10 August 2020

Morbidity and Mortality

Weekly Update (MMWU) No24
https://www.who.int/bangladesh/emergencies/coronavirus-disease-(covid-19)-update/

Photo Credit: Social Media, Bangladesh

Recovered Dead
In this issue of COVID-19 Tested Confirmed Recovered Dead Hotline
Morbidity and Mortality Weekly
Update (MMWU) No 23 (04-10
August 2020):

 dashboard with key figures;

1,273,168 260,507 150,437 3,438 18.5 million
 detailed epidemiological
update on COVID-19 pandemic
in Bangladesh; Test/1 million New Cases Recovery Rate IFR% AR/1 million
 daily and weekly distribution of
COVID-19 cases and related 7,475 2,907 57.7% 1.32% 1,529
deaths;
 growth factor of daily COVID- Laboratories PPE Stock PoE Screening
19 cases
 daily distribution of COVID-19 1,045,621 413,314
cases and rolling three-days 85 COVID-19 Labs
average per division;
 gender and age distribution of
COVID-19 deaths by division:
overall and cumulative weekly

attack rate and per division;
Last days 3,302,560 31,746
 death and recovery rates of 71,024 Samples
closed cases;
 number of COVID-19 testing 60.0%
laboratories and number of Inside Dhaka
daily tested per 1,000,000; Tests 136,707 7,029
 Geographical distribution cases
and deaths; and
 comparison data with selected 20.5%
countries in South East Asia. Positive Tests 1,093,291 360,140
WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

1. Highlights

As of 10 August 2020, according to the Institute of Epidemiology, Disease Control and Research (IEDCR), there
are 260,507 confirmed COVID-19 cases1 in Bangladesh, including 3,438 related deaths; Infection Fatality Ratio
(IFR) is 1.32%.

On 03 August 2020, the Cabinet Division Field Administration issued a circular No. 04.00.0000.514.16.002.20.140
regarding the extension of the period of restrictions on overall activities/movement until 31 August 2020 to
prevent the spread of Coronavirus disease COVID-19: the Government has decided to impose control on the overall
activities of the country and the movement of public, subject to the following conditions: while outside of home, wearing
facemask, keeping social distancing and maintaining health guidelines must be ensured, the violators will face legal
actions; the restriction will continue from 4 to 31 August 2020, including weekly holidays; highly infe cted areas should
be controlled as per the “COVID-19 Infection Risk Zone Based Control System Implementation Strategy/Guide” prepared
by the Health Services Division; and District and Upazila administrations including Local Government Division, Ministry
of Information, Ministry of Religious Affairs, Health Service Division will implement massive campaign and public
awareness activities to prevent the spread of COVID-19. Full document is available on: www.cabinet.gov.bd.

2. Coordination

On 04 August 2020, WHO published a scientific brief on Estimating mortality of COVID-19. An important characteristic
of an infectious disease, particularly one caused by a novel pathogen like SARS-CoV-2, is its severity, the ultimate
measure of which is its ability to cause death. Fatality rates help us understand the severity of a disease, identify at -risk
populations, and evaluate quality of healthcare. The brief identified two measures to be used to assess the proportion
of infected individuals with fatal outcomes: the first is Infection Fatality Ratio (IFR), which estimates this proportion of
deaths among all infected individuals and the second is Case Fatality Ratio (CFR), which estimates this proportion of
deaths among identified confirmed cases. Differences in mortality between groups of people and countries are
important proxy indicators of relative risk of death that guide policy decisions regarding scarce medical resource
allocation during the ongoing COVID-19 pandemic. This brief is intended to help countries estimate CFR and, if possible,
IFR, as appropriately and accurately as possible, while accounting for possible biases in their estimation. Full document:
https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci-Brief-Mortality-2020.1.

