Situation Report No. #15 08 June 2020 https://www.who.int/bangladesh/emergencies/coronavirus-disease-(covid-19)-update/coronavirus-disease-(covid-2019)--situation-reports

Photo: Social Media Bangladesh

Tested Confirmed Recovered Dead Hotline

410,931 68,504 14,560 930 10,128,117

Test/1 million AR/1 million Recovery Rate CFR% Isolation Beds

2,412 402.2 21.3% 1.36% 13,284

Laboratories Gender PPE Stock PoE Screening

55 COVID-19 Labs 71% 29% 1,432,323 340,267

Last Days 89,507 Samples 2,535,493 21,397

64.2% Inside Tests 572,512 7,029

16.7% Share of Positive Tests 176,119 314,845

WHO Bangladesh COVID-19 Situation Report #15 08 June 2020

1. Highlights

As of 08 June 2020, according to the Institute of Epidemiology, Disease Control and Research (IEDCR), there are 68,504 confirmed COVID-19 cases in Bangladesh, including 930 related deaths; Case Fatality Rate (CFR) is 1.36%.

On 04 June 2020, the Ministry of Foreign Affairs (MoFA) circulated a Note Verbale, which stated that from now onwards diplomatic and official passport holders may avail COVID-19 treatment in any public or private hospitals in Bangladesh providing COVID-19 treatment.

2. Coordination

On 1 June 2020, WHO published a new operational guidance for maintaining essential health services in the COVID-19 context. The guidance outlines basic principles and practical recommendations that support decision-making to ensure the continuity of select essential health services, highlighting key actions that countries should consider and contains brief sections addressing specific adaptations and considerations for life course and disease programmes in the context of COVID-19. It is intended for decision-makers and managers at the national and subnational levels. The document supersedes the earlier Operational guidance for maintaining essential health services during an outbreak and complements the recently-released Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic. Full document: https://www.who.int/publications/i/item/10665-332240

On 1 June 2020, WHO released findings of May 2020 survey, which was completed by 155 countries during a 3-week period, focusing on the impact of COVID-19 on prevention and treatment services for noncommunicable diseases (NCDs), since the pandemic began. The main finding is that health services have been partially or completely disrupted in many countries. More than half (53%) of the countries surveyed have partially or completely disrupted services for hypertension treatment; 49% for treatment for diabetes and diabetes-related complications; 42% for cancer treatment, and 31% for cardiovascular emergencies. Rehabilitation services have been disrupted in almost two-thirds (63%) of countries, even though rehabilitation is key to a healthy recovery following severe illness from COVID-19. In the majority (94%) of countries responding, ministry of health staff working in the area of NCDs were partially or fully reassigned to support COVID-19. Among the countries reporting service disruptions, globally 58% of countries are now using telemedicine (advice by telephone or online means) to replace in-person consultations; in low-income countries this figure is 42%.

On 05 June 2020, WHO published the new interim guidance on the use of masks in the context of COVID-19. The document is an update of the guidance published on 6 April 2020 and includes updated scientific evidence relevant to the use of masks for preventing transmission of Coronavirus disease 2019 (COVID-19) as well as practical considerations. It is intended for individuals in the community, public health and infection prevention and control (IPC) professionals, health care managers, health care workers (HCWs), community health workers and decision-makers. The document contains an updated information on transmission from symptomatic, pre-symptomatic and asymptomatic people infected with COVID-19, and new guidance on the targeted continuous use of medical masks by health workers working in clinical areas in health facilities in geographical areas with community transmission of COVID-19. The updated guidance includes practical advice for decision-makers on the use of medical and non-medical masks by the general public using a risk-based approach. It also carries information on non-medical mask features and characteristics, including choice of fabric, number and combination of layers, shape, coating and maintenance. Full document: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

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3. Surveillance and Laboratory

Between 8 March and 08 June 2020, according to the Institute of Epidemiology, Disease Control and Research (IEDCR) there were sixty-eight-thousand-five-hundred-four (68,504) COVID-191 confirmed by rt-PCR, including nine-hundred- thirty (930) related death cases (CFR 1.36%).

