Situation Report 16

Situation Report No. #16 15 June 2020 https://www.who.int/bangladesh/emergencies/coronavirus-disease-(covid-19)-update/coronavirus-disease-(covid-2019)-bangladesh-situation-reports

Photo: Social Media Bangladesh

Tested Confirmed Recovered Dead Hotline

519,503 90,619 14,560 1,209 11,310,820

Test/1 million New Cases Recovery Rate CFR% AR/1 million

3,050 3,099 20.6% 1.33% 532.1

Laboratories Gender PPE Stock PoE Screening

60 COVID-19 Labs 70% 30% 1,392,601 344,067

Last Days 106,478 Samples 3,135,420 22,607

63.7% Inside Dhaka Tests 562,439 7,029

17.4% Share of Positive Tests 179,759 345,218 WHO Bangladesh COVID-19 Situation Report #16 15 June 2020

1. Highlights

As of 15 June 2020, according to the Institute of Epidemiology, Disease Control and Research (IEDCR), there are 90,619 confirmed COVID-19 cases in Bangladesh, including1,209 related deaths; Case Fatality Rate (CFR) is 1.33%.

On 12 June 2020, the Ministry of Health and Family Welfare/DGHS introduced “Bangladesh Risk Zone-Based COVID- 19 Containment Implementation Strategy/Guide,” dividing areas in Red, Yellow and Green Zone based on the prevailing risk of the COVID-19 spread.

On 13 June 2020, the Ministry of Religious Affairs, Coordination Branch issued an Emergency Notification circular with the instructions for the worshipers in the Red Zone areas to offer prayers at their respective homes instead of public place of worship.

On 14 June 2020, the Ministry of Foreign Affairs (MoFA) circulated a Note Verbale, which stated that foreign investors and businessmen will be granted on-arrival visas at the port of entry in Bangladesh if he/she has a PCR-based COVID- 19 negative medical certificate (with English translation) and relevant supporting documents for obtaining investment/business visa. The COVID-19 negative medical certificate has to be received within 72 hours of his/her travel to Bangladesh.

On 15 June 2020, the Government issued a Governmental Order extending the period of conditional overall activities and movement restrictions from 16 June 2020 to 30 June 2020. In addition to the earlier enforced regulations, the Order specified that: relevant executive authorities of City Corporation, Municipality, District Commission will divide their “areas of responsibility” into Red, Yellow and Green Zones based on the MOHFW/DGHS guideline on “Bangladesh Risk Zone-Based COVID-I9 Containment Implementation Strategy/Guide” and impose restrictions on movement and business. The authorities will prepare SOPs for adequate COVID-19 testing, medical treatment at the hospitals, quarantine/ isolation and other business operation; public holidays to be declared in the Red and Yellow Zone areas for all public and private offices; and in Green Zone areas, public and private offices will remain open on a limited scale. Pregnant women and people who are sick should refrain from attending offices. Urgent and essential meetings should be arranged through online. Full document: https://iedcr.gov.bd/website/index.php/component/content/article/150- vacancyannouncemnet

2. Coordination

On 11 June 2020, WHO released a rapid advice guide regarding the “Use of chest imaging in COVID-19”. This rapid advice guide examines the evidence and makes recommendations for the use of chest imaging in acute care of adult patients with suspected, probable or confirmed COVID-19. Imaging modalities considered are radiography, computed tomography and ultrasound. This guide addresses the care pathway from presentation of the patient to a health facility to patient discharge. It considers different levels of disease severity, from asymptomatic individuals to critically ill patients. Accounting for variations in the benefits and harms of chest imaging in different situations, remarks are provided to describe the circumstances under which each recommendation would benefit patients. The guide also includes implementation considerations for different settings, provides suggestions for impact monitoring and evaluation and identifies knowledge gaps meriting further research. Full document: https://www.who.int/publications/i/item/use-of-chest-imaging-in-covid-19.

