COVID-19 and Bangladesh: Challenges and How to Address Them

Impact of Lockdown Measures and Meteorological Parameters on the COVID-19 Incidence and Mortality Rate in Bangladesh

The coronavirus disease 2019 (COVID-19) pandemic has become a public health crisis and a global catastrophe for human societies. In the absence of a vaccine, non-pharmaceutical interventions have been implemented across the world to reduce COVID-19 transmission. Recently, several studies have articulated the influence of meteorological parameters on COVID-19 infections in several countries. The purpose of this study was to investigate the effect of lockdown measures and meteorological parameters on COVID-19 daily confirmed cases and deaths in Bangladesh. Different parameters, such as case fatality rate, recovery rate, number of polymerase chain reaction tests, and percentages of confirmed cases were calculated for data covering March to September 2020. The meteorological data include daily average temperature, humidity, and wind speed, and their effects on COVID-19 data were analyzed after 0, 3, 7, and 14 days. A linear regression analysis revealed that all the studied meteorological parameters were positively correlated with the daily new cases and deaths in Bangladesh, while the highest correlations were observed for the 14 days incubation period. These results provide useful implications for the healthcare authorities to contain the pandemic in Bangladesh and beyond.

Immediate psychological responses during the initial period of the COVID-19 pandemic among Bangladeshi medical students

BACKGROUND

The most recent global pandemic of COVID-19 has been creating multidimensional damages, including a detrimental impact on the mental health status of individuals. Medical students, a vulnerable cross-section of the population, may have perceived a myriad of psychological stressors during this crisis in the background of their prevailing stressful academic pressure and preexisting higher psychological and mental health issue.

OBJECTIVE

To determine the prevalence of anxiety and depressive symptoms and to elucidate the psychological impact of COVID-19 pandemic on Bangladeshi medical students.

METHOD

A cross-sectional study design was utilized to conduct this survey. The online survey including demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS; higher scores on the subscales indicate higher levels of depressive and anxiety symptoms), was completed by 425 Bangladeshi medical students. Collected data were statistically analyzed by using SPSS (version 25.0) software.

RESULT

The HADS anxiety subscale revealed that 65.9% of the medical students had different levels of anxiety, ranging from mild (27.3%), moderate (26.8%), and severe (11.8%). As per HADS depression subscale, 49.9% of the medical students had varying degrees of depressive symptoms, with 3.3% of the participants had suffered from severe depressive symptoms. Female students had a relatively more anxiety and depressive symptoms when compared with males. The students, who were severely tensed of getting infected by the virus, were at higher risk of suffering from anxiety (3.5-fold) and depressive (2.7-fold) symptoms, when compared with no/minimally stressed students. Besides, fear of getting assaulted or humiliated on the way to hospital or home, not to be able to give maximum concentration on study after COVID-19 pandemic, students' present emotional status (agitation), had statistically significant higher risk of anxiety.

CONCLUSION

A substantial proportion of Bangladeshi medical students are experiencing pandemic-related adverse psychological impact. Poor mental health conditions of these vulnerable medical students pose important threat to their potential contribution in future health care. Thus, medical colleges and health authorities should focus on addressing their psychological needs and formulate effective strategies to ameliorate medical students' mental health status, particularly during any infectious disease outbreak.

Low uptake of COVID-19 prevention behaviours and high socioeconomic impact of lockdown measures in South Asia: Evidence from a large-scale multi-country surveillance programme

BACKGROUND

South Asia has become a major epicentre of the COVID-19 pandemic. Understanding South Asians' awareness, attitudes and experiences of early measures for the prevention of COVID-19 is key to improving the effectiveness and mitigating the social and economic impacts of pandemic responses at a critical time for the Region.

METHODS

We assessed the knowledge, behaviours, health and socio-economic circumstances of 29,809 adult men and women, at 93 locations across four South Asian countries. Data were collected during the national lockdowns implemented from March to July 2020, and compared with data collected prior to the pandemic as part of an ongoing prospective surveillance initiative.

RESULTS

Participants were 61% female, mean age 45.1 years. Almost half had one or more chronic disease, including diabetes (16%), hypertension (23%) or obesity (16%). Knowledge of the primary COVID-19 symptoms and transmission routes was high, but access to hygiene and personal protection resources was low (running water 63%, hand sanitisers 53%, paper tissues 48%). Key preventive measures were not widely adopted. Knowledge, access to, and uptake of COVID-19 prevention measures were low amongst people from disadvantaged socio-economic groups. Fifteen percent of people receiving treatment for chronic diseases reported loss of access to long-term medications; 40% reported symptoms suggestive of anxiety or depression. The prevalence of unemployment rose from 9.3% to 39.4% (P < 0.001), and household income fell by 52% (P < 0.001) during the lockdown. Younger people and those from less affluent socio-economic groups were most severely impacted. Sedentary time increased by 32% and inadequate fruit and vegetable intake increased by 10% (P < 0.001 for both), while tobacco and alcohol consumption dropped by 41% and 80%, respectively (P < 0.001), during the lockdown.

CONCLUSIONS

Our results identified important knowledge, access and uptake barriers to the prevention of COVID-19 in South Asia, and demonstrated major adverse impacts of the pandemic on chronic disease treatment, mental health, health-related behaviours, employment and household finances. We found important sociodemographic differences for impact, suggesting a widening of existing inequalities. Our findings underscore the need for immediate large-scale action to close gaps in knowledge and access to essential resources for prevention, along with measures to safeguard economic production and mitigate socio-economic impacts on the young and the poor.

A content analysis of newspaper coverage of COVID-19 pandemic for developing a pandemic management framework

BACKGROUND

The emergence of COVID-19 pandemic has not only shaken the global health sector, but also almost every other sector, including economic and education sectors. Newspapers are performing a significant role by featuring the news of COVID-19 from its very onset. The temporal fluctuation of COVID-19 related key themes presented in newspaper articles and the findings obtained from them could offer an effective lesson in dealing with future epidemics and pandemics.

AIM AND METHOD

This paper intends to develop a pandemic management framework through an automated content analysis of local newspaper coverage of COVID-19 pandemic in Bangladesh. To fulfill the aim, 7,209 newspaper articles are assembled and analyzed from three popular local newspapers named "bdnews24.com", "New Age", and "Prothom Alo English" over the period from January 1, 2020 to October 31, 2020.

RESULTS

Twelve key topics are identified: origin and outbreak of COVID-19, response of healthcare system, impact on economy, impact on lifestyle, government assistance to the crisis, regular updates, expert opinions, pharmaceutical measures, non-pharmaceutical measures, updates on vaccines, testing facilities, and local unusual activities within the system. Based on the identified topics, their timeline of discussion, and information flow in each topic, a four-stage pandemic management framework is developed for epidemic and pandemic management in future. The stages are preparedness, response, recovery, and mitigation.

CONCLUSION

This research would provide insights into stage-wise response to any biological hazard and contribute ideas to endure future outbreaks.

Improvement strategies of food supply chain through novel food processing technologies during COVID-19 pandemic

Coronavirus disease-19 (COVID-19) is a contagious disease caused by a novel corona virus (SARS-CoV-2). No medical intervention has yet succeeded, though vaccine success is expected soon. However, it may take months or years to reach the vaccine to the whole population of the world. Therefore, the technological preparedness is worth to discuss for the smooth running of food processing activities. We have explained the impact of the COVID-19 pandemic on the food supply chain (FSC) and then discussed the technological interventions to overcome these impacts. The novel and smart technologies during food processing to minimize human-to-human and human-to-food contact were compiled. The potential virus-decontamination technologies were also discussed. Finally, we concluded that these technologies would make food processing activities smarter, which would ultimately help to run the FSC smoothly during COVID-19 pandemic.

Spatiotemporal Investigations of Multi-Sensor Air Pollution Data over Bangladesh during COVID-19 Lockdown

This study investigates spatiotemporal changes in air pollution (particulate as well as gases) during the COVID-19 lockdown period over major cities of Bangladesh. The study investigated the aerosol optical depth (AOD) from the Moderate Resolution Imaging Spectroradiometer (MODIS) onboard Terra and Aqua satellites, PM2.5 and PM10 from Copernicus Atmosphere Monitoring Service (CAMS), and NO2 and O3 from TROPOMI-5P, from March to June 2019–2020. Additionally, aerosol subtypes from the Cloud-Aerosol Lidar and Infrared Pathfinder (CALIPSO) were used to explore the aerosol types. The strict lockdown (26 March–30 May 2020) led to a significant reduction in AOD (up to 47%) in all major cities, while the partial lockdown (June 2020) led to increased and decreased AOD over the study area. Significant reductions in PM2.5 (37–77%) and PM10 (33–70%) were also observed throughout the country during the strict lockdown and partial lockdown. The NO2 levels decreased by 3–25% in March 2020 in the cities of Rajshahi, Chattogram, Sylhet, Khulna, Barisal, and Mymensingh, in April by 3–43% in Dhaka, Chattogram, Khulna, Barisal, Bhola, and Mymensingh, and May by 12–42% in Rajshahi, Sylhet, Mymensingh, and Rangpur. During the partial lockdown in June, NO2 decreased (9–35%) in Dhaka, Chattogram, Sylhet, Khulna, Barisal, and Rangpur compared to 2019. On the other hand, increases were observed in ozone (O3) levels, with an average increase of 3–12% throughout the country during the strict lockdown and only a slight reduction of 1–3% in O3 during the partial lockdown. In terms of aerosol types, CALIPSO observed high levels of polluted dust followed by dust, smoke, polluted continental, and clean marine-type aerosols over the country in 2019, but all types were decreased during the lockdown. The study concludes that the strict lockdown measures were able to significantly improve air quality conditions over Bangladesh due to the shutdown of industries, vehicles, and movement of people.