The figures below are showing the daily distribution of reported confirmed COVID-19 cases, deaths and total COVID-19 test, 08 March – 08 June 2020, Bangladesh.

3,000 60 # Cases # Deaths Poly. ( # Cases ) Poly. (# Deaths) 2,500 2,000 45 1,500 30 1,000 500 15 Number of Cases (N=68,504) (N=68,504) Cases of Number 0 08/03 15/03 22/03 29/03 05/04 12/04 19/04 26/04 03/05 10/05 17/05 24/05 31/05 07/06 -500 0 -1,000 -1,500 15 -2,000

-2,500 30

-3,000 Number of Deaths (n=930) (n=930) Deaths of Number -3,500 45

y = 2E-05x4 - 3.2259x3 + 212401x2 - 6E+09x + 7E+13 3,000 400,000 # Cases Total Tests Poly. ( # Cases ) 350,000 2,500 300,000 2,000 250,000

1,500 200,000

150,000 1,000

100,000 Total Numner of tets (410,931) tets of Total Numner 500 50,000

0 0

10/03 18/04 02/06 07/03 13/03 16/03 19/03 22/03 25/03 28/03 31/03 03/04 06/04 09/04 12/04 15/04 21/04 24/04 27/04 30/04 03/05 06/05 09/05 12/05 15/05 18/05 21/05 24/05 27/05 30/05 05/06 08/06

1 WHO Bangladesh COVID-19 Situation Reports present official counts of confirmed COVID-19 as announced by the IEDCR on the indicated date. Difference in data between the WHO reports and other sources can result from using different cutoff times for the aggregation and reporting of the total number of new cases in the country.

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The figure below is showing the daily distribution of reported confirmed COVID-19 cases and outcomes, 07March – 08 June 2020, Bangladesh.

70,000 Total Deaths Active Cases Recovered 60,000

50,000

40,000

30,000

20,000 Number of Cases (N=68,504) (N=68,504) Cases of Number

10,000

0

16/03 03/04 07/03 10/03 13/03 19/03 22/03 25/03 28/03 31/03 06/04 09/04 12/04 15/04 18/04 21/04 24/04 27/04 30/04 03/05 06/05 09/05 12/05 15/05 18/05 21/05 24/05 27/05 30/05 02/06 05/06 08/06

Age and gender data are currently available for only 24% (16,197/68,504) reported confirmed COVID-19 cases: 26.9% (4,360/16,197) cases were confirmed in people between 31 and 40 years old, 23.9% (3,877) in the age group of 21 to 30 years, 18% (2,936) in the age group of 41 to 50 years and 13.3% (2,155) in the age group between 51 and 60 years old.

As on 08 June 2020, data was available for 53% (493/910) of COVID-19 related-death. The highest CFR 31.3% was reported in the age group of 61 to 70 years old, 26.9% (2,936) in the age group between 51 and 60 years and 17.4.% (86) in the older age group 71 and above.

Male represented 71% and 78% of the of total reported confirmed COVID-19 cases and deaths respectively.

The table below is showing gender and age distribution the reported confirmed COVID-19 cases (N=16,197) and Deaths (N=493), 08 June 2020, Bangladesh.

Cases Male Female Deaths

> 80 0.5% 0.2% 4.1% 1.2% > 80

71 - 80 1.4% 0.5% 10.3% 1.8% 71 - 80

61 - 70 4.4% 1.7% 24.5% 6.7% 61 - 70

51 - 60 10.0% 3.3% 21.3% 5.7% 51 - 60

41 - 50 13.5% 4.7% 11.0% 2.2% 41 - 50

31 - 40 19.8% 7.1% 4.9% 2.2% 31 - 40

21 - 30 16.1% 7.8% 1.6% 0.8% 21 - 30

11 - 20 3.4% 2.7% 0.4% 0.6% 11 - 20

0 - 10 71% 1.7% 1.3% 29% 78% 0.0% 0.6% 22% 0 - 10

4,000 3,000 2,000 1,000 0 1,000 2,000 3,000 4,000 200 150 100 50 0 50 100 150 200

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WHO Bangladesh COVID-19 Situation Report #15 08 June 2020

As of 08 June 2020, geographical distribution of confirmed reported COVID-19 cases was available on 62% of cases (42,516/68,504); of which 68.8% (29,230) were from , 16.7% (7,202) from Chattogram division, 3.1% (1,324) from division, 2.9% (1,184) from division, 2.7% (1,149) from , 2.4% (1,040) from division, 2.1% (880) from division, and 1.2% (507) from division.