On 06 August 2020, WHO published information on the COVAX facility global procurement for COVID-19 vaccines.
The Facility will have access to doses of vaccine candidates through agreements that Gavi will conclude with vaccine
manufacturers on behalf of the Facility. The Facility aims to procure 2 billion doses by the end of 202. Gavi on behalf of
the COVAX Facility will: Provide manufacturer-specific contingent volume guarantees to procure vaccines that meet
WHO’s Target Product Profile to de-risk and incentivise timely investment in expansion of manufacturing capacity and
Offer a market-wide demand guarantee, which could provide continued incentives and assurances to manufacturers to
expand production capacity and to bring products to market faster and at greater quantities. Full document:
https://www.who.int/publications/m/item/the-covax-facility.

On 07 August 2020, WHO published interim guidance on Public health surveillance for COVID-19. This document
summarizes current WHO guidance for public health surveillance of coronavirus disease 2019 (COVI D-19) in humans
caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The guidance includes: revision
of suspected and probable case definitions to integrate increased knowledge on the clinical spectrum of COVID -19 signs
and symptoms and consider situations where testing is not available to all; updated approaches to surveillance including
environmental and serological surveillance for SARS-CoV-2; revision of variables included in weekly surveillance to fit
with new case definition and objectives of surveillance (that is, inclusion of probable cases, health care workers cases
and updated age groups for reporting cases and deaths); information on the importance of the collection of metadata
for the analysis and interpretation of surveillance data; and recommendations for ending case-based reporting for global
surveillance and replacing it with aggregate reporting. Full document: https://www.who.int/publications/i/item/who-
2019-nCoV-surveillanceguidance-2020.7.

1
WHO Bangladesh COVID-19 Situation Reports present official counts of confirmed COVID-19 as announced by the IEDCR on the
indicated date. Difference in data between the WHO reports and other sources can result from using different cutoff times for the
aggregation and reporting of the total number of new cases in the country.

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WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

3. Surveillance and Laboratory

Between 8 March and 10 August 2020, according to the Institute of Epidemiology, Disease Control and Research (IEDCR)
there were two-hundred-sixty-thousand-five hundred-seven (260,507) COVID-19 confirmed by rt-PCR, including three-
thousand-four-hundred-thirty-eight (3,438): Infection Fatality Ratio (IFR2 1.32%).

In the reported week (epidemiological week 32), in comparison to the previous epidemiological week, the number of
new weekly COVID-19 cases decreased by 2.5% (16,854 and 17,293 respectively) while the number of COVID-19 new
weekly deaths increased by 8.4% (245 in week 32 vs and 226 in the previous week).

The figures below are showing the daily and weekly distribution of reported confirmed COVID-19 cases and
deaths, 08 March – 10 August 2020, Bangladesh.

4,500 100
Number of Cases (N=260,507)

# Cases # Deaths
Poly. ( # Cases ) Poly. ( # Deaths ) 80
3,000

60

1,500
40

0 20

Number of Deaths (n=3,438)

15/03

22/03

19/04

26/04

24/05

21/06

28/06

26/07
08/03

29/03

05/04

12/04

03/05

10/05

17/05

31/05

07/06

14/06

05/07

12/07

19/07

02/08

09/08
0
-1,500

20

-3,000
40

-4,500 60

30,000 350

Weekly Cases Weekly Deaths

300
25,000

250
20,000
Weekly Deaths
Weekly Cases

200
15,000
150

10,000
100

5,000
24,786
25,481
24,630
21,378
20,730
18,928
17,293
16,854
11,342
13,543
18,616
21,751

50
7,611

0 0
w10

w25
w26
w27
w28
w29
w30
w31
w32
w11
w12
w13
w14
w15
w16
w17
w18
w19
w20
w21
w22
w23
w24

2
Infection fatality ratio (IFR) is the proportion of individuals diagnosed with a disease who die from that disease and is therefore a measure of severity
among detected cases, Estimating mortality from COVID-19, WHO scientific brief, 4 August 2020. https://www.who.int/publications/i/item/WHO -20 19-
nCoV-Sci-Brief-Mortality-2020.

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WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

The map below is showing the geographical distribution of reported confirmed COVID-19 cases, number of
COVID-19 tests and Attack Rate (AR), 08 March – 10 August 2020, Bangladesh.