Geospatial analysis of COVID-19 lockdown effects on air quality in the South and Southeast Asian region

The COVID-19 pandemic, induced by the novel Coronavirus worldwide outbreak, is causing countries to introduce different types of lockdown measures to curb the contagion. The implementation of strict lockdown policies has had unprecedented impacts on air quality globally. This study is an attempt to assess the effects of COVID-19 induced lockdown measures on air quality in both regional, country, and city scales in the South and Southeast Asian region using open-source satellite-based data and software frameworks. We performed a systematic review of the national lockdown measures of 19 countries of the study area based on publicly available materials. We considered two temporal settings over a period of 66 days to assess and compare the effects of lockdown measures on air quality levels between standard business as usual and current situation COVID-19 lockdown. Results showed that compared to the same period of 2019, atmospheric NO2, SO2, PM2.5, and CO levels decreased by an average of 24.16%, 19.51%, 20.25%, and 6.88%, respectively during the lockdown, while O3 increased by a maximum of 4.52%. Among the 19 studied cities, Dhaka, Kathmandu, Jakarta, and Hanoi experienced the highest reduction of NO2 (40%-47%) during the lockdown period compared to the corresponding period of 2019. The methodological framework applied in this study can be used and extended to future research in the similar domain such as understanding long-term effects of COVID-19 mitigation measures on the atmospheric pollution at continental-scale or assessing the effects of the domestic emissions during the stay-at-home; a standard and effective COVID-19 lockdown measure applied in most of the countries.

4P Model for Dynamic Prediction of COVID-19: a Statistical and Machine Learning Approach

Around the world, scientists are racing hard to understand how the COVID-19 epidemic is spreading and growing, thus trying to find ways to prevent it before medications are available. Many different models have been proposed so far correlating different factors. Some of them are too localized to indicate a general trend of the pandemic while some others have established transient correlations only. Hence, in this study, taking Bangladesh as a case, a 4P model has been proposed based on four probabilities (4P) which have been found to be true for all affected countries. Efficiency scores have been estimated from survey analysis not only for governing authorities on managing the situation (P(G)) but also for the compliance of the citizens ((P(P)). Since immune responses to a specific pathogen can vary from person to person, the probability of a person getting infected ((P(I)) after being exposed has also been estimated. And the vital one is the probability of test positivity ((P(T)) which is a strong indicator of how effectively the infected people are diagnosed and isolated from the rest of the group that affects the rate of growth. All the four parameters have been fitted in a non-linear exponential model that partly updates itself periodically with everyday facts. Along with the model, all the four probabilistic parameters are engaged to train a recurrent neural network using long short-term memory neural network and the followed trial confirmed a ruling functionality of the 4Ps.

Treatment, Persistent Symptoms, and Depression in People Infected with COVID-19 in Bangladesh

Background: Coronavirus disease (COVID-19) has affected people's lives globally. While important research has been conducted, much remains to be known. In Bangladesh, initial treatment (self-administered, hospitalized), persistent COVID-19 symptoms ("long COVID-19"), and whether COVID-19 leads to changes in mental state, such as depressive symptoms, of people are not known. This study aimed to examine treatment, persistent symptoms, and depression in people who had been infected with COVID-19 in Bangladesh. Methods: A cross-sectional survey was conducted on 1002 individuals infected with COVID-19 (60% male; mean age = 34.7 ± 13.9; age range = 18-81 years), with data taken over a one-month period (11 September 2020 to 13 October 2020). A self-reported online questionnaire was used to collect data on socio-demographics, lifestyle, COVID-19 symptoms (during and beyond COVID-19), medication (over-the-counter or doctor-prescribed), and depression (assessed using the Patient Health Questionnaire (PHQ-9)). Results: Twenty-four percent of participants self-medicated with over-the-counter medicine when they were first diagnosed with COVID-19. Self-medication was higher among female vs. male respondents (29.6% vs. 20.2%, respectively, p = 0.002). A minority (20%) reported that they experienced persistent COVID-like symptoms after recovering from COVID-19. The most reported persistent symptoms were diarrhea (12.7%) and fatigue (11.5%). Forty-eight percent of participants were categorized as having moderate to severe depression. Based on multivariate regression analysis, depression during COVID-19 was positively associated with lower family income, poor health status, sleep disturbance, lack of physical activity, hypertension, asthma/respiratory problems, fear of COVID-19 re-infection, and persistent COVID-19 symptoms. Conclusions: The findings suggest a need for appropriate interventions for COVID-19 patients to promote physical and mental wellbeing.

Healthcare Workers' Knowledge, Attitude, and Practice Regarding Personal Protective Equipment for the Prevention of COVID-19

PURPOSE

Adequate knowledge, positive attitude, and proper practice of personal protective equipment by healthcare workers are necessary to get protection from COVID-19 infection. But this area is yet to be explored. Hence, we aimed to assess the knowledge, attitude, and practice (KAP) regarding personal protective equipment (PPE) among healthcare workers, along with a survey of the possible determinants.

SUBJECTS AND METHODS

For this cross-sectional study, online and offline surveys were conducted among a sample of 393 healthcare workers from five different districts of Bangladesh. A validated self-administered questionnaire comprising five sections (socio-demography, work-related information, knowledge, attitude, and practice) was used for data collection. Multivariate stepwise forward logistic regression was applied to find significant factors associated with good attitude, and practice using SPSS version 25.

RESULTS

The average age of the 393 participants was 28.9±5.2 years with a male-female ratio of one. Of them, 99.5% (n=391) had good knowledge, 88.8% (n=349) had positive attitude and 51.7% (n=203) had good practice regarding PPE. Results revealed that being a physician and living at home were significantly associated with a positive attitude. While being a non-physician, having lower education, working in private hospitals, and using office transport were associated with good practice regarding PPE.

CONCLUSION

The findings demonstrated that the healthcare workers had an overall good knowledge and a positive attitude but a poor practice regarding PPE. This study also highlighted the factors influencing KAP towards PPE that must be addressed in future education, awareness, and counseling programs.

Spatiotemporal patterns and trends of community transmission of the pandemic COVID-19 in South Asia: Bangladesh as a case study

South Asian (SA) countries have been fighting with the pandemic novel coronavirus disease 2019 (COVID-19) since January 2020. Earlier, the country-specific descriptive study has been done. Nevertheless, as transboundary infection, the border sharing, shared cultural and behavioral practice, effects on the temporal and spatial distribution of COVID-19 in SA is still unveiled. Therefore, this study has been revealed the spatial hotspot along with descriptive output on different parameters of COVID-19 infection. We extracted data from the WHO and the worldometer database from the onset of the outbreak up to 15 May, 2020. Europe has the highest case fatality rate (CFR, 9.22%), whereas Oceania has the highest (91.15%) recovery rate from COVID-19. Among SA countries, India has the highest number of cases (85,790), followed by Pakistan (38,799) and Bangladesh (20,065). However, the number of tests conducted was minimum in this region in comparison with other areas. The highest CFR was recorded in India (3.21%) among SA countries, whereas Nepal and Bhutan had no death record due to COVID-19 so far. The recovery rate varies from 4.75% in the Maldives to 51.02% in Sri Lanka. In Bangladesh, community transmission has been recorded, and the highest number of cases were detected in Dhaka, followed by Narayanganj and Chattogram. We detected Dhaka and its surrounding six districts, namely Gazipur, Narsingdi, Narayanganj, Munshiganj, Manikganj, and Shariatpur, as the 99% confidence-based hotspot where Faridpur and Madaripur district as the 95% confidence-based spatial hotspots of COVID-19 in Bangladesh. However, we did not find any cold spots in Bangladesh. We identified three hotspots and three cold spots at different confidence levels in India. Findings from this study suggested the "Test, Trace, and Isolation" approach for earlier detection of infection to prevent further community transmission of COVID-19.

Identification of risk factors contributing to COVID-19 incidence rates in Bangladesh: A GIS-based spatial modeling approach

BACKGROUND

COVID-19 pandemic outbreak is an unprecedented shock throughout the world, which has generated a massive social, human, and economic crisis. Identification of risk factors is crucial to prevent the COVID-19 spread by taking appropriate countermeasures effectively. Therefore, this study aimed to identify the potential risk factors contributing to the COVID-19 incidence rates at the district-level in Bangladesh.