The figure below is showing the daily distribution of reported confirmed COVID-19 cases (N=41,315) per selected division, 14 April – 07 June 2020, Bangladesh.

2,500 Dhaka Chattogram Mymensingh Ranjpur Rajshahi Khulna

2,000

1,500

1,000 Number of Cases of Number

500

-

26/04 24/05 16/04 18/04 20/04 22/04 24/04 28/04 30/04 02/05 04/05 06/05 08/05 10/05 12/05 14/05 16/05 18/05 20/05 22/05 26/05 28/05 30/05 01/06 03/06 05/06 07/06 14/04

The case doubling time can be used to conclude how fast COVID-19 infection has been spreading in Bangladesh. Available data allows us to see how quickly the number of confirmed cases increased in different divisions in Bangladesh. As of 08 June 2020, the case doubling time is 5 days in Dhaka and Chattogram, 7 days in Khulna, Sylhet, Rajshahi and 8 days in Rangpur and Mymensingh and 10 days in Barisal.

The figure below is showing the growth of COVID-19 confirmed cases in all divisions starting from the day they reported 10 confirmed cases, 08 June 2020.

D1 D2 D3 D4 D5 10,000 BSL CTG DHK KLN D6 MYM RSH RNP SYT D7 D8 1,000 D9 D10 D12

Number of Cases of Number D15 100 D20

D40

10 0 10 20 30 40 50 Days since 10th Confirm Case

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WHO Bangladesh COVID-19 Situation Report #15 08 June 2020

The figures below are showing the daily distribution of reported confirmed COVID-19 cases (N=41,315) and rolling three-days average per division, 13 April– 07 June 2020, Bangladesh.

1,500 Dhaka 3 per. Mov. Avg. (Dhaka)

1,000

500

0

04/05 14/04 16/04 18/04 20/04 22/04 24/04 26/04 28/04 30/04 02/05 06/05 08/05 10/05 12/05 14/05 16/05 18/05 20/05 22/05 24/05 26/05 28/05 30/05 01/06 03/06 05/06 07/06

600 Chattogram 3 per. Mov. Avg. (Chattogram)

400

200

0

02/05 28/05 14/04 16/04 18/04 20/04 22/04 24/04 26/04 28/04 30/04 04/05 06/05 08/05 10/05 12/05 14/05 16/05 18/05 20/05 22/05 24/05 26/05 30/05 01/06 03/06 05/06 07/06

150 Mymensingh 3 per. Mov. Avg. (Mymensingh)

100

50

0

14/04 16/04 18/04 20/04 22/04 24/04 26/04 28/04 30/04 02/05 04/05 06/05 08/05 10/05 12/05 14/05 16/05 18/05 20/05 22/05 24/05 26/05 28/05 30/05 01/06 03/06 05/06 07/06

180 Sylhet 3 per. Mov. Avg. (Sylhet)

120

60

0

16/05 30/05 14/04 16/04 18/04 20/04 22/04 24/04 26/04 28/04 30/04 02/05 04/05 06/05 08/05 10/05 12/05 14/05 18/05 20/05 22/05 24/05 26/05 28/05 01/06 03/06 05/06 07/06

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WHO Bangladesh COVID-19 Situation Report #15 08 June 2020

150 Rangpur 3 per. Mov. Avg. (Rangpur)

100

50

0

30/04 14/04 16/04 18/04 20/04 22/04 24/04 26/04 28/04 02/05 04/05 06/05 08/05 10/05 12/05 14/05 16/05 18/05 20/05 22/05 24/05 26/05 28/05 30/05 01/06 03/06 05/06 07/06

150 Barishal 3 per. Mov. Avg. (Barishal)

100

50

0

16/04 26/04 06/05 14/04 18/04 20/04 22/04 24/04 28/04 30/04 02/05 04/05 08/05 10/05 12/05 14/05 16/05 18/05 20/05 22/05 24/05 26/05 28/05 30/05 01/06 03/06 05/06 07/06

