Patients evade tests as Bangladesh border districts emerge as COVID hotspots

  • Senior Correspondent, bdnews24.com
    Published: 2021-06-09 03:15:15 BdST

Dr AKM Zahin, a medicine specialist working in Dhaka, saw 15 patients when he visited his village home in Thakurgaon, a border district. As many as 14 of them had fever.

Surprised by a “wave” of patients with symptoms of COVID-19, the doctor took to Facebook to warn the residents of the situation and urge them to follow health rules.

“But many of them do not agree to get tested. They even refuse to entertain the idea that they might have caught the coronavirus,” Dr Zahin wrote.        

Thakurgaon is not unique. Many districts in Rajshahi, Khulna, and Rangpur divisions are also in a precarious position.

With the detection of the highly infectious Delta variant, which is dominant in India amid a deadly second wave of infection, the border districts have become new COVID hotspots of Bangladesh.

The true scale of the public health crisis cannot be grasped due to a lack of tests however.

According to the Directorate General of Health Services or DGHS, the three divisions, out of eight, reported 1,331 coronavirus cases in the daily count on Tuesday, or more than 57 percent of the total in the country.

But the 6,046 samples tested in the divisions account for 32 percent of the total.

So, experts believe the number of cases would have been much higher in the three divisions had they conducted enough tests.

Despite the struggle to keep the deadly outbreak under control for nearly one and a half years, it has not been possible to raise awareness among the people.

Many patients lead daily life normally by hiding their symptoms as they fear they will face social isolation if the news of their infection spread, which is ultimately giving a rise to the number of infections.

Aslamul Haque, a madrasa teacher living in Bagerhat municipality, and his wife lost their ability to smell and taste when they caught fever around a month ago.

Despite the symptoms that strongly suggest they caught the coronavirus, the couple did not undergo tests and recovered through medication prescribed by a doctor.

“Had we tested positive for the coronavirus, (authorities) would have put red flags at our home. Our relatives and neighbours would have known about it,” Aslamul said.  

Besides the fear of social isolation, Gouranga Das in Thakurgaon’s Ranishonkoil said he did not make arrangements for her wife’s coronavirus test last month when she caught fever because of the sufferings they would have to face to get the test.

WHAT’S HAPPENING IN THE VILLAGES?

It is far more difficult for the residents of villages to get coronavirus tests, especially due to a lack of proper transport.

The villagers also do not see the disease as much of a threat either because they have not seen the devastation caused in the urban areas.

Taking over-the-counter medicines on the pharmacist’s recommendations is what most of the patients are doing.

Maksudur Rahman Ratan, who runs a pharmacy in Chuadanga’s Damurhuda, said three-fourths of the patients visiting his shop now have the symptoms of COVID-19.

“I am advising them to get the coronavirus test, but many of them are not paying heed,” he said.

Dr Abu Hena Mohammad Jamal, Damurhuda Upazila health and family planning officer, said he heard many of the patients are not eager to undergo the test.  

The authorities have shut down the cattle markets in the Upazila and asked the residents of the bordering villages not to leave home without an emergency, said Nazrul Islam Sarker, the deputy commissioner of Chuadanga district.

Speaking to bdnews24.com after returning from Thakurgaon, Dr Zahin said 80 percent of the patients he saw were from the bordering villages or Thakurgaon town. 

Citing the patients, he said people in almost all homes were catching fever, but only the patients with severe symptoms were visiting doctors. 

Dr Habib-E-Rosul Liton of Thakurgaon General Hospital said the number of patients with fever has increased at the government facility, and most of the patients are from villages.

“Most of them are taking medicine from local pharmacies. Those with serious conditions are coming to us,” he said.

In a Facebook post, Dr Liton warned: “This is for those who have been complacent that the number of coronavirus cases is low in villages -- 60 percent of the patients I am getting now are from villages. The situation is worsening more rapidly that it was five to seven days ago. The patients’ condition is also worsening quickly. The hospital’s isolation department is almost filled up.”

ASYMPTOMATIC, OR HIDING SYMPTOMS

The number of coronavirus cases in Naogaon has been rising since the Eid-ul-Fitr holidays when people defied a nationwide lockdown to travel back to their village and town homes amid a second wave of infection.

The district administration put Naogaon Municipality and Niamatpur Upazila on a stricter lockdown for seven days from Jun 3 as the situation continued to take a turn for the worse.

Now a small study conducted by the Directorate General of Health Services has found more than 8 percent of the randomly selected participants positive for COVID-19 in rapid antigen tests.

It indicates that 3 to 5 percent of the border district’s 3 million-strong population have contracted the coronavirus sometime during the pandemic, according to its Civil Surgeon Dr Abu Hanif.

Most of the 1,580 participants, including students, passengers, labourers, shopkeepers and others, had no symptoms when their samples were tested instantly after collection at all 11 Upazilas in the district on Sunday and Monday.

Besides the asymptomatic patients, many are hiding symptoms and declining to get tested, believes Dr Tareque Hossain of Naogaon General Hospital.

Subrata Das, medical officer at Bagerhat Civil Surgeon’s Office, said he also saw a trend among the people, be they educated or illiterate, to not undergo tests by claiming that they have caught the seasonal flu.

“I can’t make them understand that they are risking their lives by evading the tests out of fear of social isolation,” said Dr SM Shahnewa of Bagerhat General Hospital.

Dr Golam Rabbani of Barind Medical College Hospital in Rajshahi, said the cost of the tests and transport also discourage some patients. “Tests have increased in past two weeks, but a large number of patients are still not willing to undergo them.”

WHERE IS THE FAILURE?

Rajib Nandy, an assistant professor at Chattogram University’s communication and journalism department who was involved in a study on the fear about the coronavirus in Bangladesh, said the authorities should have presented the correct information in “a manner more acceptable to the people”.

From the experience he gathered in the study based on five cases, he said, “Coupled with the flow of extra information and a lack of coordination in communication, the fear has increased the complications related to the pandemic.”

Nandy said the authorities failed to communicate with the people by using the pandemic-related words, such as lockdown, isolation and home quarantine.

He believes the language used in posters, notices or advertisements could be more communicative and effective.

Public health expert Dr Mushtuq Husain said having measures to quarantine those crossing the border legally is not enough to stop the spread of the Delta variant.

The government also needs to make arrangements for quarantine of those coming illegally from India without frightening them, he said.

“And people are putting red flags in many areas with high infection rates. It’s inhumane and terrifying (for the infected and their families). We can use the Red Crescent’s flag by taking their permission. But red flags mean hatred towards the infected people who in fact deserve support.”

The government should ensure support for the patients from low-income families so that they can quarantine properly, added the former chief scientific officer at the government disease control agency IEDCR.

“Otherwise," he warned, "they will not reveal test results.”

[Additional reporting by Naogaon, Bagerhat, Chuadanga, Satkhira and Chanpainawabganj correspondents]