'The health authorities will repeat their mistakes if they fail to predict the situation again'
Experts fear a lack of accurate information may hinder the fight to contain Covid-19 and may potentially lead to a second wave of the novel coronavirus in Bangladesh.
The management Information System (MIS) unit of the Directorate General of Health Services (DGHS), said they have enough information to make necessary preparations, even though some information is missing.
Asked about the status of Covid 19 information preserved by the unit, MIS unit Senior System Analyst Sukhendu Shekhor Roy admitted they lack some data on Covid-19.
“Maintaining 100% data is impossible after the mistakes that have been made earlier,” he added.
However, MIS unit Director Dr Habibur Rahman denied any lackings in their data and said they have enough to make a roadmap for a possible second wave of Covid-19.
According to data from the DGHS and Institute of Epidemiology Disease Control and Research (IEDCR) revealed a week ago, they do not have data on more than 100,000 Covid-19 positive patients.
Current in-charge of DGHS control room Dr AB Md Shamsuzzaman said there are discrepancies between the data of IEDCR and DGHS.
“The Covid-19 Dashboard of DGHS includes a disclaimer that district wise cases may not equal the total number of confirmed cases,” he added.
Asked about the mismatch in the information, he said: “I don’t know how IEDCR is collecting data. Measures will be taken only using data from the MIS unit.”
Atiqul Haque, associate professor of the department of public health and informatics of Bangabandhu Sheikh Mujib Medical University (BSMMU), said proper preparation for a second wave can never be taken without an accurate forecast
“The health authorities will repeat their mistakes if they fail to predict the situation again. To avoid the same mistakes, what is most important is accurate data,” he added.
He also said differences between the data provided by the DGHS and data from hospitals is raising serious doubts about the accuracy of the information that has been collected.
“The information management of the DGHS could lead to serious jeopardy. One can realize this from hearing that the DGHS control room lost lots of data when one of its hard disks crashed,” the academic added.
Information crucial to restoring trust
Prof Be-Nazir Ahmed, former director of the Institute of Epidemiology, Disease Control, and Research (IEDCR), last month told Dhaka Tribune that information is not only the key for predicting what is coming and what we have to do, but also to establish better management.
“Several corruption allegations have emerged, and mistrust has been created between patients and health care providers. If a well managed information system can be developed, some of these issues can be solved,” he said.
“For example, if data on required PPE for healthcare professionals could be maintained through a single database that is open to all the authorities of the connected facilities, it would help create trust between them and they would be more motivated in providing services,” Prof Be-Nazir explained.
An inter hospital network with open access for all could have been built and it would have prevented patients from having to go door-to-door and would help them trust healthcare facilities, he added.
Preparation impossible without roadmap
The National Technical Advisory Committee (NTAC) on Covid-19 has long recommended a strengthening of information systems and did so once again after a virtual meeting on Sunday night.
In a press release, NTAC emphasized preparing for a possible second wave of Covid-19 in the country and agreed to provide necessary assistance to DGHS to formulate a roadmap for the upcoming situation.
“Without accurate information, the preparation would never be suitable for the upcoming situation,” said Professor Nazrul Islam, former VC of BSMMU and member of NTAC.
“The positivity rate has already started increasing again in the last three days, from around 11% to 14%. It might be a coincidence or might be the start of the second phase, but it is impossible to say if the health authorities do not have proper data,” the eminent virologists added.
“We know what to do and how to tackle the situation in fighting the first phase. But without proper data, it would be impossible to implement the right measures for what may be coming,” he added.
The professor said the MIS unit is providing information on deaths, gender and age, but not on the length of time patients undergo treatment, where they are being treated, the behaviour of critical patients, and other such matters. If the information is provided in a timely manner, it would help find loopholes in clinical management.
Public Health and Informatics expert Atiqul Haque said doctors are the professionals worst affected by Covid-19, but there is no information on why they are getting infected so much.
“If we could find why they are getting infected so much, it could help ensure their safety,” he added.