150 Rajshahi 3 per. Mov. Avg. (Rajshahi)

100

50

0

20/05 14/04 16/04 18/04 20/04 22/04 24/04 26/04 28/04 30/04 02/05 04/05 06/05 08/05 10/05 12/05 14/05 16/05 18/05 22/05 24/05 26/05 28/05 30/05 01/06 03/06 05/06 07/06

90 Khulna 3 per. Mov. Avg. (Khulna)

60

30

0

14/04 16/04 18/04 20/04 22/04 24/04 26/04 28/04 30/04 02/05 04/05 06/05 08/05 10/05 12/05 14/05 16/05 18/05 20/05 22/05 24/05 26/05 28/05 30/05 01/06 03/06 05/06 07/06

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WHO Bangladesh COVID-19 Situation Report #15 08 June 2020

The overall COVID-19 attack rate (the total number of cases divided by the total population) in Bangladesh [1] has been on a steady increase since 4 April 2020. On 08 June, Bangladesh attack rate (AR) is 402.2 per 1 million, and 100% (64/64) of districts with the total population of 170,306,468 people have confirmed COVID-19 cases.

According to the available data for 42,516 cases, the highest AR continues to be observed in the Dhaka division (678.6/1,000,000). Within the Dhaka division, Dhaka city has the highest AR (2,489.4/1,000,000), followed by district (769.4/1,000,000), Munshiganj (661.1/1,000,000), (298.5/1,000,000), (262.5/1,000,000), Gopalganj (227.2/1,000,000), Faridpur (187.9/1,000000), Madaripur (162.5/1,000,000), Shariatpur (114.9/1,000,000), Kishoreganj (104.6/1000,000), Manikganj (101.4/1,000,000), Rajbari (81.4/1,000,000) Narshingdi (73.7/1,000,000), and while the lowest AR 12.9/1,000,000 was reported from .

The second highest COVID-19 Attack Rate is reported from Chattogram division of (214.3/1,000,000). Within the division, Cox’s Bazar reported the highest AR (357.9/1,000,000) followed by Chattogram district (345.8/1,000,000), Noakhali (235.4/1,000,000), Cumilla (189.3/1,000,000), Feni (170.6/1,000,000), Bandarban (106.7/1000,000), Rangamati (96.5/1,000,000), Chandpur (89.3/1,000,000), Lakshmipur (70.4/1,000,000) and (64.8/1,000,000).

The 3rd highest AR in the country was reported from (101.9/1,000,000). Within the Mymensingh division, has the highest AR (112.9/1,000,000) followed by Netrokona (104.3/1,000,000), Mymensingh (102.0/1,000,000), followed by, and (79.1/1,000,000).

Sylhet division reported overall AR (101.0/1000,000) with the highest AR in (166.5/1000,000) followed by Sunamganj (74.4/1,000,000), (70.9/1,000,000) and Maulvibazar district (51.1/1,000,000).

Rangpur division reported overall AR of (61.1/1,000,000) with the highest AR in at (151.5/1,000,000) followed by Nilphamari (63.6/1,000,000), (51.5/1,000,000), and (45.0/1,000,000).

Barishal division has overall AR 51.5/1,000,000 with the highest AR in Barguna (76.7/1,000,000) followed by Barishal (66.6/1,000,000) and Jhalokathi (50.8/1,000,000.) has overall AR 47.6/1,000,000 with the highest AR in (169.4/1,000,000 followed by Naogaon (69.0/1,000,000), and Bogura district (66.9/1,000,000).

In although the overall AR is low at 47.4/1,000,00 but with high AR for (83.2/1,000,000) followed by Khulna (68.2/1,000,000), Kushita (57.8/1,000,000) and Jashore (50.8/1,000,000).

The following figure is showing the attack rate per 1,000,000 population of reported confirmed COVID-19 cases in selected divisions, 14 April - 07 June 2020, Bangladesh.