WHO issued a note “Asks’ to the private sector in the response to COVID-19”, outlining areas where the private sector has a critical role to play locally, nationally and globally. The private sector is requested to help protect their stakeholders and business by providing information, protecting jobs and livelihoods, and acting responsibly. Private sector is also encouraged to engage/participate in COVID-19 response through making essential supplies and services available and repurposing production facilities for essential supplies, where feasible. The financial support is invited through the WHO COVID-19 Solidarity Response Fund and support to NGOs and community needs in coordination with local authorities. Full document: https://www.who.int/publications/m/item/asks-to-the-private-sectorin-the-response-to-covid-19.

2 | P a g e WHO Bangladesh COVID-19 Situation Report #16 15 June 2020 3. Surveillance and Laboratory

Between 9 March and 15 June 2020, according to the Institute of Epidemiology, Disease Control and Research (IEDCR) there were nighty-thousand-six-hundred-nineteen (90,619) COVID-191 confirmed by rt-PCR, including one-thousand two-hundred-nine (1,209) related death cases (CFR 1.33%).

The figures below are showing the daily and weekly distribution of reported confirmed COVID-19 cases, deaths and daily cumulative number of COVID-19 testing, 09 March – 15 June 2020, Bangladesh.

4,000 90 # Cases # Deaths Poly. (# Cases) Poly. (# Deaths) 75 3,000 60 2,000 45 1,000

30 Number of Cases Cases (N=90,619) Number of 0 15 09/03 16/03 23/03 30/03 06/04 13/04 20/04 27/04 04/05 11/05 18/05 25/05 01/06 08/06 15/06 0 -1,000 15 -2,000 30 -3,000 45

-4,000 60 (n=1,209) Deaths Number of

25,000 300 # Cases # Deaths 3 per. Mov. Avg. ( # Cases ) 250 20,000

200 15,000

150

10,000

Weekly Cases Weekly Weekly Deaths Weekly 100

5,000 50

0 0 w10 w11 w12 w13 w14 w15 w16 w17 w18 w19 w20 w21 w22 w23 w24

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.

3 | P a g e WHO Bangladesh COVID-19 Situation Report #16 15 June 2020

100,000 550,000 Total Cases Total Tests Poly. ( Total Cases ) 500,000

80,000 450,000 400,000 350,000 60,000 300,000 250,000 40,000 200,000 150,000 20,000

100,000 (N=519,503) ofNumner tets Total 50,000

0 0

17/03 26/03 29/03 07/04 19/04 28/04 01/05 10/05 22/05 31/05 03/06 12/06 08/03 11/03 14/03 20/03 23/03 01/04 04/04 10/04 13/04 16/04 22/04 25/04 04/05 07/05 13/05 16/05 19/05 25/05 28/05 06/06 09/06 15/06

Age and gender data are currently available for only 24% (21,423/90,619) reported confirmed COVID-19 cases: 26.5% (5.669/21,423) cases were confirmed in people between 31 and 40 years old, 26.3% (5,641) in the age group of 21 to 30 years, 17.7% (3,787) in the age group of 41 to 50 years and 11.9% (2,544) in the age group between 51 and 60 years old. As on 08 June 2020, data was available for 58.9% (712/1,209) of COVID-19 related-death.

The highest CFR 31.6% (225/712) was reported in the age group of 61 to 70 years old, 25% (178) in the age group between 51 and 60 years and 19.1% (136) in the older age group 71 and above.

Male represented 70% and 79% 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=21,423) and Deaths (N=712), 15 June 2020, Bangladesh.

Cases Deaths Male Female

> 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 70% 1.7% 1.3% 30% 79% 0.0% 0.6% 21% 0 - 10 4,500 3,500 2,500 1,500 5000 500 1,500 2,500 3,500 4,500 200 150 100 50 0 50 100 150 200

4 | P a g e

WHO Bangladesh COVID-19 Situation Report #16 15 June 2020

As of 08 June 2020, geographical distribution of confirmed reported COVID-19 cases was available on 57% of cases (51,271/90,619); of which 67% (34,341) were from Dhaka division, 18.0% (9,234) from Chattogram division, 3.3% (1,686) from Mymensingh division, 2.9% (1,471) from Khulna division, 2.8% (1,413) from Sylhet division, 2.6% (1,335) from Rangpur division, 2.2% (1,122) from Rajshahi division, and 1.3% (669) from Barisal division.