METHOD

Spatial regression methods were applied in this study to fulfill the aim. Data related to 28 demographic, economic, built environment, health, and facilities related factors were collected from secondary sources and analyzed to explain the spatial variability of this disease incidence. Three global (ordinary least squares (OLS), spatial lag model (SLM), and spatial error model (SEM)) and one local (geographically weighted regression (GWR)) regression models were developed in this study.

RESULTS

The results of the models identified four factors: percentage of the urban population, monthly consumption, number of health workers, and distance from the capital city, as significant risk factors affecting the COVID-19 incidence rates in Bangladesh. Among the four developed models, the GWR model performed the best in explaining the variation of COVID-19 incidence rates across Bangladesh, with an R 2 value of 78.6%.

CONCLUSION

Findings and discussions from this research offer a better insight into the COVID-19 situation, which helped discuss policy implications to negotiate the future epidemic crisis. The primary policy response would be to decentralize the urban population and economic activities from and around the capital city, Dhaka, to create self-sufficient regions throughout the country, especially in the north-western region.

Suicidal behaviors and suicide risk among Bangladeshi people during the COVID-19 pandemic: An online cross-sectional survey

BACKGROUND

Suicide, a major public health concern, is a leading cause of injury and death worldwide. The present study aims to assess suicidal behaviors and suicide risk among Bangladeshi people during COVID-19.

METHODS

A cross-sectional online survey was conducted from July 10 to July 20, 2020, involving 1,415 Bangladeshi residents ages 18 years or older. Data was collected via an anonymous online questionnaire. The Suicide Behaviors Questionnaire-Revised was used to assess suicide risk. The depression and anxiety subscales of the Depression Anxiety Stress Scale 21 were used to assess depression and anxiety. Logistic regression analyses and Pearson's correlation were performed to examine the association of variables.

RESULTS

The prevalence of suicide ideation and planning among Bangladeshi people during the COVID-19 pandemic was 19.0% and 18.5%, respectively. Having suicidal risk during the COVID-19 pandemic was reported by 33.5% participants. Suicide risk was associated higher with females, divorced or widowed marital statuses and low educational attainment (i.e., secondary or below and higher secondary/diploma). Additionally, living in high COVID-19 prevalent areas, having economic loss due to the COVID-19 pandemic, relatives or acquaintances die from COVID-19, direct contact with COVID-19 patient(s), and fear of COVID-19 infection were associated with suicide risk.

CONCLUSIONS

The COVID-19 pandemic imposes significant psychological consequences on people, thus, concerned authorities should pay attention to people's mental health and focus on suicide prevention and awareness during and after the COVID-19 pandemic.

Prolonged lockdown and academic uncertainties in Bangladesh: A qualitative investigation during the COVID-19 pandemic

The erratic nature of the novel coronavirus disease (COVID-19) forced the Bangladeshi government to shut down all the educational institutions since March 18, 2020. This prolonged closure not only detached the students from their study but also increased anxiety among them regarding their future academic as well as professional careers. The present study aimed to explore the perception and understanding of the students and teachers regarding the impact of COVID-19 on the academic life and career pursuit of university students in Bangladesh. With a semi-structured interview schedule, data for this qualitative study were collected from 8 purposively selected participants, using telephone interviews, affiliated with a public university in Bangladesh. Students argued that the extended closure is responsible for the delayed graduation of the senior students, thereby, mounting mental stress and frustration among them. The informants unequivocally opposed the online education platform, as a solution for the ongoing gap, due to scarcity of the resources, and unequal accesses and opportunities for all. It has been suggested that the education gap can be reduced by shortening the term, curtailing the preparatory leave, and taking extra classes over the weekends when the universities re-open together with enforced collective health hygiene.

Utilisation, Availability and Price Changes of Medicines and Protection Equipment for COVID-19 Among Selected Regions in India: Findings and Implications

Background: COVID-19 has already claimed a considerable number of lives worldwide. However, there are concerns with treatment recommendations given the extent of conflicting results with suggested treatments and misinformation, some of which has resulted in increased prices and shortages alongside increasing use and prices of personal protective equipment (PPE). This is a concern in countries such as India where there have been high patient co-payments and an appreciable number of families going into poverty when members become ill. However, balanced against pricing controls. Community pharmacists play a significant role in disease management in India, and this will remain. Consequently, there is a need to review prices and availability of pertinent medicines during the early stages of the COVID-19 pandemic in India to provide future direction. Objective: Assess current utilisation and price changes as well as shortages of pertinent medicines and equipment during the early stages of the pandemic. Our Approach: Multiple approach involving a review of treatments and ongoing activities across India to reduce the spread of the virus alongside questioning pharmacies in selected cities from early March to end May 2020. Our Activities: 111 pharmacies took part, giving a response rate of 80%. Encouragingly, no change in utilisation of antimalarial medicines in 45% of pharmacies despite endorsements and for antibiotics in 57.7% of pharmacies, helped by increasing need for a prescription for dispensing. In addition, increased purchasing of PPE (over 98%). No price increases were seen for antimalarials and antibiotics in 83.8 and 91.9% of pharmacies respectively although shortages were seen for antimalarials in 70.3% of pharmacies, lower for antibiotics (9.9% of pharmacies). However, price increases were typically seen for PPE (over 90% of stores) as well as for analgesics (over 50% of pharmacies). Shortages were also seen for PPE (88.3%). Conclusion: The pandemic has impacted on utilisation and prices of pertinent medicines and PPE in India but moderated by increased scrutiny. Key stakeholder groups can play a role with enhancing evidenced-based approaches and reducing inappropriate purchasing in the future.

A survey of psychological distress among Bangladeshi people during the COVID-19 pandemic

Introduction

Previous studies conducted on the psychological impact of infectious outbreaks have found heavy psychological burdens among general population with more severe affect in the current pandemic. The main aim of this study is to examine the level of psychological distress during COVID-19 in Bangladesh and explore factors associated with higher psychological distress.

Methods

An internet-based, cross-sectional survey was conducted from March to April 2020 in Bangladesh among adults 18 years old and above using structured online questionnaires distributed through emails and other social media throughout Bangladesh with an overall response rate of 34%. Modified version of the Covid19 peritraumatic distress index (CPDI) was used to measure distress. Univariate and Bivariate analysis was used to estimate prevalence of CPDI symptoms and test for the associations between CPDI and the exposure variables. Logistic regression analyses were used to estimate the odds ratios of our outcome variable by exposure variables.

Results

Overall, 44.3% of respondents were suffering from mild to moderate distress and 9.5% were suffering from severe distress. Female respondents were 2.435 times more likely to suffer from CPDI mild to severe distress than males. As compared to Dhaka and Mymensing region of Bangladesh, odds of distress was 1.945 times more in Chittagong/Sylhet region (p-value = 0.035).

Conclusion

Large proportion of adult population in Bangladesh are experiencing psychological distress, with level of distress varies by different symptoms and predictors. This study suggest the need to develop comprehensive crisis prevention system including epidemiological monitoring, screening, and referral with targeted intervention to reduce psychological distress.

Population-Level Preparedness About Preventive Practices Against Coronavirus Disease 2019: A Cross-Sectional Study Among Adults in Bangladesh

This study assessed the preparedness regarding the preventive practices toward the coronavirus disease 2019 (COVID-19) among the adult population in Bangladesh. Data were collected through an online survey with a sample size of 1,056. We constructed four variables (individual, household, economic, and community and social distancing) related to preparedness based on the principal component analysis of eight items. We employed descriptive statistics and multiple linear regression analysis. The results showed that the accuracy rate of the overall preparedness scale was 68.9%. The preparedness level related to economic, individual, household, and community and social distancing was 64.9, 77.1, 50.4, and 83.2%, respectively. However, the economic preparedness significantly varied by sex, education, occupation, attitude, and worries related to COVID-19. Individual preparedness was significantly associated with education, residence, and attitudes. The household preparedness significantly varied by education, residence, and worries, while the respondent's community and social distancing-related preparedness significantly varied by sex, region, residence, and attitude. This study implies the necessity of the coverage of financial schemes for the vulnerable group. Increased coverage of health education regarding personal hygiene targeting the less educated and rural population should be ensured.

Impacts of nationwide lockdown due to COVID-19 outbreak on air quality in Bangladesh: a spatiotemporal analysis

In Bangladesh, a nationwide lockdown was imposed on 26 March 2020, due to the COVID-19 pandemic. Due to restricted emissions, it was hypothesized that the air quality has been improved during lockdown throughout the country. The study is intended to assess the impact of nationwide lockdown measures on air quality in Bangladesh. We analyzed satellite data for four different air pollutants (NO₂, SO₂, CO, and O₃) to assess the changes in the atmospheric concentrations of pollutants in major cities as well as across the country. In this study, the concentrations of NO₂, SO₂, CO, and O₃ from 1 February to 30 May of the year 2019 and 2020 were analyzed. The average SO₂ and NO₂ concentrations were decreased by 43 and 40%, respectively, while tropospheric O₃ were found to be increased with a maximum of > 7%. Among the major cities, Dhaka, Gazipur, Chattogram, and Narayanganj were found to be more influenced by the restricted emissions. In Dhaka, NO₂ and SO₂ concentrations were decreased approximately by 69 and 67%, respectively. Our analysis reveals that NO₂ concentrations are highly correlated with the regional COVID-19 cases (r = 0.74). The study concludes that the lockdown measures significantly reduced air pollution because of reduced vehicular and industrial emissions in Bangladesh.