250 CTG RNP KLN MYM BSL RSH SYT

200

150

100 Attack Attack Rate/1,000,000 50

0

17/04 20/04 23/04 26/04 29/04 02/05 05/05 08/05 11/05 14/05 17/05 20/05 23/05 26/05 29/05 01/06 04/06 07/06 14/04

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WHO Bangladesh COVID-19 Situation Report #15 08 June 2020

As of 08 June 2020, the case doubling time in Bangladesh remains five (6.5) days. Available data allows us to see how quickly the number of confirmed cases increased in Bangladesh and some other countries in the WHO South-East Asia region: India, Indonesia, Thailand and Sri Lanka.

The figure below is showing the growth of COVID-19 confirmed cases in selected South East Asian countries starting from the day they reported 100 confirmed cases, 08 June 2020.

D1 D2 D3 D4 D5 D6 D7 100000 India D8

Bangladesh D9 D10 Indonesia 10000 D12

Malaysia D15 Number of Cases of Number Thailand D20 1000 Sri Lanka

D40

100 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 Days since 100th Confirm Case

Bangladesh reported its first confirmed COVID-19 death on 18 March 2020 (10 days after reporting the first confirmed COVID-19 case). CFR in Bangladesh showed a decline from 10% on 06 April down to 1.36% on 08 June 2020.

The figure below is showing the daily reported confirmed COVID-19 deaths in selected South East Asian countries starting from the day they reported 5th confirmed death, 08 June 2020.

D1 D2 D3 D4 D5 D6 D7 5000 India D8 D9 D10 Indonesia D12 500 Bangladesh D15

Malaysia Number of Deaths of Number D20 50 Thailand D40 Sri Lanka

5 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 Days since 5th Confirm Death

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WHO Bangladesh COVID-19 Situation Report #15 08 June 2020

As of 08 June 2020, there were 15,490 (22.8%) COVID-19 cases with known outcome (closed cases), and out of them 94.0% (14,560/15,490) were cured and 6.0% (910) died. The death rate on closed cases in Bangladesh is lower than the 10.0% (406,461/3,874,873) global average as of 08 June 2020.

The figure below is showing the death and recovery rates over cumulative closed confirmed COVID-19 cases, 10 March – 08 June 2020, Bangladesh.

100% Death% Recovery%

80%

60%

40%

20% Number of Closed Cases (N=15,490) (N=15,490) Cases Closed of Number

0%

10/03 13/03 16/03 19/03 22/03 25/03 28/03 31/03 03/04 06/04 09/04 12/04 15/04 18/04 21/04 24/04 27/04 30/04 03/05 06/05 09/05 12/05 15/05 18/05 21/05 24/05 27/05 30/05 02/06 05/06 08/06

The highest recovery rate is observed in Rangpur division with 50% (569/1,149) of all recoveries, followed by Barishal With 46% (232/507), Mymensingh - 43% (565/1,324), Khulna accounts for 8% (335/880), Rajshahi - 37% (388/1,040), Dhaka - 37% (10,721/29,230) and Sylhet - 33% (387/1,184). The lowest recovery rate of 19 % is found in Chattogram division (1,363/7,202).

The figure below is showing COVID-19 recovery rates per division (N=14,560), 08 March – 08 June 2020, Bangladesh

Chattogram 19%

Sylhet 33%

Dhaka 37%

Rajshahi 37%

Khulna 38%

Mymensingh 43%

Barishal 46%

Rangpur 50%

0% 10% 20% 30% 40% 50% 60%

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WHO Bangladesh COVID-19 Situation Report #15 08 June 2020

Growth factor (every day's new cases / new cases on the previous day) between 0 and 1 indicates a decline; when it is above 1 it signals an increase, and if is persistently above 1 this could signify exponential growth. On April 3, the Growth factor (GF) for COVID-19 cases in Bangladesh reached the highest of 2.5, on 12 April it was 2.3. Since the beginning of May 2020, the GF has been within the range of 0.8 – 1.4, and on 08 June 2020, the GF is 1.0.

The figure below is showing the Growth Factor of daily confirmed COVID-19 cases, 10 March – 08 June 2020, Bangladesh.