The figure below is showing the daily distribution of reported confirmed COVID-19 cases (N=51,217) per division, 15 April – 14 June 2020, Bangladesh.

2,500 Dhaka Chattogram Mymensingh Ranjpur Sylhet Rajshahi Khulna Barishal

2,000

1,500

1,000 Number Cases Number of

500

17/04 23/04 29/04 05/05 09/05 15/05 21/05 27/05 02/06 06/06 12/06 15/04 19/04 21/04 25/04 27/04 01/05 03/05 07/05 11/05 13/05 17/05 19/05 23/05 25/05 29/05 31/05 04/06 08/06 10/06 14/06

The case doubling time can be used to conclude how fast COVID-19 infection has been spreading in the country. Available data allows us to see how quickly the number of confirmed cases increased in different divisions in Bangladesh.

As of 15 June 2020, the case doubling time is 6 days in Dhaka and Chattogram, Khulna, Sylhet divisions and Rajshahi division 7 days, Rangpur and Mymensingh divisions 8 days and 10 days for Barisal division.

The figure below is showing the case-doubling time of COVID-19 confirmed cases in all divisions starting from the day they reported 10 confirmed cases, 15 June 2020, Bangladesh.

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

D15 Number Cases Number of 100 D20

D40

10 0 10 20 30 40 50 60 Days since 10th Confirm Case

5 | P a g e

WHO Bangladesh COVID-19 Situation Report #16 15 June 2020 The case doubling time is 6 days in Dhaka, Narayanganj and Dhaka districts 7 days, Munshiganj, Gazipur and Faridpur districts 8, and 10 days for Gopalganj district.

The figure below is showing the growth of COVID-19 confirmed cases in all districts of Dhaka division starting from the day they reported 10 confirmed cases, 15 June 2020, Bangladesh.

D1 D2 D3 D4 D5 D6 10,000 DHK_district DHK_city Faridpur D7 Gazipur Gopalganj Munshiganj D8 Narayanganj D9 1,000 D10 D12

D15 Number Cases Number of 100 D20

D40

10 0 10 20 30 40 50 60 Days since 10th Confirm Case

In Chattogram division till 15 June 2020, the case doubling time is high in Feni and Noakhali districts at 5 days, Cox’s Bazar district 6 days, Chattogram district 7 days, Cumilla district 8 days, Chandpur district 10 days and 15 days for Laxmipur district.

The figure below is showing the growth of COVID-19 confirmed cases in all districts of Chattogram division starting from the day they reported 10 confirmed cases, 15 June 2020, Bangladesh.

D1 D2 D3 D4 D5 D6 10,000 Chandpur Chattogram Cox's Bazar D7 Cumilla Feni Lakshmipur D8 Noakhali D9 1,000 D10 D12

D15 Number Cases Number of 100 D20

D40

10 0 10 20 30 40 50 60 Days since 10th Confirm Case

6 | P a g e

WHO Bangladesh COVID-19 Situation Report #16 15 June 2020 The figures below are showing the daily distribution of reported confirmed COVID-19 cases (N=51,217) and rolling three-days average per division, 13 April – 14 June 2020, Bangladesh.

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

1,000

500

13/04 23/04 03/05 13/05 15/05 23/05 25/05 02/06 04/06 14/06 15/04 17/04 19/04 21/04 25/04 27/04 29/04 01/05 05/05 07/05 09/05 11/05 17/05 19/05 21/05 27/05 29/05 31/05 06/06 08/06 10/06 12/06

600 Chattogram 3 per. Mov. Avg. (Chattogram) 500

400

300

200

100

13/04 17/04 21/04 25/04 29/04 03/05 07/05 11/05 15/05 19/05 23/05 27/05 31/05 04/06 08/06 12/06 15/04 19/04 23/04 27/04 01/05 05/05 09/05 13/05 17/05 21/05 25/05 29/05 02/06 06/06 10/06 14/06

