As tests pile up, infections spread, patients suffer

Babul Dewan, 65, had suffered from a sore throat, fever and breathing problems for a week before he and his two family members could provide samples for Covid-19 tests at a kiosk set up at Shaheed Ahsan Ullah Master School at Tongi on May 31.

Now, 15 days after the collection of their samples, they are yet to receive the test results even though Babul's son Al Amin Dewan has already contacted Brac, Institute of Epidemiology Disease Control and Research (IEDCR) and the health directorate several times.

His wife and two daughters are also suffering from fever and respiratory problems. But as precious time ticks by, this delay in getting the test reports is also holding up their treatment. 

The situation in remote areas is also similar if not worse. After suspecting coronavirus symptoms, Dr Easfinaul Hoque, a medical practitioner at a private hospital in Cox's Bazar, went to Cox's Bazar Medical College Hospital to get tested for Covid-19 on May 27. 

It took 19 days for him to get an SMS from the health directorate that he was negative. The SMS showed that his sample was received on June 6. 

Dr Easfinaul's family members questioned the authenticity of the report as his sample was taken on May 27, but the report showed June 6 as the collection date.

Thus, many suspected Covid-19 patients are having to wait for too long for the treatment which cannot be started without the test reports.

On June 3, Iliach Hossain, resident at Pirgacha in Rangpur, died with Covid-19 symptoms. Samples were collected from his body for testing the same day but the report came eight days later on June 11 that said he had been infected with coronavirus.

In the meantime, Iliach's wife moved to her father's home in Nilphamari. Her relatives came in contact with her. Now, all are in quarantine after the positive test report.

Health experts say the main objective of coronavirus testing is to isolate coronavirus patients and limit transmission. But because of a delay in test results, the infected are going about freely contributing to an ever increasing number of infections.

Dr Jahidur Rahman, assistant Professor, Department of Virology at Shaheed Suhrawardy Medical College and Hospital, told The Business Standard that the ramping up of coronavirus tests is of no benefit as the infected are not being separated quickly with delivery of test results taking too much time, resulting in suffering of the patients and a waste of the government's money.

Dr Jahidur Rahman said the virus survives three days if it is kept in a virus transport medium at a temperature of 4-6 degrees Celsius after its collection. The test must be done on it within the days to get accurate results.

Professor Nazrul Islam, a virologist and former vice-chancellor of Bangabandhu Sheikh Mujib Medical University, told The Business Standard that the test report could go wrong if the cold chain is not maintained properly after taking samples.

It is fair to question the accuracy of a report if someone receives it 10-15 days after submitting samples, he added.

Backlog of samples keeps rising at labs

On average, 1,200-1,500 samples are being collected every day in Chattogram. However, 700 to 800 of them are being tested.

The district is struggling with a large number of samples due to a lack of capacity at the labs. To remove the backlog about 4,000 samples had to be sent to Dhaka for testing on June 10.

Dr Shakil Ahmed, chief of the Bangladesh Institute of Tropical and Infectious Diseases lab, said, "We get 600 samples every day. But we can test 250 to 300. In the last four days, the backlog reached around 1,000."

The PCR machine at the Department of Microbiology in Khulna Medical College has a maximum capacity to perform 192 tests in one day. But they are receiving 300 samples on an average per day. With samples piling up, it takes five to seven days to deliver test reports to patients.

Manpower crisis main reason for delay in the delivery of test results

The coronavirus testing labs lack necessary equipment and skilled and adequate medical technologists. There is also a lack of virologists.

Professor Nazrul Islam, a member of the government's National Advisory Committee on coronavirus, told The Business Standard that coronavirus tests are now being performed in 59 labs. But most of the labs are working with one or two technologists. Manpower crisis is evident everywhere, from sample collection to testing.

Now, the collection of samples has gone up to a great extent as the rate of infection increases. The inadequate workforce is now overworked, working for three months at a stretch. So, there are delays in performing the tests and delivering reports. Errors are also showing up in the test reports due to work pressure, he added.

Only three technologists and six volunteers are now working at the lab of Kushtia General Hospital.

Dr Nazmin Rahman, in-charge of Kushtia PCR Lab, said, "With the human resources we have, it is possible to test 150-200 samples a day. But we have been receiving 300-350 for the last seven-eight days. That is why there has been a backlog of test results."

When asked about the overall situation, Prof Nasima Sultana, additional director general (administration) of the health directorate, told The Business Standard, "Backlogs of samples have been created at labs as sample collection has gone up significantly. So, report delivery is getting late. I am working to solve those problems."