3.0

2.5

Growth Factor 2 2.0

1.5

Growth Factor 1 Growth Factor Growth 1.0

0.5

0.0

09/04 30/05 10/03 13/03 16/03 19/03 22/03 25/03 28/03 31/03 03/04 06/04 12/04 15/04 18/04 21/04 24/04 27/04 30/04 03/05 06/05 09/05 12/05 15/05 18/05 21/05 24/05 27/05 02/06 05/06 08/06

As of 08 June 2020, according to IEDCR, a total of 410,931 COVID-19 tests with the overall positivity rate of 16.7% were conducted in Bangladesh by 55 laboratories (29 laboratories in Dhaka and 27 laboratories in other divisions of the country). The latest laboratories, which have started the testing: in Dhaka - CSBF Health Center and TMSS Medical College and Rafatullah Community Hospital and Sheikh Fazilatunnessa Mujib Memorial KPJ Specialized Hospital, Gazipur - outside Dhaka. 64.6% of all tested sample were tested by laboratories in the Dhaka division, and 35.4% - outside Dhaka.

The graph below is showing the daily number of COVID-19 tests, 07 March – 08 June 2020, Bangladesh.

15000

12000

9000

6000

Number of Tests (N=410,931) (N=410,931) Tests of Number 3000

0

05/06 08/06 07/03 10/03 13/03 16/03 19/03 22/03 25/03 28/03 31/03 03/04 06/04 09/04 12/04 15/04 18/04 21/04 24/04 27/04 30/04 03/05 06/05 09/05 12/05 15/05 18/05 21/05 24/05 27/05 30/05 02/06

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WHO Bangladesh COVID-19 Situation Report #15 08 June 2020

The graph below is showing the weekly cumulative number of COVID-19 testing and positivity rate, 08 March – 08 June 2020, Bangladesh

>410 Thousand 400 T As of 08 June 2020 65347 89,059 300 T 68,175

52,821 200 T 41,123

34,845 08 March 2020 100 T 22,764 410,931 First Bangladesh case reported 14,172 Tests N = 6,577 786 1,774 234 368 Positive N = 68,504 0 T 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Epi Week

COVID-19 testing coverage has been gradually increasing in Bangladesh, reaching now 2,412/1,000,000 but is still lower than in Maldives (53,604/1,000,000), Malaysia (18,864/1,000,000), Thailand (6,708/1,000,000), Nepal (8,290/1,000,000), Sri Lanka (3,595/1,000,000) and India (3,462/1,000,000) but higher than Indonesia (1,511/1,000,000) and Egypt (1,321/1,000,000).

The graph below is showing the daily cumulative number of COVID-19 testing per 1,000,000 population, 07 March – 08 June 2020, Bangladesh.

Tests/1,000,000 Population 2,500

2,000

1,500

1,000

500

-

09/05 15/05 10/03 13/03 16/03 19/03 22/03 25/03 28/03 31/03 03/04 06/04 09/04 12/04 15/04 18/04 21/04 24/04 27/04 30/04 03/05 06/05 12/05 18/05 21/05 24/05 27/05 30/05 02/06 05/06 08/06 07/03

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WHO Bangladesh COVID-19 Situation Report #15 08 June 2020

4. Contact Tracing, Points of Entry (PoEs) and Quarantine

According to the DGHS, as of 08 June 2020, the current institutional quarantine capacity in the country is represented by 629 centres across 64 districts, which can receive 31,991 individuals. people. A total of 16,162 individuals were placed in quarantine facilities and of them 12,539 (78%) have been already released. By 08 June 2020, in total 11,871 individuals were isolated in designated health facilitates all over the country, of them 36% (4,319/11,871) have been released, and 7,552 (64%) are presently in isolation facilities.

The highest number of people (6,547) in quarantine facilities was reported on 24 April 2020 while presently, the figure reduced by half to 4,319. Between 17 March to 08 June 2020, total 287,263 individuals were placed under home quarantine all the over the county and to date 82% (234,814/287263) have been already released. Remaining 18% (52,449 individuals) are in home quarantine now.

The figures below are showing the number of individuals in home and facility quarantine and individuals released, 17 Mach – 08 June 2020, Bangladesh.