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

120

27/04 29/04 01/05 19/05 21/05 23/05 10/06 12/06 14/06 13/04 15/04 17/04 19/04 21/04 23/04 25/04 03/05 05/05 07/05 09/05 11/05 13/05 15/05 17/05 25/05 27/05 29/05 31/05 02/06 04/06 06/06 08/06

150 Barishal 3 per. Mov. Avg. (Barishal) 125

100

15/04 17/04 27/04 29/04 09/05 11/05 23/05 25/05 04/06 06/06 13/04 19/04 21/04 23/04 25/04 01/05 03/05 05/05 07/05 13/05 15/05 17/05 19/05 21/05 27/05 29/05 31/05 02/06 08/06 10/06 12/06 14/06

7 | P a g e

WHO Bangladesh COVID-19 Situation Report #16 15 June 2020

180 Sylhet 3 per. Mov. Avg. (Sylhet) 150

120

07/05 09/05 11/05 13/05 15/05 17/05 19/05 21/05 23/05 25/05 13/04 15/04 17/04 19/04 21/04 23/04 25/04 27/04 29/04 01/05 03/05 05/05 27/05 29/05 31/05 02/06 04/06 06/06 08/06 10/06 12/06 14/06

150 Mymensingh 3 per. Mov. Avg. (Mymensingh) 120

17/04 25/04 27/04 05/05 07/05 15/05 23/05 25/05 02/06 04/06 12/06 13/04 15/04 19/04 21/04 23/04 29/04 01/05 03/05 09/05 11/05 13/05 17/05 19/05 21/05 27/05 29/05 31/05 06/06 08/06 10/06 14/06

100 Ranjpur 3 per. Mov. Avg. (Ranjpur)

23/04 25/04 27/04 29/04 01/05 23/05 25/05 27/05 29/05 31/05 13/04 15/04 17/04 19/04 21/04 03/05 05/05 07/05 09/05 11/05 13/05 15/05 17/05 19/05 21/05 02/06 04/06 06/06 08/06 10/06 12/06 14/06

Khulna 3 per. Mov. Avg. (Khulna) 100

13/04 15/04 17/04 19/04 21/04 23/04 25/04 27/04 29/04 01/05 03/05 05/05 07/05 09/05 11/05 13/05 15/05 17/05 19/05 21/05 23/05 25/05 27/05 29/05 31/05 02/06 04/06 06/06 08/06 10/06 12/06 14/06

8 | P a g e

WHO Bangladesh COVID-19 Situation Report #16 15 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 15 June, Bangladesh attack rate (AR) is 532.1 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 51,271 cases, the highest AR continues to be observed in the Dhaka division (797.2/1,000,000). Within the Dhaka division, Dhaka city has the highest AR (2,859.6/1,000,000), followed by Munshiganj (876.4/1,000,000), Narayanganj district (852.0.4/1,000,000), Dhaka district (341.3/1,000,000), Gazipur (315.3/1,000,000), Faridpur (307.3/1,000000), Gopalganj (280.8/1,000,000), Madaripur (155.1/1,000,000), Shariatpur (163.2/1,000,000), Kishoreganj (155.1/1000,000), Rajbari (113.6/1,000,000), Manikganj (102.6/1,000,000), Narshingdi (83.3/1,000,000) and the lowest AR 12.9/1,000,000 was reported from Tangail district.

The second highest COVID-19 Attack Rate is reported from Chattogram division of (274.8/1,000,000). Within the division, Cox’s Bazar reported the highest AR (494.9/1,000,000) followed by Chattogram district (408.7/1,000,000), Feni (293.0/1,000,000), Noakhali district (279.5/1,000,000), Cumilla district (264.5/1,000,000), Bandarban district (159.0/1000,000), Chandpur district (129.2/1,000,000), Rangamati district (122.0/1,000,000), Khagrachhari district (115.7/1,000,000), Brahmanbaria district (73.2/1,000,000) and Lakshmipur district (71.4/1,000,000).

The 3rd highest AR in the country was reported from Mymensingh division (129.7/1,000,000). Within the Mymensingh division, Mymensingh district has the highest AR (141.5/1,000,000) followed by Jamalpur district (133.5/1,000,000), Netrokona district (114.6/1,000,000) and Sherpur district (104.0/1,000,000).

