disease surveillance and outbreak investigation – has come up with data related to only 231,445 cases as of Sunday.
That means the authorities have failed to include the details of at least 106,075 reported cases in the list that is officially updated daily.
Responding to Dhaka Tribune’s queries on why the tally has not been kept properly even six months after the detection of the first Covid-19 case, Habibur Rahman, Director of the Management Information System (MIS) of the DGHS, said many of the field offices had not been able to update the information directly to the directorate, leading to the situation in question.
“At the same time, information regarding many patients remains absent from the database since they were not updated due to inaccurate information about their names, age, mobile numbers, or complete addresses,” he said.
He said the directorate had so far identified around 60,000 such cases about which it was trying to update information.
The DGHS has been handling Covid-19 related data since early May.
The DGHS director also said the IEDCR, which initially kept some of the information pending because of the same problem, was also trying to update the tally.
“We are now trying to find out a mechanism on how information from different laboratories can be uploaded directly at the database to minimize the crisis,” said Habibur Rahman.
‘Labs at fault’
Former IEDCR director Dr Meerjady Sabrina Flora said many of the labs – who send test reports – lack the addresses of patients, creating a problem in the database of geographical location.
“Many of the mobile numbers also remain switched off after the test results are notified, creating trouble for IEDCR to update the list. The problem of information missing is higher when it comes to laboratories in Dhaka, but it is lower in districts as the data can be cross checked with respective civil surgeons of the districts to get accurate data,” said Flora, now an additional director general (planning and development) at the DGHS.
However, she pointed out that many of the locations of the patients are now being tracked with the support of Access to Information (A2i) of the government who can track movement of the cell numbers provided at the sample forms, even if the patient does not respond to phone calls.
“Currently, we are prioritizing updating the list for patients of the last 14 days because contact tracing has to be done during the period. The rest are gradually being updated by MIS of the DGHS,” she said.
‘Focus on analysis based on real-time data’
Speaking to Dhaka Tribune, Mohammad Mushtuq Husain, consultant for the National Action Plan for Health Security (NAPHS) and former principal scientific officer (PSO) of IEDCR, also cited the absence of all details of patients behind the missing information in the IEDCR tally.
“Complexities relating to entering information into the database may have created the crisis. The IEDCR only updates information to its tally only when it receives all the information required in all fields,” he said.
However, he said, one had to make do with whatever information was available of a patient – say age, even if the mobile number was missing or the spelling of the name was wrong – and enter it into the list.
“The number of figures missing is too high and there is no need for someone being a ‘super perfectionist’. In a pandemic-like situation, the authorities should not wait to get all the information, but should rather focus on analyses based on real-time data,” said the expert.
He stressed the need for the data to be updated immediately and for more manpower to be employed in the process to help update the geographical list of Covid-19 patients for the sake of analyses and contact tracing.
“Field offices should be allowed to update the data in real time to the system to quickly update the list,” he opined.