300,000 Presently in Home Quarantine Total Home Quarantined Total Home Released 250,000

200,000

150,000

100,000

64,005 64,005

62,107 62,107

61,633 61,633

59,903 59,903

56,749 56,749

56,610 56,610

56,295 56,295

55,601 55,601

55,465 55,465

54,616 54,616

54,254 54,254

53,635 53,635

52,449 52,449

52,391 52,391

52,071 52,071

51,645 51,645

51,243 51,243

48,883 48,883

46,085 46,085

44,059 44,059

42,008 42,008

38,165 38,165

36,632 36,632

36,034 36,034 34,220 34,220

50,000 32,159

30,173 30,173

26,290 26,290

23,537 23,537

19,553 19,553

16,665 16,665

15,424 15,424

12,638 12,638

12,243 12,243

8,794 8,794

5,750 5,750

3,760 3,760

1,515 1,515 1,387 1,387

0

20/03 03/06 17/03 23/03 26/03 29/03 01/04 04/04 07/04 10/04 13/04 16/04 19/04 22/04 25/04 28/04 01/05 04/05 07/05 10/05 13/05 16/05 19/05 22/05 25/05 28/05 31/05 06/06

18,000 Presently in Facility Quarantine Total Facility Quarantined 15,000

12,000

9,000

6,547 6,547

6,481 6,481

6,416 6,416

6,112 6,112

5,772 5,772

5,390 5,390

5,301 5,301 5,105 5,105

6,000 4,926

4,644 4,644

4,257 4,257

4,184 4,184

4,082 4,082

4,073 4,073

4,058 4,058

4,006 4,006

4,003 4,003

3,684 3,684

3,680 3,680

3,677 3,677

3,671 3,671

3,666 3,666

3,625 3,625

3,623 3,623

3,598 3,598

3,574 3,574

3,488 3,488 3,263 3,263

3,000 2,121

1,403 1,403

781 781

233 233

162 162

137 137 138

130 130

113 113

98 98

92 92

84 84

70 70

66 66 64 64

0

20/03 03/06 17/03 23/03 26/03 29/03 01/04 04/04 07/04 10/04 13/04 16/04 19/04 22/04 25/04 28/04 01/05 04/05 07/05 10/05 13/05 16/05 19/05 22/05 25/05 28/05 31/05 06/06

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WHO Bangladesh COVID-19 Situation Report #15 08 June 2020

5. Case Management and infection Control

On 3 June, the Logistics and Procurement Pillar under the Country Preparedness and Response Plan Bangladesh organized a meeting at DGHS to provide an orientation on the UN Supply Portal System for Requestors and Managers. Benefits and advantages of using the global supply portal were presented, which include the improved reliability and access to quality products, streamlined procurement process which is in accordance with the public procurement principles, and others. The session also addressed concerns and clarifications regarding the system. The meeting was attended by senior DGHS officials including ADG Admin, ADG Planning, focal person for procurement and supplies and other senior officials. From UN side, WFP, UNICEF and WHO participated to present the Supply Portal and provide clarifications on the operation and options available in the portal. The supply portal is a mechanism supporting the Strategic Preparedness and Response Plan to enable the supply of essential items including PPE, diagnostics, and clinical management equipment to cover shortages in the national market.

On 4 June, the Logistics and Procurement Pillar held their weekly meeting to discuss the current submissions to the UN supply portal and the emerging country needs, where UN support has been requested. The supply portal is open for use to development partners supporting the COVID-19 response and government. Hence, a validation process has been put in place where the supply coordinator reviews a set of information to ensure the any submitted procurement project aligns with the government or refugee response plans, ensures the quantities are within the limits of the original government approved country quantity requirements, updates an internal/external comprehensive overall item tracking report, then validates the request in the system. After submitted requests have been validated and approved at country and global levels, the supply portal control tower assigns a procurement agency to issue the purchase order and process the funding. WFP will manage logistics of the procured goods to ensure smooth shipping, receipt and distribution of the commodities, according to the request. A list of items eligible for procurement using the supply portal is available at the following link https://www.who.int/publications/i/item/emergency-global-supply-chain-system-(covid-19)- catalogue.