Water, sanitation, hygiene and waste disposal practices as COVID-19 response strategy: insights from Bangladesh

The COVID-19 pandemic has caused a global emergence, and the absence of a proven vaccine or medicine has led to the implementation of measures to prevent and control the spread of the virus. Wearing protective equipment like mask and gloves, washing hands via soap, frequent use of antiseptic solution and maintaining social distance are being applied globally to reduce the transmission rate. Therefore, this study was intended to investigate water, sanitation and hygienic (WASH) behaviour, protective equipment use and their disposal practices among Bangladeshi residents amid the COVID-19 pandemic. Based on the study aims, data were collected mainly via an online survey and analysed through a set of statistical tools including T test, one-way ANOVA and principal component analysis (PCA). This study found that almost 89.80% of the respondents reported to know about the COVID-19 and its preventive measures. WASH status of the respondents is found quite good, where 94.60% stated to have available potable water, 99% have improved toilet facilities, 95% wash their hands via soap, and 79.80% clean their house and toilets by antiseptic solutions properly. Moreover, nearly 94.50% and 54.80% people reported to use face mask and hand gloves, respectively, but the disposal practice of these protective equipment is inappropriate. More than 50% of people reported disposing of their used mask, gloves and tissue with other household wastes, which is alarming for public health and environmental perspective. Moreover, the WASH and waste disposal practices of the marginal people were found very poor and not at a satisfactory level. The results of statistical analysis focused on WASH and waste disposal practices as well as the factors which influence these practices. It is found that gender, occupation, area of residence, and level of education of the participants mainly influence the WASH and waste disposal practices. It is expected that this study exposed the necessity to introduce proper infectious waste management policy and also the increase in awareness level among mass people regarding the preventive measures of COVID-19 infection to combat against disease transmission and environmental pollution.

SUPPLEMENTARY INFORMATION

The online version of this article (10.1007/s10668-020-01151-9) contains supplementary material, which is available to authorized users.

Exploring depressive symptoms and its associates among Bangladeshi older adults amid COVID-19 pandemic: findings from a cross-sectional study

PURPOSE

Depression, one of the most common mental disorders, is up-surging worldwide amid the ongoing coronavirus disease 2019 (COVID-19) pandemic, especially among the older population. This study aims to measure prevalent depressive symptoms and its associates among older adults amid the COVID-19 pandemic in Bangladesh.

METHODS

This cross-sectional study was carried out among 1032 older Bangladeshi adults, aged 60 years and above, through telephone interviews in October 2020. We used a semi-structured questionnaire to collect data on participants' socio-demographic and lifestyle characteristics, pre-existing medical conditions, and COVID-19-related information. Meanwhile, depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15). The binary logistic regression model was used to identify the factors associated with depressive symptoms.

RESULTS

Two-in-five participants showed depressive symptoms on the GDS-15 scale. Poor socioeconomic characteristic such as low family income, dependency on the family for living, recipient of financial support during the pandemic was associated with higher odds of depressive symptoms. Participants with pre-existing medical conditions had 91% higher odds of depressive symptoms. Social isolation, captured in terms of living alone (aOR = 2.11, 95% CI 1.11-4.01), less frequent communication during pandemic (aOR = 1.55, 95% CI 1.07-2.26), perceived loneliness (aOR = 2.25, 95% CI 1.47-3.45), and isolation from others (aOR = 2.45, 95% CI 1.62-3.70) were associated with higher odds of depressive symptoms.

CONCLUSIONS

Our study found a sizeable proportion of study participants with depressive symptoms amidst the ongoing pandemic. The findings of the present study call for the urgent need for mental health support package targeting this vulnerable group of population.

Do knowledge and attitudes matter for preventive behavioral practices toward the COVID-19? A cross-sectional online survey among the adult population in Bangladesh

The Government of Bangladesh has adopted several non-therapeutic measures to tackle the pandemic of SARS-CoV-2. However, the curve of COVID-19 positive cases has not significantly flattened yet, as the adoption of preventive measures by the general population is predominantly a behavioral phenomenon that is often influenced by people's knowledge and attitudes. This study aimed to assess the levels of knowledge, attitudes, and preventive behavioral practices toward COVID-19 and their interrelationships among the population of Bangladesh aged 18 years and above. This study adopted a web-based cross-sectional survey design and collected data from 1056 respondents using the online platform Google Form. We employed the independent sample t-test, one-way ANOVA, Pearson's product-moment correlation, and Spearman rank-order correlation to produce the bivariate level statistics. We also run multiple linear and logistic regression models to identify the factors affecting knowledge, attitudes, and preventive behavioral practices toward COVID-19. The respondents had an average knowledge score of 17.29 (Standard Deviation (SD) = 3.30). The average score for attitude scale toward COVID-19 was 13.6 (SD = 3.7). The respondents had excellent preventive behavioral practices toward COVID-19 (mean 7.7, SD = 0.72). However, this study found that knowledge and attitudes did not matter for preventive behavioral practices toward COVID-19. Instead, education appeared as a sole predictor for preventive behavioral practices toward COVID-19; that means preventive behavioral practices toward COVID-19 was lower among the less educated respondents. This study suggests increasing education as a long-term strategy and taking immediate action to increase knowledge and decrease negative attitudes toward COVID-19 through targeted health education initiatives as a short-term strategy.

Women's Knowledge, Attitude, and Perceptions Toward COVID-19 in Lower-Middle-Income Countries: A Representative Cross-Sectional Study in Bangladesh

The coronavirus disease 2019 (COVID-19) is a global health emergency of unprecedented proportions. Countries around the world have taken extraordinary steps to control the disease. The preventive measures face challenges in low and lower middle income countries (LICs and LMICs). Especially the marginalized communities, e.g., women are the hardest hit of the virus. This study took Bangladesh as a representative LMIC and aimed to determine the level of knowledge, perception, attitude, and preparedness related to COVID-19 among the adult women in the country. Using a comprehensive questionnaire, we channeled a cross-sectional study among adult women in Bangladesh. Participant's self-reported data on the knowledge, attitude, and preparedness were tabulated and analyzed using suitable statistical tools. A total of 1,869 adults from 61 districts of Bangladesh took part in this study. Ninety seven percentage of the participants claimed to have heard of COVID-19 before it arrived in Bangladesh. Regarding the general knowledge related to COVID-19's causal agent, symptoms, and treatment, the positive response rate was nearly 80%, with a mean of 10.68 ± 1.72. Younger and educated women had better knowledge levels compared to the older and lower-educated participants (p < 0.01). More efforts are required to educate women with older age and lower socioeconomic status. An overall positive attitude and perception were observed, although a significant proportion of the participants opined that the Government's efforts in controlling the outbreak were not adequate. Although the participants had a satisfactory level of knowledge and a positive attitude in adopting preventive measures against COVID-19, greater efforts are needed from the healthcare authorities and Government.

Behavioral preventive measures and the use of medicines and herbal products among the public in response to Covid-19 in Bangladesh: A cross-sectional study

The present study was conducted to assess the behavioral preventive measures and the use of medicines and herbal foods/products among the public in response to Covid-19. A cross-sectional survey comprised of 1222 participants was conducted from 27 June to 20 July 2020. Kruskal-Wallis test was used to identify the differences in behavioral preventive practices across different demographic categories. To identify the factors associated with the use of preventive medicines and herbal foods/products, multivariable logistic regression was performed. Most participants adopted the recommended preventive practices such as washing hands more frequently (87.5%), staying home more often (85.5%), avoiding crowds (86%), and wearing masks (91.6%). About half of the smokers reported a decreased rate of smoking during the pandemic. Also, 14.8% took medicines, 57.6% took herbal foods/products, and 11.2% took both medicines and herbal foods/products as preventive measure against Covid-19. Arsenicum album, vitamin supplements, and zinc supplements were the most commonly used preventive medicines. Gender, age, and fear of Covid-19 were significantly associated with the use of both preventive medicines and herbal foods/products. For the management of Covid-19 related symptoms, paracetamol, antihistamines, antibiotics, and mineral (zinc and calcium) supplements were used most often. Most participants sought information from non-medical sources while using medicines and herbal products. Moreover, potentially inappropriate and unnecessary use of certain drugs was identified.

