Insights into the first wave of the COVID-19 pandemic in Bangladesh: Lessons learned from a high-risk country

Siam, M. H. B.; Hasan, M. M.; Raheem, E.; Khan, M. H. r.; Siddiqee, M. H.; Hossain, M. S.

Background South Asian countries including Bangladesh have been struggling to control the COVID-19 pandemic despite imposing months of lockdown and other public health measures (as of June 30, 2020). In-depth epidemiological information from these countries is lacking. From the perspective of Bangladesh, this study aims to understand the epidemiological features and gaps in public health preparedness. Method This study used publicly available data (8 March-30 June 2020) from the respective health departments of Bangladesh and Johns Hopkins University Coronavirus Resource Centre. Descriptive statistics was used to report the incidence, case fatality rates (CFR), and trend analysis. Spatial distribution maps were created using ArcGIS Desktop. Infection dynamics were analyzed via SIR models. Findings In 66 days of nationwide lockdown and other public health efforts, a total of 47,153 cases and 650 deaths were reported. However, the incidence was increased by around 50% within a week after relaxing the lockdown. Males were disproportionately affected in terms of infections (71%) and deaths (77%) than females. The CFR for males was higher than females (1.38% vs 1.01%). Over 50% of infected cases were reported among young adults (20-40-year age group). Geospatial analysis between 7 June 2020 and 20 June 2020 showed that the incidences increased 4 to 10-fold in 12 administrative districts while it decreased in the epicenter. As compared to the EU and USA, trends of the cumulative incidence were slower in South Asia with lower mortality. Conclusion Our findings on gaps in public health preparedness and epidemiological characteristics would contribute to facilitating better public health decisions for managing current and future pandemics like COVID-19 in the settings of developing countries.