On 4 June, a virtual meeting was organized by SEARO on Laboratory Diagnostics Procurement and Supply Chain Systems for COVID-19. WHO-HQ presented key information on WHO’s support to countries in diagnostics related to COVID-19. An overview was provided on the existing automated and manual platforms which are commonly used in countries and the WHO approved kits for detection of COVID-19. To-date, ten products have been approved under the WHO Emergency Use Listing for In vitro diagnostics (IVDs) Detecting SARS-CoV-2 Nucleic Acid. As the global supply of quality- assured diagnostics is limited, an allocation plans necessary to support country access. The operations group of the Diagnostics Consortium for COVID-19 agreed a set of principles for country allocations. Low- and middle-income countries are eligible for procurement through the supply portal. Several vulnerability criteria are considered as a proxy of health system capacity, including the existing SRPP vulnerability index, DALYs, and maternal, adult, or under-5 mortality rates. For the current period (4 weeks) allocation, it was agreed that the maternal mortality rate would be the best proxy and is a robust metric. UNICEF data was used to provide the maternal mortality rate for each country. The task force assesses requests based on the country demand/need through the Essential Supplies Forecasting Tool (ESFT) forecast, status of the outbreak and latest epidemiology by country, vulnerability factor and adjustment proportions, actions already taken such as previous allocations or donations, and other relevant factors.

Communications are ongoing with local producers of personal protective equipment (PPE) to ensure conformity with the WHO requirements. An increase in the production of cloth masks of various fabrics is noted. This is in line with the country’s move towards returning to the “new normal” regarding movement and resuming business in various occupations. Wearing a mask has been made a legal requirement, with severe punishments applicable to individuals not wearing masks in public. The Directorate General of Drug Administration (DGDA) issues no-objection-certificates for PPE products, based on a pre-defined set of testing parameters, developed with support of a technical working group convened by WHO and supported by USAID and JICA.

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WHO Bangladesh COVID-19 Situation Report #15 08 June 2020 6. Risk Communication and Public Awareness

Following the Government’s instructions that all people must wear face masks when are outside their homes, WHO country office worked within a taskforce under Inter Agency Coordination Group together with DGHS, RCCE partners and private sector representatives for creating a set of guidelines for individuals and communities to be able to easily produce their own masks.

Further on the public communication regarding wearing of masks, DGHS and RCCE partners are planning a country wide communication campaign for reinforcing the use of masks as well the appropriate modality to use the protective items.

WHO HQ issued advice for the public on when and how to use masks. The guidance materials include videos and infographics which can be accessed at the following link https://www.who.int/emergencies/diseases/novel-coronavirus- 2019/advice-for-public/when-and-how-to-use-masks.

As stigma against confirmed COVID-19 patients and people showing COVID-19 related symptoms are of growing concern, RCCE partners have further increased the production and dissemination of communication materials for addressing stigma and discrimination.

7. Useful COVID-19 links:

WHO Bangladesh COVID-19 Situation Reports: https://www.who.int/bangladesh/emergencies/coronavirus-disease- (covid-19)-update/coronavirus-disease-(covid-2019)-bangladesh-situation-reports

Latest global WHO Situation Report # 139 as of 07 June 2020: https://www.who.int/docs/default- source/coronaviruse/situation-reports/20200607-covid-19-sitrep-139.pdf?sfvrsn=79dc6d08_2

COVID-19 Situation in the WHO South-East Asia Region: https://www.who.int/southeastasia/outbreaks-and- emergencies/novel-coronavirus-2019

WHO Bangladesh awareness and risk communication materials in Bengali: https://www.who.int/bangladesh/emergencies/coronavirus-disease-(covid-19)-update

COVID-19 related information from the IEDCR: https://www.iedcr.gov.bd/index.php/component/content/article/73- ncov-2019

COVID-19 updates from the Directorate General of Health Services, Ministry of Health and Family Welfare, Government of The People’s Republic of Bangladesh: https://dghs.gov.bd/index.php/en/home/5343-covid-19-update

Contact: Dr Bardan Jung Rana, WHO Representative to Bangladesh, [email protected] Dr Hammam El Sakka, Senior Medical Epidemiologist, Team Leader, WHE, COVID-19 IM, WHO-BAN, [email protected] 15 | P a g e