Epidemic Spread and Its Management Through Governance and Leadership Response Influencing the Arising Challenges Around COVID-19 in Pakistan-A Lesson Learnt for Low Income Countries With Limited Resource

The coronavirus disease (COVID-19) was first reported in China (Wuhan) at the end of 2019. It has rapidly spread over 216 countries, including the USA, UK, Europe, Russia, and many Asian countries. It has affected more than 4.5 million people, and around 0.3 million deaths have been reported globally. Many preventive measures have been adopted worldwide to mitigate its spread. The government of Pakistan has also taken many preventive measures to combat the COVID-19 outbreak, such as rapid response by governance, continuous monitoring of the pandemic spread in the affected areas, and integration of resources from multiple sectors, including health, education, defense, and media. According to global statistics, the number of COVID-19 cases in the country remained remarkably lower than the expected number for the first 169 days, as compared to other countries. A total of 286,674 confirmed cases, including 16,475 active, 6,139 deaths, and 264,060 (92%) recoveries were reported. The study finds that strict adherence to national policies, effective governance, and unity at the national level resulted in better outcomes. Hence, the preventive measures, rapid responses, and strategies adopted for combating the challenges could be adopted as a learning tool for other countries having similar work environments and financial constraints. This paper can help and guide governance/public actions in response to the possible rebound of coronavirus this fall/winter.

Pandemic response management framework based on efficiency of COVID-19 control and treatment

Aims: The existing response management system for pandemic disease fell short of controlling COVID-19. This study evaluates the response management relative efficiency of 58 countries in two stages, using two models. Materials & methods: Data envelopment analysis was applied for efficiency analysis. Results: 89.6% of countries were inefficient in pandemic control and 79% were inefficient in treatment measures. Sensitivity analysis underlines resources as a critical factor. Further examination points to absence of a robust and uniform mitigation measure against the pandemic in most countries. Conclusions: Preventing spread is not only the first line of defense; it is the only line of defense. The lack of a global public health database support system and uniform response compounded inefficiency. A robust pandemic response management framework is developed based on practices of key performers. Action plans are proposed, with a recommendation for a global public health pandemic database monitoring and support system as the nucleus.

Mental health outcomes during the COVID-19 and perceptions towards the pandemic: Findings from a cross sectional study among Bangladeshi students

Although the COVID-19 pandemic triggered commination on both physical and mental wellbeing since its outbreak, the impact of the pandemic on mental health difficulties among Bangladeshi students is still lack in substantial evidence. The study aimed to explore such an impact on mental health among Bangladeshi students and their perception towards the COVID-19 pandemic. A web-based cross-sectional study was conducted among 589 students from Bangladesh in between April 29th to 7th May 2020. Data was collected by using an online questionnaire on demographic status, perceptions towards COVID-19, and mental health symptoms by using the Depression, Anxiety and Stress Scale (DASS 21). About 26.66% and 61.97% of students reported mild to extremely severe anxiety symptoms, and depressive symptoms, respectively, and 57.05% reported mild to extremely severe levels of stress. Multivariate logistic regression reported that students' age, gender, family income, residence, and family size are associated with mental health difficulties. Negative perceptions on the effect of the pandemic on life events, mental health, disruptions in education, and health care system, existing physical health conditions, and COVID-19 like symptoms were significantly associated with poor mental outcomes. It is suggested that students' mental health difficulties should be monitored to provide adequate support and services during this ongoing pandemic.

Convalescent Plasma Therapy for Management of COVID-19: Perspectives and Deployment in the Current Global Pandemic

The world is striving against the severe crisis of the COVID-19 pandemic. Healthcare professionals are struggling to treat their patients based on nonspecific therapies. Amidst this uncertainty, convalescent plasma therapy (CPT) has appeared to be an interim adjuvant therapy for severely ill patients of COVID-19 until long-term clinical trial treatment options are available. Considering the transfusion-related hazards, especially lung injuries and microbial transmission, where sensitivity is not ensured, rigorous trials should be conducted to determine this therapy's efficacy. Moreover, the ratio of recovered cases to plasma donors is not satisfying, which questioning this therapy's availability and accessibility. Although some countries are making the treatment free, the attributable cost mandates a justification for its suitability and sustainability. Our article aimed to review the published facts and findings of CPT's effectiveness in lowering the mortality rate of COVID-19. This pandemic showed that healthcare systems worldwide need core reform. A unified global collaboration must align and coordinate to face the current pandemic and enhance world readiness for future outbreaks based on health equity and equality.

Socio-psychological impact on Bangladeshi students during COVID-19

Background: The socio-psychological impact of COVID-19 has affected the whole world. Bangladesh, one of the most dangerous places as stated by WHO, was first infected at the beginning of March 2020, later than other countries. Bangladesh is now one of the 20 most affected countries in the world, but the psychological effects for university students during the epidemic period are not researched.

Design and methods: To address this gap, the present study attempts to discover the socio-psychological impact of COVID-19 on university students in Bangladesh. We conducted an online survey using a questionnaire with a simple random sampling technique and we received 474 responses.

Results: In this study, numerous psychological concerns were reported. The study is limited to university students, which may affect the generalizability of the research.

Conclusions: Our findings suggest a need to build awareness of the mental health implications of the pandemic for university students.

Prevalence and Associated Risk Factors of Mortality Among COVID-19 Patients: A Meta-Analysis

OBJECTIVES

The main aim of this study was to find the prevalence of mortality among hospitalized COVID-19 infected patients and associated risk factors for death.

METHODS

Three electronic databases including PubMed, Science Direct and Google Scholar were searched to identify relevant cohort studies of COVID-19 disease from January 1, 2020, to August 11, 2020. A random-effects model was used to calculate pooled prevalence rate (PR), risk ratio (RR) and 95% confidence interval (CI) for both effect measures. Cochrane chi-square test statistic Q, [Formula: see text], and [Formula: see text] tests were used to measure the presence of heterogeneity. Publication bias and sensitivity of the included studies were also tested.

RESULTS

In this meta-analysis, a total of 58 studies with 122,191 patients were analyzed. The pooled prevalence rate of mortality among the hospitalized COVID-19 patients was 18.88%, 95% CI (16.46-21.30), p < 0.001. Highest mortality was found in Europe [PR 26.85%, 95% CI (19.41-34.29), p < 0.001] followed by North America [PR 21.47%, 95% CI (16.27-26.68), p < 0.001] and Asia [PR 14.83%, 95% CI (12.46- 17.21), p < 0.001]. An significant association were found between mortality among COVID-19 infected patients and older age (> 65 years vs. < 65 years) [RR 3.59, 95% CI (1.87-6.90), p < 0.001], gender (male vs. female) [RR 1.63, 95% CI (1.43-1.87), p < 0.001], ICU admitted patients [RR 3.72, 95% CI (2.70-5.13), p < 0.001], obesity [RR 2.18, 95% CI (1.10-4.34), p < 0.05], hypertension [RR 2.08,95% CI (1.79-2.43) p < 0.001], diabetes [RR 1.87, 95% CI (1.23-2.84), p < 0.001], cardiovascular disease [RR 2.51, 95% CI (1.20-5.26), p < 0.05], and cancer [RR 2.31, 95% CI (1.80-2.97), p < 0.001]. In addition, significant association for high risk of mortality were also found for cerebrovascular disease, COPD, coronary heart disease, chronic renal disease, chronic liver disease, chronic lung disease and chronic kidney disease.

CONCLUSION

This meta-analysis revealed that the mortality rate among COVID-19 patients was highest in the European region and older age, gender, ICU patients, patients with comorbidity had a high risk for case fatality. Those findings would help the health care providers to reduce the mortality rate and combat this pandemic to save lives using limited resources.

Psychological burden of the COVID-19 pandemic and its associated factors among frontline doctors of Bangladesh: a cross-sectional study

Background: Frontline doctors are the most vulnerable and high-risk population to get the novel coronavirus disease 2019 (COVID-19) infection. Hence, we aimed to evaluate the anxiety, depression, sleep disturbance and fear of COVID-19 among frontline doctors of Bangladesh during the pandemic, and the associated factors for these psychological symptoms. Methods: In total, 370 frontline doctors who were involved in the treatment of suspected or confirmed COVID-19 patients during the pandemic took part in an online cross-sectional study. Recruitment was completed using convenience sampling and the data were collected after the start of community transmission of COVID-19 in the country. Anxiety and depression, sleep disturbance, and fear of COVID-19 were assessed by the Patient Health Questionnaire-4, two-item version of the Sleep Condition Indicator, and the Fear of Coronavirus-19 scale, respectively. Socio-demographic information, health service-related information, co-morbidity, and smoking history were collected for evaluating risk factors. The proportion of psychological symptoms were presented using descriptive statistics and the associated factors were identified using multinomial logistic regression analysis. Results: Of the doctors, 36.5% had anxiety, 38.4% had depression, 18.6% had insomnia, and 31.9% had fear of COVID-19. In multinomial logistic regression, inadequate resources in the workplace were found as the single most significant predictor for all psychological outcomes: anxiety and/or depression (severe, OR 3.0, p=0.01; moderate, OR 5.3, p=0.000; mild, OR 2.3, p=0.003), sleep disturbance (moderate, OR 1.9, p=0.02), and fear of COVID-19 (severe, OR 1.9, p=0.03; moderate, OR 1.8, p=0.03). Conclusions: The study demonstrated a high burden of psychological symptoms among frontline doctors of Bangladesh during the COVID-19 pandemic situation. Inadequate resources are contributing to the poor mental health of Bangladeshi doctors. The supply of sufficient resources in workplaces and mental health counseling may help to mitigate the burden of the psychological symptoms identified among the respondents..

