Tag: Testing

Bangladesh’s citizens struggle with getting medical care for COVID

As of July 14th, Bangladesh has registered about 190,057 COVID-19 cases and 2,424 deaths. Medical experts say that the real numbers are likely higher because of the lack of testing going on. Though there are roughly 3,000 new cases accumulating each day, hospitals have many empty beds, as citizens are scared to enter hospitals.

In the capital Dhaka, roughly 4,800 of the 6,300 beds set aside for COVID patients are not being used, and there are only 100 patients in a new 2,000-bed field hospital built for the pandemic. In Chittagong, authorities say only half of its dedicated beds are currently filled. According to the health department, the beds aren’t being used because many people are being treated at home. “Most of the patients have mild symptoms. Adequate telemedicine services are available. That may be the reason for empty beds in hospitals,” Nasima Sultana, health department deputy head asserted.

An official for a medical charity has told of the patients hesitations, stating that many have said they’d “rather die at home than die in a hospital.” A survey of 80,000 people carried out with the UN found that 44% of Bangladeshis were “too scared” to even use the government’s COVID helpline. The fear stems from the country’s hospitals not being “patient-friendly.” Rashid e Mahbub, head of the Bangladesh Health Rights Movement spoke on the issue further, “A negative perception have been treated, and that is promoting many patients to stay at home. Few people can afford the expensive private hospitals. […] A significant number of COVID-19 patients are dying at home.”

“We heard the doctors and nurses don’t come near patients for fear of being infected,” an anonymous woman stated. The hospitals had poor reputations before the pandemic, and thousands of wealthier citizens went to Thailand or Singapore for check-ups instead. With borders closed, they are unable to do that. Patients die at home without being followed up by doctors from the Directorate General of Health Services (DGHS).

Virologist Nazrul Islam said that the questionable patient management system of the DGHS was resulting in the at-home deaths and the patients staying at home were not being followed up with and not declared recovered on confirmatory tests. He believes that the flawed management will prolong the stay of the virus.

Author: Camryn Thomas

Taiwan’s successful approach to COVID

The world has recognized Taiwan for its effective response to the COVID outbreak. Taiwan has had a total of 446 cases and only 7 deaths as of June 20th, and has eased social distancing restrictions. Restrictions on the total number of people allowed at social gatherings and socially distanced seating arrangements have been removed. Wearing masks in public will still be required, but eating will be allowed in most instances.

Similar to Vietnam, Taiwan focused heavily on the systematic use of its digital health infrastructure after the SARS outbreak in 2003. They used effective testing, isolation, and contact tracing to control the viral spread, and with their electronic health records, they were able to reorient toward slowing the pandemic.

Every person in Taiwan has a health card with an ID unique to them so that doctors and hospitals can access online medical records. Health providers use the cards to document care for reimbursement from the Ministry of Health, which allows the ministry regular, real-time data on visits and use of services. The health card was repurposed when COVID-19 hit to stop the spread by sending physicians alerts about patients at higher risk based on travel history. This utilization allowed for better identification of candidates for testing when supplies were limited. No other society has such an effective real-time electronic heath record system, and this is one of the main attributes of Taiwan’s success, leading to the current opening.

Taiwan has allowed masks to be purchased on the free market, after they were rationed since January when the military was tasked by the government to create them. Taiwan has since exceeded 20 million in production. Many of these masks are being donated to other countries to help their fight against the virus. Whether or not the rest of the world will learn from Taiwan’s success can only be determined by the future, but in the meantime, Taiwan’s aid during this crisis has not gone unnoticed.

Author: Camryn Thomas

Vietnam’s Containment of COVID-19

Despite Vietnam being regarded as “highly vulnerable” to the COVID-19 pandemic because it shares a border with China, it was among the first to lift virtually all domestic containment measures due to a lack of cases. Vietnam used a cost-effective containment strategy resulting in having only 352 confirmed cases and zero deaths over the course of the COVID-19 pandemic, in a population over near 100 million people.

Many wonder about the country’s success, and it can be attributed to their experience with previous outbreaks like SARS in 2003. The Prime Minister prioritized health over economic concerns, and the strategy was successfully deployed with the help of the military, public security services, and grass-root organizations. Through the country was not immune to the economic impact of COVID-19, it is expected to be milder than most countries in the region, as lockdown measures have already been lifted, allowing for businesses to resume operations.

When the World Health Organization (WHO) received reports from China back in December 2019 of “several cases of an unusual pneumonia,” Vietnam finalized a health risk assessment. “Vietnam responded to this outbreak early and proactively. Its first risk assessment exercise was conducted in early January – soon after cases in China started being reported,” Kidong Park, the WHO’s representative to Vietnam said. By the end of January, the Ministry of Health had issued outbreak prevention and detection guidance, and the country issued its National Response Plan and established a National Steering Committee on Epidemic Prevention. Strict containment measures like airport health screenings, physical distancing, travel bans on foreign visitors, public event cancellations, and a 14-day quarantine period for international arrivals were gradually adopted. Schools have been closed since January. The shutdown on non-essential services and strict restrictions of movements were imposed nationwide for three weeks in early April.