4|Pa g e
WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

Out of the total 260,507 COVID-19 cases registered as of 10 August 2020, 57.75% (150,437) - recovered, 1.32% (3,438)
- died and 40.93% (106,632) are active cases.

The figure below is showing active vs recovered confirmed COVID-19 cases outcomes per epidemiological week,
08 March – 10 August, Bangladesh.

Epi Week
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
0T
Active cases N = 106,632

Thousands
140 T
10 T

20 T 120 T

30 T
100 T
40 T
80 T
50 T

60 T 60 T

70 T
40 T
80 T
20 T
90 T
Recovered N = 150,437
100 T 0T

In the epidemiological week 32, the number of COVID-19 active cases increased by 3.7%, in comparison to the previous
week (102,954 and 99,243) and at the same time, the number of recovered COVID-19 cases decreased by 11.0%
(11,531 and 12,240 respectively).

The figure below is showing the weekly outcomes of the reported confirmed COVID-19 cases, 08 March – 10
August 2020, Bangladesh.

Weekly Recovery

100000 Weekly Avg. Active

102,954
99,243
94,105
88,851

87,300
85,357
73,775
60,400

60,349

Weekly Deaths
44,702
31,736
22,470

10000
14,900
10,196
7,337
3,972

1000
1,471
281

100
315

310
300
274

266
292

245
283

226
238
29

170
27

152

10
100
57

54

51
12

32

10,650

16,898

20,989

18,028

12,240

12,957

11,531
25

26,347
1471
2725

2528

2880

4122

4823
48
12

14

37

55
4
1

3
1

9
1

1
w11

w14

w19

w22

w24

w27

w30

w32
w10

w12
w13

w15
w16
w17
w18

w20
w21

w23

w25
w26

w28
w29

w31

As of 10 August 2020, there were 153,875 (59.1%) COVID-19 cases with known outcome (i.e. closed cases). Out of all
closed cases, 97.8% (150,437/153,875) were cured and 2.20% (3,438) died. The recovery rate of about 97% in the

5|Pa g e
WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

closed cases as not shown change since 16 June 2020. The Case Fatality Rate (CFR)3 in the closed cases in Bangladesh
is lower than the 5.38% (734,490/13,648,785) global average as of 10 August 2020.

The figure below is showing the death and recovery rates over cumulative closed confirmed COVID -19 cases, 08
March – 10 August 2020, Bangladesh.

CFR Recovery%
100%
Number of Closed Cases (n=153,875)

80%

60%

40%

20%

0%
13/03
18/03
23/03

22/04
27/04

27/05
01/06

01/07
06/07
11/07

10/08
08/03

28/03
02/04
07/04
12/04
17/04

02/05
07/05
12/05
17/05
22/05

06/06
11/06
16/06
21/06
26/06

16/07
21/07
26/07
31/07
05/08
As of 10 August 2020, 26.9% cases were confirmed in people between 31 and 40 years old, 20.7% - in the age group
of 21 to 30, 18.8% - 41 to 50 years and 15.0% in the age group between 51 and 60 years old. The highest death rate
(30.7%) was reported in the age group of 61 to 70 years old, 25.6% in the older age group of 71 and above and 24.2%
- in the age group between 51 and 60 years. Male represented 72% and 79% of the of total reported confirmed COVID-
19 cases and deaths respectively.

The figure below is showing geographical and age-sex distribution of the reported confirmed COVID-19 deaths,
10 August 2020, Bangladesh.

Dhaka 1,586 (47%) 5.2% 1.5% > 80

Chattogram 830 (27%) 15.9% 3.0% 71 - 80

24.4% 6.3% 61 - 70
Khulna 263 (8%)
19.8% 4.4% 51 - 60
Rajshahi 211 (6%)
8.2% 2.1% 41 - 50
Sylhet 158 (5%)
4.0% 1.7% 31 - 40
Rangpur 138 (4%)
1.1% 1.0% 21 - 30

Barishal 137 (4%) 0.4% 11 - 20

0.5%

Mymensingh 76 (2%) N = 3,399 79% 0.1% 0.3% 0 - 10

21%
- 200 400 600 800 1,000 1,200 1,400 800 600 400 200 200 400

3
Number of deaths from disease/ (number of deaths from the disease + number of recovered from the disease X100: Estimating mortality from
COVID-19, WHO scientific brief, 4 August 2020. https://www.who.int/publications/i/item/WHO -2019-nCoV-Sci-Br ief-Mortality-2020.WHO.