Psychological burden of the COVID-19 pandemic and its associated factors among frontline doctors of Bangladesh: a cross-sectional study

Background: Frontline doctors are the most vulnerable and high-risk population to get the novel coronavirus disease 2019 (COVID-19) infection. Hence, we aimed to evaluate the anxiety, depression, sleep disturbance and fear of COVID-19 among frontline doctors of Bangladesh during the pandemic, and the associated factors for these psychological symptoms. Methods: In total, 370 frontline doctors who were involved in the treatment of suspected or confirmed COVID-19 patients during the pandemic took part in an online cross-sectional study. Recruitment was completed using convenience sampling and the data were collected after the start of community transmission of COVID-19 in the country. Anxiety and depression, sleep disturbance, and fear of COVID-19 were assessed by the Patient Health Questionnaire-4, two-item version of the Sleep Condition Indicator, and the Fear of Coronavirus-19 scale, respectively. Socio-demographic information, health service-related information, co-morbidity, and smoking history were collected for evaluating risk factors. The proportion of psychological symptoms were presented using descriptive statistics and the associated factors were identified using multinomial logistic regression analysis. Results: Of the doctors, 36.5% had anxiety, 38.4% had depression, 18.6% had insomnia, and 31.9% had fear of COVID-19. In multinomial logistic regression, inadequate resources in the workplace were found as the single most significant predictor for all psychological outcomes: anxiety and/or depression (severe, OR 3.0, p=0.01; moderate, OR 5.3, p=0.000; mild, OR 2.3, p=0.003), sleep disturbance (moderate, OR 1.9, p=0.02), and fear of COVID-19 (severe, OR 1.9, p=0.03; moderate, OR 1.8, p=0.03). Conclusions: The study demonstrated a high burden of psychological symptoms among frontline doctors of Bangladesh during the COVID-19 pandemic situation. Inadequate resources are contributing to the poor mental health of Bangladeshi doctors. The supply of sufficient resources in workplaces and mental health counseling may help to mitigate the burden of the psychological symptoms identified among the respondents..

Psychological burden of the COVID-19 pandemic and its associated factors among frontline doctors of Bangladesh: a cross-sectional study

Background: Frontline doctors are the most vulnerable and high-risk population to get the novel coronavirus disease 2019 (COVID-19) infection. Hence, we aimed to evaluate the anxiety, depression, sleep disturbance and fear of COVID-19 among frontline doctors of Bangladesh during the pandemic, and the associated factors for these psychological symptoms. Methods: In total, 370 frontline doctors who were involved in the treatment of suspected or confirmed COVID-19 patients during the pandemic took part in an online cross-sectional study. Recruitment was completed using convenience sampling and the data were collected after the start of community transmission of COVID-19 in the country. Anxiety and depression, sleep disturbance, and fear of COVID-19 were assessed by the Patient Health Questionnaire-4, two-item version of the Sleep Condition Indicator, and the Fear of Coronavirus-19 scale, respectively. Socio-demographic information, health service-related information, co-morbidity, and smoking history were collected for evaluating risk factors. The proportion of psychological symptoms were presented using descriptive statistics and the associated factors were identified using multinomial logistic regression analysis. Results: Of the doctors, 36.5% had anxiety, 38.4% had depression, 18.6% had insomnia, and 31.9% had fear of COVID-19. In multinomial logistic regression, inadequate resources in the workplace were found as the single most significant predictor for all psychological outcomes: anxiety and/or depression (severe, OR 3.0, p=0.01; moderate, OR 5.3, p=0.000; mild, OR 2.3, p=0.003), sleep disturbance (moderate, OR 1.9, p=0.02), and fear of COVID-19 (severe, OR 1.9, p=0.03; moderate, OR 1.8, p=0.03). Conclusions: The study demonstrated a high burden of psychological symptoms among frontline doctors of Bangladesh during the COVID-19 pandemic situation. Inadequate resources are contributing to the poor mental health of Bangladeshi doctors. The supply of sufficient resources in workplaces and mental health counseling may help to mitigate the burden of the psychological symptoms identified among the respondents..

COVID-19: psychological effects on a COVID-19 quarantined population in Bangladesh

BACKGROUND

It had been seven months since the first confirmed case (8th March, 2020) of COVID-19 in Bangladesh and people have now got a more complete picture of the extent of the pandemic. Therefore, it is time to evaluate the effects of COVID-19 on mental health. The current population-based study aimed to assess the prevalence of depression and PTSD of the quarantined people in Bangladesh during COVID-19 outbreak.

METHODS

A total of 5792 individuals comprised the population of this study. Subjects were respondents to an online questionnaire that was administered through social media. The questionnaire included questions on personal information, quarantine related knowledge, items of the Impact of Event Scale-Revised (IES-R) and the Center for Epidemiologic Studies-Depression (CES-D) scale. Data were collected and analyzed by regression utilizing a using IBM SPSS-22 (Statistical Package for Social Science, Chicago, IL, USA).

RESULTS

The most post-traumatic stress disorder (PTSD) symptoms had on the male (n = 1392, 75.7%) who had institutional quarantine. The most depression symptoms were on the female (n = 920, 72.8%) whose income was more than 75000 takas in Bangladeshi currency. 81.8% of respondents had PTSD and their scores ≥24 in the IES-R scale. On the other hand, the respondent's income was 40000-74999 takas in Bangladesh currency had more PTSD symptoms and the odd ratio 19.3 (95% CI: 12.5-27.3), adjusted odds ratio 22.9 (95% CI: 15.6-32.4), after adjusting all personal variables. 85.9% respondents scored 16 ≤ in the CES-D scale, meaning they were depressed. The respondents whose education level grade 10 were most depressed and the odd ratio of 3.8 (95% CI: 3.1-4.65), adjusted odds ratio of 13.19 (95% CI: 9.88-17.62) after adjusting all personal variables.

CONCLUSIONS

The prevalence of depression and PTSD of the quarantined people higher than that of the affected group during the outbreak of COVID-19 in Bangladesh. If the administration and health care workers become conscious of such results, actions and policies can be taken to improve the consequential sufferings.

COVID-19 Transmission: Bangladesh Perspective

The sudden emergence of the COVID-19 pandemic has tested the strength of the public health system of the most developed nations and created a “new normal”. Many nations are struggling to curb the epidemic in spite of expanding testing facilities. In this study, we consider the case of Bangladesh, and fit a simple compartmental model holding a feature to distinguish between identified infected and infectious with time series data using least square fitting as well as the likelihood approach; prior to which, dynamics of the model were analyzed mathematically and the identifiability of the parameters has also been confirmed. The performance of the likelihood approach was found to be more promising and was used for further analysis. We performed fitting for different lengths of time intervals starting from the beginning of the outbreak, and examined the evolution of the key parameters from Bangladesh’s perspective. In addition, we deduced profile likelihood and 95% confidence interval for each of the estimated parameters. Our study demonstrates that the parameters defining the infectious and quarantine rates change with time as a consequence of the change in lock-down strategies and expansion of testing facilities. As a result, the value of the basic reproduction number R0 was shown to be between 1.5 and 12. The analysis reveals that the projected time and amplitude of the peak vary following the change in infectious and quarantine rates obtained through different lock-down strategies and expansion of testing facilities. The identification rate determines whether the observed peak shows the true prevalence. We find that by restricting the spread through quick identification and quarantine, or by implementing lock-down to reduce overall contact rate, the peak could be delayed, and the amplitude of the peak could be reduced. Another novelty of this study is that the model presented here can infer the unidentified COVID cases besides estimating the officially confirmed COVID cases.

Tackling the COVID-19 pandemic: The Bangladesh perspective

An outbreak of a COVID-19 pandemic disease, caused by a novel coronavirus SARS-CoV-2, has posed a serious threat to global human health. Bangladesh has also come under the attack of this viral disease. Here, we aimed to describe the responses of Bangladesh to tackle the COVID-19, particularly on how Bangladesh is dealing with this novel viral disease with its limited resources. The first case of a COVID-19 patient was detected in Bangladesh on March 8, 2020. Since then, a total of 263,503 peoples are officially reported as COVID-19 infected with 3,471 deaths until August 11, 2020. To combat the COVID-19, the government has taken various steps viz. diagnosis of the suspected cases, quarantine of doubted people and isolation of infected patients, local or regional lockdown, closure of all government and private offices, increase public awareness and enforce social distancing, etc. Moreover, to address the socio-economic situations, the government announced several financial stimulus packages of about USD 11.90 billion. However, the government got 3 months since the disease was first reported in China, but the country failed in making proper strategies including contact tracing, introducing antibody/antigen-based rapid detection kit, and also failed to make multi-disciplinary team to combat this disease. Further, limited testing facilities and inadequate treatment service along with public unawareness are the major challenges for Bangladesh to tackle this situation effectively. Along with the government, personal awareness and assistance of non-government organizations, private organizations, researchers, doctors, industrialists, and international organizations are firmly required to mitigate this highly contagious disease.

