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The data gives us clear directives on Covid-19 policy

Why are we not following them?
They say that when Rome was burning, its mad emperor Nero stood on its great walls and fiddled while his city was destroyed. While it’s difficult to verify the veracity of an event that is said to have occurred in the year 64, this image comes to mind when we look at Trump and Bolsonara’s (mis)handling of the coronavirus pandemic in their respective countries.
In the early days of the pandemic, there was a phrase that was thrown around a lot—the “flattening of the curve”. Basically, this is a public health strategy to slow down the spread of coronavirus—in a visual representation of the number of people infected within a country, the rate of infection will rise until it reaches a peak, after which, when safety measures such as lockdowns and social distancing start to kick in, it will even out, and eventually, the cases will begin to drop. If you look at the trajectory of the pandemic in the US, you will see a frightening trend where the pandemic looks like it is likely to peak around end April, largely evens out in May and then starts to shoot up in June, reaching record highs in July and August. This clearly demonstrates a failure in US policy. According to a Financial Times report from July 17, “public health experts say the recent surge in virus cases is a direct result of the reopening in April and May of several states where the coronavirus case count was still climbing, albeit from a relatively low base.”
In Brazil, the data is downright weird—a record high of almost 71,000 cases on July 29 is followed by less than 18,000 cases on August 3, with a spike to over 56,000 newly infected the very next day. The data is erratic throughout and there seems to be no letting up of this trend, which points towards flawed reporting. This is backed up by the fact that by April, patients using the public health network in Brazil were only being tested if they were hospitalised with severe symptoms, according to Al Jazeera. A New York Times report detailed the coronavirus data related fiasco in early June, when the Brazilian health ministry came under furious criticism for taking down the website that reported cumulative coronavirus numbers, only to be ordered by the country’s Supreme Court to reinstate the information. The Brazilian case illustrates a unique problem that seems to have risen in the middle of the pandemic—a lack of transparency regarding Covid-19 related data in countries that tend to have weak democracies and inefficient or corrupt institutions. This theory was tested by Al Jazeera in a detailed report, where they used Transparency International’s Corruption Perceptions Index and the Economist Intelligence Unit’s Democracy Index as lenses through which to view the number of reported cases, and found “striking differences in the number of confirmed Covid-19 cases that those nations deemed transparent and democratic reported compared to the numbers reported by nations perceived to be corrupt and authoritarian.”
This in no way means that we can’t place our faith in data; if anything, it tells us we need it more than ever. As can be seen from the examples of Brazil and the US, the data will eventually lead you to the bigger picture when you view it from various angles and attempt to contextually analyse it. In terms of the coronavirus curve in South Asia, it is clear that India is still on its way to reaching its peak—with over 84,000 new infections on September 3, it is now being described as the new epicentre of the global pandemic. In Pakistan, the curve seems to have flattened out, with cases falling from a peak of almost 6,000 new cases per day in mid-June to less than 500 per day in late August. In Bangladesh, there is perhaps reason to be cautiously optimistic, since our curve seems to be heading in the same trajectory, albeit at a slower rate—in mid-June, we saw up to 4,000 infected per day, but are currently getting around 2,000 new cases of coronavirus per day.
However, there is a huge catch here. While in both these nations, testing has increased as the pandemic progressed, Bangladesh is the only country that actually reduced testing when the pandemic was at its peak. This rings a lot of alarm bells with regard to underreporting. If you look at the global data on the rate of testing per million of the population, India ranks 120th in the world, Pakistan is at 150 and Bangladesh stands at 159. In fact, the severity of underreporting was highlighted by the health authorities themselves—in the preliminary findings of a cross-sectional study jointly conducted by IEDCR and icddr,b in the capital between April 18 and July 5, it was found that nearly 20 lakh Dhaka residents could be Covid-19 positive, with roughly 78 percent of them being asymptomatic.
Another factor to take into consideration is the positivity rate, or the percentage of all coronavirus tests performed that are actually positive. While Pakistan also has relatively low rates of testing, its positivity rate is currently at 1.7 percent. In May, the World Health Organization (WHO) recommended that the positivity rate remain below five percent for at least two weeks before governments consider relaxing Covid-19 measures. The positivity rate in Bangladesh has been at an average of 16.7 percent over the last week. In comparison, India, one of the worst affected countries in the world right now, has a positivity rate of 7.7 percent. The only countries in the world that are worse off than Bangladesh in terms of the positivity rate can be counted on one hand (almost)—Mexico, Colombia, Bolivia, Argentina, Paraguay and Iraq.
It doesn’t take a data scientist to understand that this scenario is hugely distressing for Bangladesh. Which is why it beggars belief that the government has gone ahead with its decision to relax Covid-19 measures. According to WHO guidelines, it is very clear what needs to be done when a country has a high positivity rate—increase testing, enforce strict regulations regarding wearing masks, ensure physical distancing and avoid large gatherings, especially in enclosed spaces. While it is encouraging that the number of tests have gone up in Bangladesh in recent days, we are still getting fewer tests done now than we did in June. Without a clear picture of the Covid-19 related data, especially in terms of the extent of the spread of the virus, how can we ever formulate coherent policy during the pandemic, which is clearly far from over for us?
It is true that the youthful population of Bangladesh means that compared to many other countries, our death rates are lower (although we must also factor in underreporting in the case of deaths as well). It is also true that to keep the economy from crashing and to prevent those employed in the informal and other low-wage sectors from being pushed into destitution, it is not possible for a country like Bangladesh to be in perpetual lockdown. But that in no way explains why we would lift all restrictions on public movement and mass gatherings. We have already seen reports on how public transport services are not following government health safety directions. Much like the attempt at localised lockdowns, social distancing rules and the wearing of masks (which is mandatory by name only) are also fizzling out. Yet these measures have been proven to be essential to preventing community transmission of Covid-19.
There is enough evidence from around the world that a premature relaxation of restrictions can only lead to increase in infections that become more difficult to contain. If we don’t let go of this lethargic approach to the pandemic—remember the health minister casually assuring us that coronavirus will leave the country on its own eventually?—it will take us months before we can even come close to flattening the curve. Whatever gains we have made since the pandemic began will be reversed, and all our efforts will have been for nothing. The recent fiascos over fake Covid-19 certificates and rampant corruption in the health sector has already reduced public trust in the authorities. The continued mishandling of the pandemic is a mistake they can ill afford at the moment.
Shuprova Tasneem is a member of the editorial team at The Daily Star.
Her Twitter handle is @shuprovatasneem