Sylhet division reported overall AR (120.6/1000,000) with the highest AR in Sylhet district (166.5/1000,000) followed by Sunamganj district (151.8/1,000,000), Habiganj district (72.1/1,000,000) and Maulvibazar district (51.1/1,000,000).

Rangpur division reported overall AR of (71.5/1,000,000) with the highest AR in Rangpur district at (187.6/1,000,000) followed by Nilphamari district (63.6/1,000,000), Dinajpur (52.0/1,000,000), and Thakurgaon district (45.0/1,000,000).

In Khulna division reported overall AR (79.3/1,000,00) but with high AR for Khulna district (148.11,000,000) followed by Kushtia district (107.7/1,000,000), Chuadanga district (101.9/1,000,000) and Jashore (77.4/1,000,000).

In Barishal division although the overall AR is low at AR 68.0/1,000,000 with the highest AR in by Barguna district (82.4/1,000,000) followed Barisha (81.5/1,000,000). Rajshahi division has overall AR (51.3/1,000,000) with the highest AR in Joypurhat district (169.4/1,000,000), Naogaon district (69.3/1,000,000), and Bogura district (66.9/1,000,000).

The following figure is showing the attack rate per 1,000,000 population of reported confirmed COVID-19 cases in selected divisions, 13 April - 14 June 2020, Bangladesh.

300 CTG RNP KLN MYM BSL SYT 250

200

150

100 Attack Rate/1,000,000 Attack

17/04 23/04 29/04 03/05 09/05 15/05 21/05 27/05 02/06 06/06 12/06 15/04 19/04 21/04 25/04 27/04 01/05 05/05 07/05 11/05 13/05 17/05 19/05 23/05 25/05 29/05 31/05 04/06 08/06 10/06 14/06 13/04

9 | P a g e

WHO Bangladesh COVID-19 Situation Report #16 15 June 2020 Out of the total 90,619 conformed COVID-19 registered as of 15 June 2020, 20.6% (18,730/90,619) of the cases recovered, 78.0% are active cases and 1.3% - died.

The figure below is showing the outcomes of reported confirmed COVID-19 cases outcome per epidemiological week, 08 March – 15 June 2020, Bangladesh.

100000 Weekly Recovery Weekly Active # Deaths Log. (Weekly Recovery) Log. ( Weekly Active ) Log. (# Deaths)

10000

1000 283

100 238

170

152

100

51 32

10 25

3 2 1 w10 w11 w12 w13 w14 w15 w16 w17 w18 w19 w20 w21 w22 w23 w24

As of 08 June 2020, there were 19,939 (22.0%) COVID-19 cases with known outcome (closed cases), and out of all closed cases 93.9 (18,730/19,939) were cured and 6.1% (1,209) died. The death rate on closed cases in Bangladesh is lower than the 10.0% (436,218/4,581,165) global average as of 15 June 2020.

The figure below is showing the death and recovery rates over cumulative closed confirmed COVID-19 cases, 11 March – 15 June 2020, Bangladesh.

Death% Recovery% 100%

80%

60%

40%

20% Number of Closed Cases Cases Closed (N=19,939) Number of

14/03 20/03 04/04 10/04 16/04 01/05 07/05 13/05 28/05 03/06 09/06 11/03 17/03 23/03 26/03 29/03 01/04 07/04 13/04 19/04 22/04 25/04 28/04 04/05 10/05 16/05 19/05 22/05 25/05 31/05 06/06 12/06 15/06

The highest recovery rate is observed in Barishal division with 61% (369/607) of all recoveries, followed by Rangpur division with 59% (747/1275), Rajshahi division - 43% (475/1103), Mymensingh division - 42% (680/1633), Dhaka division - 39% (12,935/32952), Sylhet division - 34% (451/1336) and Khulna division- 31% (385/1261). The lowest recovery rate of 19 % is found in Chattogram division (1,363/7,202).