Challenges Faced by Rohingya Refugees in the COVID-19 Pandemic

In August 2017, Bangladesh saw a massive influx of Rohingya refugees following their violent persecution by the Myanmar authorities. Since then, the district of Cox’s Bazar has been home to nearly 900,000 Rohingya refugees living in the densely populated and unhygienic camps. The refugees have been living in makeshift settlements which are cramped into one another, making it extremely difficult to maintain “social distance”. The overcrowded conditions coupled with the low literacy level, lack of basic sanitation facilities, face masks and gloves and limited communication make these camps an ideal place for the virus to spread rapidly. As nations struggle to contain the SARS-CoV-2 virus, refugees are one such population who are extremely vulnerable to the effects of this outbreak. If issues are not addressed at an early stage, its effects can be catastrophic.

Impact of COVID-19 pandemic on the mental health of children in Bangladesh: A cross-sectional study

COVID-19 pandemic poses a significant mental health threat among children in Bangladesh. This study aims to explore the impact of COVID-19 on the mental health of children during the lockdown in Bangladesh. An online cross-sectional study was conducted from 25th April to 9th May 2020 among 384 parents having at least one child aged between 5-15 years using non-probability sampling. K-means clustering used to group children according to mental health score and confirmatory factor analysis (CFA) performed to identify the relationship among the parental behavior and child mental health, and also these associations were assessed through chi-square test. Children were classified into four groups where 43% of child had subthreshold mental disturbances (mean Major Depressive Disorder (MDD)-10; 2.8), 30.5% had mild (mean MDD-10; 8.9), 19.3% suffered moderately (mean MDD-10; 15.9), and 7.2% of child suffered from severe disturbances (mean MDD-10; 25.2). The higher percentage of mental health disturbances of children with the higher education level of parents, relative infected by COVID-19 (yes), parents still need to go the workplace (yes), and parent's abnormal behavior but lower to their counterparts. This paper demonstrates large proportions of children are suffering from mental health disturbances in Bangladesh during the period of lockdown. Implementation of psychological intervention strategies and improvement in house-hold financial conditions, literacy of parents, taking care of children, and job security may help in improving the psychological/mental status of children and the authors believe that the findings will be beneficial to accelerate the rate of achieving the Sustainable Development Goal (SDG) linked to health status in Bangladesh.

Knowledge, attitudes, and fear of COVID-19 during the Rapid Rise Period in Bangladesh

The study aims to determine the level of Knowledge, Attitude, and Practice (KAP) related to COVID-19 preventive health habits and perception of fear towards COVID-19 in subjects living in Bangladesh.

DESIGN

Prospective, cross-sectional survey of (n = 2157) male and female subjects, 13-88 years of age, living in Bangladesh.

METHODS

Ethical approval and trial registration were obtained before the commencement of the study. Subjects who volunteered to participate and signed the informed consent were enrolled in the study and completed the structured questionnaire on KAP and Fear of COVID-19 scale (FCV-19S).

RESULTS

Twenty-eight percent (28.69%) of subjects reported one or more COVID-19 symptoms, and 21.4% of subjects reported one or more co-morbidities. Knowledge scores were slightly higher in males (8.75± 1.58) than females (8.66± 1.70). Knowledge was significantly correlated with age (p < .005), an education level (p < .001), attitude (p < .001), and urban location (p < .001). Knowledge scores showed an inverse correlation with fear scores (p < .001). Eighty-three percent (83.7%) of subjects with COVID-19 symptoms reported wearing a mask in public, and 75.4% of subjects reported staying away from crowded places. Subjects with one or more symptoms reported higher fear compared to subjects without (18.73± 4.6; 18.45± 5.1).

CONCLUSION

Bangladeshis reported a high prevalence of self-isolation, positive preventive health behaviors related to COVID-19, and moderate to high fear levels. Higher knowledge and Practice were found in males, higher education levels, older age, and urban location. Fear of COVID-19 was more prevalent in female and elderly subjects. A positive attitude was reported for the majority of subjects, reflecting the belief that COVID-19 was controllable and containable.

Knowledge, attitudes and practices associated with the COVID-19 among slum dwellers resided in Dhaka City: A Bangladeshi interview-based survey.. [DOI: 10.1101/2020.09.15.20195255]

Background

The emergent COVID-19 has impacted unprecedentedly to all classes of people. Slum-dwellers’ knowledge, attitudes and practices (KAP) towards COVID-19 are currently poorly understood. To investigate the KAP towards COVID-19 among slum dwellers resided in Dhaka City, Bangladesh.

Methods

A cross-sectional offline survey was carried out enrolling 406 slum dwellers (53.2% male; mean age=44.9 years [SD=12.1]; age range=18-85 years) between August and September, 2020. The face to face interview was conducted to collect data from 6 selected slum areas in Dhaka City using convenience sampling. The questionnaire consisted of informed consent along with questions concerning observational checklists, socio-demographics, and KAP.

Results

A sizeable minority were observed without wearing face masks during the survey periods (18.2%) and a vast portion (97.5%) without any hand protection. The mean scores of KAP were 6.1±2.6 (out of 17), 12.3±1.7 (out of 14), and 9.8±1.6 (out of 12), respectively. Moreover, the KAP were strongly and positively correlated with each other.

Conclusions

The findings revealed that the majority of slum dwellers in Bangladesh have limited knowledge of COVID-19. Poor practices (i.e., face mask and hand protection) were directly observed during the survey. The findings suggest the immediate implementation of health education programs and adequate interventions.

Geospatial modelling on the spread and dynamics of 154 day outbreak of the novel coronavirus (COVID-19) pandemic in Bangladesh towards vulnerability zoning and management approaches

The novel COVID-19 is a worldwide transmitted pandemic and has received global attention. Since there is no effective medication yet, to minimize and control the transmission of the COVID-19, non-pharmaceutical interventions (NPIs) are followed globally. However, for the implementation of needful NPIs through effective management strategies and planning, space–time-based information on the nature, magnitude, pattern of transmission, hotspots, the potential risk factors, vulnerability, and risk level of the pandemic are important. Hence, this study was an attempt to in-depth assess and analyze the COVID-19 outbreak and transmission dynamics through space and time in Bangladesh using 154 day real-time epidemiological data series. District-level data were analyzed for the geospatial analysis and modelling using GIS. Getis‐Ord Gi* statistics was applied for the hotspot analysis, and on the other hand, the analytical hierarchy process-based weighted sum method (AHP-WSM) was used for the modelling of vulnerability zoning of COVID-19. In Bangladesh, the status of the pandemic COVID-19 still is in exposure level. Disease transmitted at a high rate (20.37%), and doubling time of the cases were 11 days (latest week of the study period). The fatality rate was comparatively low (1.3%), and the recovery rate was about 57.50%. Geospatial analysis exhibits the disease propagates from the central parts, and Dhaka was the most exposed district followed by Chattogram, Narayanganj, Cumilla, and Bogra. A single strong clustering pattern in the central part, which spread out mainly to the south-eastern part, was identified as a prime hotspot in both the cases and deaths distributions. Additionally, potential linkages between the transmission of disease and the selected factors that gear up the spreading of the disease were identified. The central, eastern, and south-eastern parts were recognized as high vulnerable zone, and conversely, the western, south-western, north-western, and north-eastern parts as medium vulnerable zone. The vulnerable zoning exercise made it possible to identify vulnerable areas with the different magnitude that require urgent intervention through proper management and action plan, and accordingly, comprehensive management strategies were anticipated. Thus, this study will be a useful guide towards understanding the space–time-based investigations and vulnerable area delineation of the COVID-19 and assist to formulate an effective management action plan to reduce and control the disease propagation and impacts. By appropriate adjustment of some factors with local relevance, COVID-19 vulnerability zoning derived here can be applied to other regions, and generally can be used for any other infectious disease. This method was applied at a regional scale, but the availability of larger scale data of the determining factors could be applied in small areas too, and accordingly, management strategies can be formulated.

Psychological states of Bangladeshi people four months after the COVID-19 pandemic: An online survey

BACKGROUND

The COVID-19 pandemic essentially imposes psychological effects on people. As the pandemic progresses, people experience psychological trauma gradually, which can change over time. The present study aimed to assess the prevalence of depression, anxiety, and stress among Bangladeshi people four months after the COVID-19 outbreak.

METHODS

An online cross-sectional survey was conducted among Bangladeshi citizens aged ≥18 years from June 1 to June 10, 2020. The participants completed an online questionnaire examining socio-demographic variables and COVID-19 related factors, along with the Depression Anxiety and Stress Scale 21. A total of 1146 respondents have been included in the study. Data were analyzed using the Statistical Package for Social Sciences, IBM Statistics version 22.0.

