COVID-19 trend in Bangladesh: deviation from epidemiological model and critical analysis of the possible factors

Abstract

Background: Since its first report on March 08, COVID-19 positive cases and number of deaths are increasing in Bangladesh. In the first month of COVID-19 infection, incidence of daily positive cases did follow the susceptible, infected and recovered (SIR) based predictions we reported in April, but started to deviate in the following months. COVID-19 transmission and disease progression depends on multifaceted determinants e.g. viral genetics, host immunity, social distancing, co-morbidity, socio-demographic and environmental parameters. Therefore deviation in confirmed cases from predicted model may appear and warrant thorough investigation. Methods: In this short report, we compared real data with SIR model and analyzed the possible factors associated with the deviation which included preventive intervention strategies, socioeconomic capabilities, climatic and meteorological indexes, acquired immunity of Bangladeshi population, demographic characteristics, health indicators and food habits. Results: The key factor responsible for the observed deviation was found to be the number of tests performed. Having population with low median age, young age groups are being mostly infected. Low prevalence of non-communicable diseases among them and strong immunity compared to the elderly might have kept most of them asymptomatic with silent recovery. Warm temperature, humidity and UV index of Bangladesh during this summer period might have contributed to the slow progression of infection. Longer daylight mediated immunity, fresh air circulations and ventilation, less population density in rural areas and certain food habits perhaps helped the large number of populations to restrict the infection up to a level. Conclusion: Despite all these helpful determinants in Bangladesh, person to person contact is still the leading risk factor for COVID-19 transmission. Infection may increase rapidly if safe distance and preventive measures are not strictly followed while resuming the normal social and work life. Expanding test capacity, strong collaborative action plans, strategies and implementation are needed immediately to prevent catastrophe.

Space-Time Patterns, Change, and Propagation of COVID-19 Risk Relative to the Intervention Scenarios in Bangladesh

“…Their findings suggest that early growth of COVID-19 cases followed an exponential pattern with an estimated 5.16 days doubling period. A recent study [ 14 ] reported that the COVID-19 trend in Bangladesh showed deviation from the epidemiological model, and they identified potential factors responsible for this deviation. Overall, Bangladesh’s COVID-19 characteristic patterns reflect the following: an inadequate testing and treatment capacity, insufficient supply of personal protection equipment, poor public sanitation practices, poorly managed public health care system and services, lack of public awareness, large-scale violation of social distancing order ( Figure 1 , Figure 3, Figure A2 and Figure A3 ), a large vulnerable population (e.g., Rohingya refugees), community-level transmission, and dire economic impacts [ 15 ].…”

Do knowledge and attitudes matter for preventive behavioral practices toward the COVID-19? A cross-sectional online survey among the adult population in Bangladesh

“…That means the number of people tested positive is dependent on the number of tests. It should be mentioned here that the number of tests per day has also declined since the fourth month of the pandemic due to people’s dwindling interest resulting from various aspects, such as social stigma, fear, long queue, and waiting time in sample collection, delayed in providing test results, and introducing fees for tests [ 3 ]. It should be noted that Bangladesh is ranked 15 th globally in terms of the total number of COVID-19 positive cases while 157 th in terms of tests per million population (as on 25 September 2020) [ 4 ].…”

Acceptance of a Symptom-Based Approach for COVID-19 rtRT-PCR Testing to Conserve Resources in a Lower Middle-Income Setting

“…The extensive hassle of travel, the inability to get a suitable web-based slot or the long queue at the testing site might have limited their access for a regular check-up. 12 …”