The number of labs testing samples for Covid-19 has increased from one to 257 in the last 13 months after the first novel coronavirus patient was identified in the country, but a shortage of lab technicians is behind the still low number of tests done in Bangladesh.
Experts say the spread of infection cannot be contained unless tests are increased significantly.
With the shortage of lab personnel at testing facilities, people's sufferings to submit samples for the Covid-19 test and get the test results still continue.
Experts believe that the test rate cannot be increased due to the crisis of lab personnel and a lack of proper management to motivate the people working in the laboratory. They urged the authority to do more tests to take advantage of the lockdown to curb infection, but this cannot be done without increasing lab technologists and technicians.
Currently, 121 labs run RT-PCR tests, 34 centres run tests using the GeneXpert System, and 102 labs run antigen tests. However, more than 30 of these labs do not run Covid-19 test every day.
The Directorate General of Health Services (DGHS) said 4,417 Covid-19 patients were identified by testing 18,906 samples during the 24 hours till Friday 8am, which was the lowest number of daily tests in the last 27 days.
Dr Jahidur Rahman, assistant professor at the Virology Department of Shaheed Suhrawardy Medical College and Hospital, told TBS, "The RT-PCR labs are now testing at their maximum capacity. The number of tests will not increase but decrease due to the technologist crisis and management crisis."
"Those who have been working in the RT-PCR lab for more than a year are not getting any kind of incentive, transport facility or even one meal per day. The manpower is not sufficient. Some people have to do a lot of work, so everyone is tired. In order to increase the tests, more lab technologists have to be hired. The lab workers have to be provided with transportation or incentives," Dr Rahman continued.
"The South African variant of the novel coronavirus is highly contagious. Recently we have been observing that 3-4 members of a family test Covid-19 positive one day after a person in the family catches the virus. So, the infected persons have to be isolated by doing more and more tests. Now people need to be motivated to do antigen tests, which can provide the report in a short time," he added.
There are no RT-PCR labs in 34 districts of the country. Of the 121 RT-PCR labs in the country, 69 are private and 52 are government labs.
Dr Mohammad Mushtuq Husain, adviser to the Institute of Epidemiology, Disease Control and Research (IEDCR), told The Business Standard that the patients' suffering will be reduced if antigen tests are introduced in all hospitals in Dhaka.
The technologist crisis is not over yet
There are eight technologists in the Covid-19 lab of the Suhrawardy Hospital. They have been working continuously for the last 13 months.
A lab technologist at the Suhrawardy Hospital, requesting anonymity, said they have to work in the lab in addition to performing their duties in the Virology Department at the hospital. Besides, the Covid-19 lab personnel are supposed to stay in quarantine for seven days after working in the lab for the same period, but they cannot do that due to a shortage of workers.
He said, "We do not even get weekly holidays due to increased work pressure. In order to increase the test, it is necessary to increase the number of machines as well as the number of skilled technologists."
In June last year, Prime Minister Sheikh Hasina directed the authorities concerned to recruit 1,200 medical technologists and 1,800 medical technicians for Covid-19 testing on an emergency basis. The appointment process has not been completed yet, although 10 months have passed since the prime minister gave the directive.
On 29 June last year, the DGHS issued recruitment notices for 889 posts of medical technologists and 1,800 posts of medical technicians. About 74,000 job seekers took the written test on 12, 18 and 19 December last year. The viva exam of the medical technologists was held on 22 February and the medical technicians on 10 March this year, but the candidates have not been selected and been appointed yet.
Selim Mollah, former general secretary of the Bangladesh Medical Technologist Association, told TBS there are not enough technologists at the government level to cope with the increased pressure of tests amid the second wave of Covid-19.
"The government has already recruited about 6,000 nurses and 2,000 doctors to treat Covid-19 patients, while 2,000 more doctors are in the process of being recruited. But it is disappointing not to hire the medical technologists despite the prime minister's instructions," said Selim.
He said the medical technologists who attended the written and viva exams should be recruited immediately to increase the Covid-19 tests. He also called for the recruitment of 25,000 unemployed medical technologists in government jobs by an executive order.
Bangladesh lags far behind in Covid-19 testing
According to statistics website Worldometers, Afghanistan is the only South Asian country to do fewer Covid-19 tests than Bangladesh.
Maldives and Bhutan are the countries which conduct the highest number of tests in this region.
In Afghanistan, one out of every 105 people gets tested for Covid-19.
Meanwhile, one out of every 32 people in Bangladesh is tested for the deadly virus.
In India, one in five people is tested for Covid-19, while in Sri Lanka, one out of every nine people is tested.
Increase in testing samples increases new Covid-19 cases
The number of new Covid-19 patients increases when the number of tests increases in the country, and the number of new cases drops when less samples are tested.
On 7 April this year, 34,630 samples were tested and 7,626 new patients were identified, the highest ever in the country.
If the number of tests is more than 30,000, the number of daily cases crosses 7,000. Once the tests decrease, the number of patients decreases too. Experts said the exact number of Covid-19 patients in the country is not available due to a lack of tests.
For the first time in the country, more than 20,000 Covid-19 tests were done on 16 March this year, and more than 30,000 samples were tested in one day on 4 April.
The rate of tests has decreased amid lockdown
The number of tests has decreased due to traffic problems during the lockdown. Also many people have left Dhaka, where a large number of tests are done.
The country reported 24,825 Covid-19 tests on Wednesday, which came down to 19,959 on Thursday, and further dropped to 18,906 on Friday.
Dr Jahidur Rahman thinks that the pressure of the tests will increase when everyone returns from outside Dhaka after the lockdown.
What the DGHS said
Professor Dr ABM Khurshid Alam, director general of the DGHS, told TBS that the country has the capacity to test 50,000 samples for Covid-19 per day.
He said, "The scope of the tests has increased and we also have the ability to test. We have no kit crisis. Antigen tests are also being done in Dhaka hospitals. We cannot do anything if people do not come for testing. Those who have symptoms are being tested. We will actually test those who need to be tested."
Commenting on not appointing medical technologists, he said, "There were reports in the newspapers about corruption in the recruitment exams. So we have to investigate that. It would have been very beneficial to employ 3,000 technologists amid this pandemic. But since the allegation has been raised, it has to be investigated. That is why the appointment is being delayed."