RESULTS

The prevalence of moderate to the extremely severe levels of depression, anxiety, and stress was 47.2%, 46.0%, and 32.5%, respectively, with no significant gender differences. The prevalence of anxiety and stress was significantly higher in participants aged >30 than in participants aged 18-30 years. Daily follow up COVID-19 related news, having COVID-19 symptoms so far, having contact (direct or indirect) with COVID-19 infected person, and fear of infection were significantly associated with depression, anxiety, and stress.

CONCLUSIONS

Sizable proportions of participants had depression, anxiety and stress four months after the COVID-19 outbreak in Bangladesh. The findings of this study underscores the need for strategies aimed at reducing these psychological sufferings in Bangladeshi people in the context of COVID-19.

Best–Worst Method for Modelling Mobility Choice after COVID-19: Evidence from Italy

All countries have suffered from the COVID-19 crisis; the pandemic has adversely impacted all sectors. In this study, we examine the transport sector with a specific focus on the problem of commuting mode choice and propose a new decision-making approach for the alternative modes after synthesizing expert opinions. As a methodology, a customized model of the recently developed best–worst method (BWM) is used to evaluate mobility choice alternatives. The survey reflects citizens’ opinions toward mobility choices in two Italian cities, Palermo and Catania, before and during the pandemic. BWM is a useful tool for examining mobility choice in big cities. The adopted model is easy to apply and capable of providing effective solutions for sustainable mode choice. The urban context is analyzed considering the importance of transport choices, evaluating the variation of resilience to the changing opinions of users.

The COVID-19 pandemic and the public health challenges in Bangladesh: a commentary

Purpose

The purpose of this paper is to highlight the current pandemic situation of coronavirus disease 2019 (COVID-19) in Bangladesh, how the Government is managing this unprecedented condition and encountering these increasing public health challenges.

Design/methodology/approach

This paper is a viewpoint of the current COVID-19 pandemic situation in Bangladesh.

Findings

As one of the most densely populated countries, Bangladesh is vulnerable to COVID-19. Currently, the infection of COVID-19 is spreading fast and started to capture all the parts of Bangladesh. The Government of Bangladesh has already taken several preventive measures to overcome the pandemic such as declaring hotspots of COVID-19 and setting lockdowns, increasing mass awareness through social media and satellite TV channels. They are also encouraging private and community healthcare initiatives to increase hospital beds and COVID-19 treatment facilities. Besides, the Government has deployed defence force and additional health workers and increased public holidays to reduce the number of coronavirus infections. However, both the number of infected people and the death toll is rising, and there are growing challenges that the Government and public healthcare professions need to overcome.

Originality/value

This paper delivers information about the present developing situation of COVID-19 in Bangladesh, how the Government is handling and public health challenges that have raised. This paper can be helpful for the policymakers and Government officials for effective public health interventions.

Social Stigma as a Barrier to Covid-19 Responses to Community Well-Being in Bangladesh

This commentary looks at the social stigma as a barrier to Covid-19 responses to community well-being in Bangladesh. The Covid-19 in Bangladesh particular the way the people respond this has many dimensions to view from sociological perspective. The main objective of this commentary is to analysis how this response is related to social stigma. Gathering information from the recent literature, results showed that there are number of causes around such stigma that include misinformation, feeling of insecurity, fear of responsibility, administrative malfunction, and lack of trust on treatment. These causes of stigma have number of forms such as humor-prone stigma, residential stigma, organizational stigma, community-stigma, and apathetical stigma. Results also show that there are many effects of stigma such as health-risks, harassment, discrimination, life-insecurity, psychological disorder, loss of social capital and emotional capital, shattering family bond and social solidarity that work as barrier to community well-being. This commentary recommends to overcome the barriers through strengthening and decentralization of the COVID-19 medical facilities including testing, tracing, formal quarantining, and special treatment for coronavirus in coronavirus hospitals by allocating a large figure of the state budget and also by taking initiatives of public-private partnership for health management.

COVID-19: A perspective on Africa's capacity and response

Global powerhouses with tried and tested health systems have struggled to contain the COVID-19 pandemic. One is left to wonder what will be left of Africa, the second most populous continent after Asia, which is torn by civil wars, hunger, and diseases like AIDS and TB and, in recent years, the Ebola Virus Disease (EVD). The majority of countries' health systems, already dependent on donor aid, are ill-equipped and under-resourced to deal with the raging pandemic. There is a lack of isolation and intensive care infrastructure, ventilators, and financial resources to bankroll the fight against COVID-19 pandemic. However, there is some cause for optimism, for example, in West Africa where infrastructure like diagnostic testing facilities, intensive care units, surveillance, and systems for reporting emergencies used during the EVD outbreak of 2013-2016 can be leveraged to fight the COVID-19 pandemic. Further, a number of African countries have responded swiftly by activating the necessary political and financial tools to combat the pandemic. Technical support from continental bodies like the Africa Centers for Disease Control and global development partners has improved the capacity of the continent to handle the pandemic. In this article, the authors unpack, review, and share a perspective on Africa's capacity to contain and control the COVID-19 pandemic and review the current response.

COVID-19 Government Response Event Dataset (CoronaNet v.1.0)

Governments worldwide have implemented countless policies in response to the COVID-19 pandemic. We present an initial public release of a large hand-coded dataset of over 13,000 such policy announcements across more than 195 countries. The dataset is updated daily, with a 5-day lag for validity checking. We document policies across numerous dimensions, including the type of policy, national versus subnational enforcement, the specific human group and geographical region targeted by the policy, and the time frame within which each policy is implemented. We further analyse the dataset using a Bayesian measurement model, which shows the quick acceleration of the adoption of costly policies across countries beginning in mid-March 2020 through 24 May 2020. We believe that these data will be instrumental for helping policymakers and researchers assess, among other objectives, how effective different policies are in addressing the spread and health outcomes of COVID-19.

Detection of SARS-CoV-2 RNA in conjunctival swab of a COVID-19 patient: The first report from Bangladesh

Coronavirus disease-19 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 RNA (SARS-CoV-2 RNA). It usually manifests by fever and/or respiratory illness. Here, we present a case of COVID-19 patient who initially presented ocular symptoms like redness, itching, and watery discharge. Afterward, the patient developed fever and anosmia suggestive of COVID-19 disease. Nasopharyngeal swab and conjunctival swab test for SARS-CoV-2 RNA revealed positive by reverse-transcriptase real-time polymerase chain reaction. The patient was managed symptomatically at home and did not require any hospital admission. On day 12, the patient clinically recovered fully and his follow-up testing for SARS-CoV-2 RNA of both conjunctival swab and nasopharyngeal swab became undetected. This report emphasized that conjunctival mucosa may be considered as a portal of entrance for SARS-CoV-2 RNA in addition to the respiratory route. This study highlighted that any kind of ocular manifestations, such as conjunctival hyperemia, chemosis, watery discharge, periorbital erythema, and burning sensation should never be overlooked for probable COVID-19 in current pandemic settings. Moreover, strict eye protection using goggles/face shield should be used by all health care workers despite any working environment while caring for patients with or without COVID-19-related signs.

Identifying the Associated Risk Factors of Sleep Disturbance During the COVID-19 Lockdown in Bangladesh: A Web-Based Survey

BACKGROUND

Bangladesh, a developing country with a lower-middle-income and one of the world's most densely populated areas, has been severely affected by COVID-19. This global epidemic is not only affecting the physical health of the patients but also causing severe psychological effects among those who have not yet been infected. Sleep disturbance is one of the key symptoms of major depression and one of the proven risk factors for suicide. The objective of this study is to identify the risk factors associated with sleep disturbance which has developed as a general impact of COVID-19 and new normal life during the lockdown (a measure to control the spread of COVID-19) in Bangladesh.

METHODS

Demographic characteristics, COVID-19, and lockdown related information have been collected from 1,128 individuals by conducting a web-based survey. Respondent's perspective regarding sleep disturbance during COVID-19 lockdown is considered as the outcome of interest which is dichotomous. Descriptive statistics methods have been applied to explore the distribution of respondent's demographic characteristics. Pearson's chi-square tests have been performed to relate the sleep disturbance status of the respondents to their demographic, personal, and COVID-19 related information. Furthermore, a multivariable logistic regression model has been adopted to identify the significant association of sleep disturbance with the demographic, COVID-19, and lockdown related information of respondents during the COVID-19 lockdown in Bangladesh.

FINDINGS

The prevalence of sleep disturbance during the COVID-19 lockdown is found to be higher among participants aged 31-40 years. Gender disparity has also been observed in favor of male participants, whereas no significant regional heterogeneity has been found. Working from home or doing online classes during the lockdown has been found as a potential predictive factor of sleep disturbance. Losing a job has been considered as an adverse economic effect of COVID-19, which also induces sleep disturbance. Perception regarding the risk of getting infected and anxiety triggered the chance of developing sleep disturbance. The sleeping schedule is also found as a risk factor for sleep disturbance.

CONCLUSION

Evidence-based policies are required to combat psychological challenges that have arisen due to COVID-19, primarily targeting the groups who are largely suffering from sleep disturbance.