10 | P a g e

WHO Bangladesh COVID-19 Situation Report #16 15 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 June 2020, the GF has been within the range of 0.8 – 1.2, and on 15 June 2020, the GF is 0.8.

The figure below is showing the Growth Factor of daily confirmed COVID-19 cases, 08 March – 15 June 2020, Bangladesh.

3.0

2.5 Growth Factor 2 2.0

1.5

Growth Factor 1 Growth Growth Factor 1.0

0.5

0.0

20/03 26/03 01/04 07/04 28/04 04/05 10/05 16/05 31/05 06/06 12/06 08/03 11/03 14/03 17/03 23/03 29/03 04/04 10/04 13/04 16/04 19/04 22/04 25/04 01/05 07/05 13/05 19/05 22/05 25/05 28/05 03/06 09/06 15/06

As of 15 June 2020, the case doubling time in Bangladesh remains five (7.2) days (3/4 day more than the previous update on 08 June 2020). 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, 15 June 2020.

D1 D2 D3 D4 D5 D6 D7 100000 India Indonesia D9 Malaysia Sri Lanka D8 Thailand Bangladesh 10000 D10 D12

D15 Number Cases Number of D20 1000

D40

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

11 | P a g e

WHO Bangladesh COVID-19 Situation Report #16 15 June 2020

As of 15 June 2020, according to IEDCR, a total of 519,503 COVID-19 tests with the overall positivity rate of 17.4% were conducted in Bangladesh by 60 laboratories (30 laboratories in Dhaka and 30 laboratories in other divisions of the country). The latest laboratories, which have started the testing: in Dhaka - Dr. Lal Path Labs Bangladesh Limited, Aichi Hospital Ltd., Uttara and Shaheed Tajuddin Ahmad Medical College, Gazipur, Chattogram University, and Imperial Hospital Limited, Chattogram - outside Dhaka. 63.7% of all tested sample were tested by laboratories in the Dhaka division, and 36.3% - outside Dhaka.

The graph below is showing the weekly cumulative number of COVID-19 testing and positivity rate, 08 March – 15 June 2020, Bangladesh.

519.5 Thousand 500 T As of 15 June 2020 89,057

400 T 106,478 65,347

300 T 68,175

52,821 200 T 41,123 08 March 2020 34,845 First Bangladesh case reported 100 T 22,764 Tests N = 519,503 6,577 14,172 786 1,774 234 368 Positive N = 90,619 0 T 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Epi Week COVID-19 testing coverage has been gradually increasing in Bangladesh, reaching now 3,050/1,000,000 but is still lower than in Maldives (53,586/1,000,000), Malaysia (20,287/1,000,000), Nepal (12,299/1,000,000), Thailand (6,708/1,000,000), Sri Lanka (4,015/1,000,000) and India (4,186/1,000,000).

The graph below is showing the daily cumulative number of COVID-19 testing per 1,000,000 population, 08 March – 15 June 2020, Bangladesh.

18000 3500

# Test Tests/1,000,000 Population 3000 15000

2500 12000

2000 9000 1500

6000

1000 Number of Tests Tests (N=519,503) Number of 3000 500

0 0

20-03 29-03 04-04 13-04 19-04 28-04 04-05 13-05 19-05 28-05 12-06 08-03 11-03 14-03 17-03 23-03 26-03 01-04 07-04 10-04 16-04 22-04 25-04 01-05 07-05 10-05 16-05 22-05 25-05 31-05 03-06 06-06 09-06 15-06

12 | P a g e

WHO Bangladesh COVID-19 Situation Report #16 15 June 2020

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

According to the DGHS, as of 15 June 2020, the current institutional quarantine capacity in the country is represented by 629 centres across 64 districts, which can receive 31,991 persons. A total of 16,964 individuals were placed in quarantine facilities and of them 13,210 (78%) have been already released. By 15 June 2020, in total 15,844 individuals were isolated in designated health facilitates all over the country, of them 37% (5,818/15,844) have been released, and 10,026 (63%) 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 3,763. Between 17 March to 15 June 2020, total 323,358 individuals were placed under home quarantine all the over the county and to date 81% (261,689/323,358) have been already released. Remaining 19% (60,669 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 – 15 June 2020, Bangladesh.