Wearing masks in public is strictly enforced, violators could face 9-month prison sentences for violations. Those not wearing a face masks who are found to have infected another person could face up to 12 years in prison.

Many countries with advanced economies around the world adopted mass-testing strategies, while Vietnam focused on high-risk and suspected cases, conducting only 350,000 tests (less than 1 percent of its population). The confirmed tests had a 1 in 35 ratio, the highest in the world, and as a result, the country used extensive contact tracing, and isolation and quarantining for up to third-tier contacts. To help limit transmission, the groups who lived near confirmed cases were tested and isolated swiftly, and would sometimes include entire villages and neighborhoods. Nearly half a million people were subject to vigorous quarantining either at home, or in state-run facilities and hospitals; those who were in hospital care got treatment and quarantine free of charge.  This early containment and use of already existing public and military facilities proved to be cost effective.

Author: Camryn Thomas

Preparation for the second wave

Since the virus’ first appearance in China late last year, over 8 million people have been infected, and almost 450 thousand have died due to the virus around the world. While some countries have had fewer cases over the course of their lockdown, experts are warning about the imminent possibility of a second wave. Countries across East Asia are trying to stave off a bloom in case numbers.

Fukuoka, a major city in Japan, reported no new cases from the end of April to May 22nd, but since then the city has reported 119 cases from May 25th to June 2nd, putting the city on the front line of the country’s second wave of infections. In Tokyo, 34 new cases were recorded on June 2nd, which is the first time the daily number of infections have risen above 30 since May 14th. These small surges in case were anticipated, and while there is no imminent state of emergency, “the bottom line is that we must quickly move to respond to the situation and to avoid the further spread of the disease by identifying the chains of transmission,” according to Dr. Shigeru Omi.

Recently in Beijing, there have been 27 new infections, many of which were linked back to a wholesale food market (Xinfadi in the Fentai district). This discovery has sparked mass testing and surrounding neighborhood lockdowns. The number has since spiked to 106 confirmed infections. “The epidemic situation in the capital is extremely severe,” said Beijing city spokesman Xu Hejian.

South Korea’s health authorities also report being in the midst of a “second wave” around Seoul because of the small, persistent outbreaks taking place in May, and while the Korea Centers for Disease Control and Prevention (KCDC) has said that South Korea’s first wave hadn’t really ended, KCDC director Jeong Eun-kyeong has said that the holiday weekend in early May marked the beginning of a new wave of infections. “In the metropolitan area, we believe that the first wave was from March to April as well as February to March,” Jeong said, “then we see that the second wave which was triggered by the May holiday has been going on.”

In February, South Korea reported a peak of over 900 cases a day, and ever since, intensive tracking and testing reduced the case numbers to single digits by late April. In early May, however, with the celebration over holiday weekend in Seoul and eased social distancing guidelines, new cases spiked, pushing forward the anticipated second-wave.

Author: Camryn Thomas

South Korea’s response to COVID-19, with Prof. Ji-Yeon Jo

The Carolina Asia Center’s director, Prof. Ji-Yeon Jo, was interviewed by the department chair of Asia and Middle East Studies, Prof. Morgan Pitelka (also a former CAC director) about the way that South Korea has managed its response to the novel coronavirus pandemic. This video interview comes from the DAMES series “Forty for Forty.”

Japan’s Preparation for Second Wave

Public officials and private companies across Japan are working on ways to prepare for a second wave of coronavirus infections. Currently, there have been over 17,000 people who have tested positive, and over 900 people have died in the country.

This preparation includes the addition of another 18 countries to Japan’s entry ban list, expanding the list from 111 to 129. While Japan adds countries such as Cuba and Lebanon, they consider easing the entry ban for Thailand, Australia, and another two nations.

The country tries to boost testing numbers as companies work together to speed up the manufacturing process for test kits. Fujirebio, along with two major electronics firms, will help expand capacity to create its nation tests. These kits can identify an infection much faster than PCR tests, with results in around 30 minutes. Toshiba will provide assistance and space to make the kits, while Hitachi will help make the process more efficient.

Japanese lawmakers will soon begin debating a new supplementary budget this week to support the government’s fight against coronavirus of which will include a reserve fund worth $91.5 billion. Half of this proposed money would go toward protecting jobs, supporting people in need, and helping local governments boost their medical systems, but there is opposition as some lawmakers feel that the government shouldn’t be given such a large “blank check.”

Japan’s Prime Minister Abe Shinzo has pledged $300 million to help an international organization develop a vaccine. This is an additional $200 million from last month’s pledge. Abe has said, “The development of vaccines is in progress, collecting all the wisdom of humans […] we need to be well prepared to deliver them speedily to developing countries once they become available.”

Japan’s health ministry has laid out a plan designed to shorten the time needed to put coronavirus vaccines into practical use and speed up the process by simultaneously promoting both research and development and its production.

The health ministry has earmarked about $455 million, as subsidies to institutions involved in vaccine development in the proposed second supplementary budget for the fiscal year, and also about $1.3 billion in the extra budget to encourage private companies to invest in production facilities.

It normally takes a few years to develop and mass produce a vaccine, but the ministry’s officials say the hope to reduce the time substantially, and to start vaccinating the public in the first half of next year.

Author: Camryn Thomas