400,000 Presently in Home Quarantine Total Home Quarantined 350,000

300,000

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

56,295 56,295

55,601 55,601

57,906

57,237

56,610

55,549

55,465

54,616

54,254

53,635

53,180

52,391

48,883 48,883

52,071

51,645

51,243

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

32,159 32,159

30,173 30,173 26,290 26,290

50,000 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

23/03 01/04 10/04 19/04 28/04 07/05 16/05 25/05 03/06 12/06 17/03 20/03 26/03 29/03 04/04 07/04 13/04 16/04 22/04 25/04 01/05 04/05 10/05 13/05 19/05 22/05 28/05 31/05 06/06 09/06 15/06

20,000 Presently in Facility Quarantine Total Facility Quarantined

16,000

12,000

8,000

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

4,926 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

3,763

3,684

3,680

3,677

3,671

3,666

3,625

3,598

3,574

3,548

3,263 3,263

3,488 3,458

4,000 3,450

2,121 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

23/03 01/04 10/04 19/04 28/04 07/05 16/05 25/05 03/06 12/06 17/03 20/03 26/03 29/03 04/04 07/04 13/04 16/04 22/04 25/04 01/05 04/05 10/05 13/05 19/05 22/05 28/05 31/05 06/06 09/06 15/06

13 | P a g e

WHO Bangladesh COVID-19 Situation Report #16 15 June 2020

5. Case Management and infection Control

On 12 June, WHO-HQ convened a global technical advisory group (TAG) meeting on specifications on personal protective equipment (PPE). The TAG PPE group includes three subgroups providing independent technical advice to WHO on specifications of PPE, local production and country allocations. For the first subgroup meeting on technical specifications, the relevant testing parameters were agreed for medical masks and respirators. The TAG is considering the inclusion of Chinese standards to facilitate market access of compliant products given the global shortages and delay time in conducting tests at laboratories approved for testing according to European and/or US standards.

On 15 June 2020, a meeting was held in DGHS to review the Bangladesh Preparedness and Response Plan (BPRP) document submitted to MOHFW. The main recommendations were: revise the POE and Surveillance chapter; and the new zoning system.

The number of items approved under the WHO Emergency Use Listing (EUL) for SARS-CoV-2 in vitro diagnostic products remains at 10 items. Four products are listed as “not approved” and 33 are under review. Regarding rapid diagnostic tests for SARS-CoV-2 virus antibody, WHO received six expressions of interest and thus far none have been approved.

6. Risk Communication and Public Awareness

WHO together with RCCE group are supporting DGHS for designing and implementing communication activities to further emphasize the importance of masks wearing for increasing community protection against COVID, correct use of masks and simple steps for producing the items at home or at community level. A taskforce created under Inter-Agency Coordination Group and consisted of UN partners, NGO’s and Private sectors developed a Standard Operating Procedure on how to make masks at home in order empower individuals and communities to affordably produce the protection items.

Working for better communicate on protection measure, RCCE partners are also further developing communication materials addressed to stigma and discrimination, important factors with potential of changing health seeking habits among communities by hiding symptoms and not following proper health advices. WHO has been producing risk communication materials on stigma and discrimination also for addressing increasing incidence of the issues in communities especially towards frontline responders, including health workers.

Furthermore, RCCE partners have intensified activities for addressing rumors, misinformation and disinformation, working with fact-checking and social media platforms for containing and eliminating the information that has the potential of being dangerous to population. In line with this, WHO Bangladesh and WHO South East Asia Regional Office are also working with BOOM Bangladesh for providing technical accurate health information to address rumors and misinformation.

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

EPI-WIN: WHO information network for epidemics: https://www.who.int/teams/risk-communication

Latest global WHO Situation Report # 146 as of 14 June 2020: https://www.who.int/docs/default- source/coronaviruse/situation-reports/20200614-covid-19-sitrep-146.pdf?sfvrsn=5b89bdad_6

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 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, Team14 | P aLeader, g e WHE, COVID-19 IM, WHO-BAN, [email protected]