6|Pa g e
WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

As of 10 August 2020, geographical distribution of confirmed reported COVID-19 cases was available on 100% of cases
(242,102/242,102). Of all cases, 64.7% reported from Dhaka division, 14.4% from Chattogram, 5.5% - from Rajshahi,
5.1% - from Khulna, 3.2% - from Sylhet, 2.7% - from Rangpur, 2.5% from Barishal and the lowest 1.9% from -
Mymensingh division.

The figure below is showing the daily distribution of reported confirmed COVID-19 cases per division, 12 April –
10 August 2020.

4,500
Dhaka Chattogram Mymensingh Rangpur Sylhet Rajshahi Khulna Barishal
4,000

3,500

3,000
Number of Cases

2,500

2,000

1,500

1,000

500

0
19/06

27/06

05/07

13/07

21/07

29/07

06/08
12/04
16/04
20/04
24/04
28/04
02/05
06/05
10/05
14/05
18/05
22/05
26/05
30/05
03/06
07/06
11/06
15/06

23/06

01/07

09/07

17/07

25/07

02/08

10/08
Available data allows to see how quickly the number of confirmed cases increased in different divisions in Bangladesh
by looking at the case doubling time in each division. As of 10 August 2020, case doubling time is 12.5 days in Dhaka
division, 15 days in Chattogram and Khulna, between 16 to 20 days in Rajshahi, Sylhet and Barisal divisions and
more than 20 days in for Mymensingh and Rangpur divisions.

The figure below is showing the case-doubling time of COVID-19 confirmed cases in all divisions starting from
the day each reported 500th confirmed cases, 10 August 2020, Bangladesh.

500,000
D1 D2 D3 D4 D5 D6 D7 D8 D9 D10

BSL CTG DHK KLN D12

MYM RSH RNP SYT

50,000 D15
Number of Cases

D20

5,000 D30

D50

500
0 10 20 30 40 50 60 70 80 90 100
Days since 500th Confirm Case

7|Pa g e
WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

Case doubling time is 13.5 days in Dhaka city, 18.5 days in Faridpur district, between 20-30 days in, Narayanganj,
Gazipur and Dhaka districts and more that 30 days in Munshiganj and Kishoreganj districts.

The figure below is showing the growth of COVID-19 confirmed cases in all districts of Dhaka division starting
from the day each reported 500th confirmed cases, 10 August 2020, Bangladesh.

500,000
D1 D2 D3 D4 D5 D6 D7 D8 D9 D10
Dhaka City Narayanganj
D12
Faridpur Gazipur
Dhaka District Munshiganj
50,000 D15
Kishoreganj
Number of Cases

D20

5,000
D30

D50

500
0 10 20 30 40 50 60 70 80 90 100
Days since 500th Confirm Case

In the epidemiological week 32, case doubling time Chattogram district is 18.0 days (2.0 days less than in comparison
with the previous epidemiological week 31); between 20-30 days in Cumilla, Noakhali, Cox’s Bazar, Feni and
Rangamati districts and Lakshmipur districts it is more than 30 days.

The figure below is showing the growth of COVID-19 confirmed cases in all districts of Chattogram division
starting from the day each reported 100th confirmed cases, 10 August 2020, Bangladesh.

50,000
D1 D2 D3 D4 D5 D6 D7 D8 D9 D10 D12 D15
Chattogram Cumilla
Cox's Bazar Noakhali
Brahmanbaria Chandpur D20
Lakshmipur
Number of Cases

5,000 D30

D50

500
0 10 20 30 40 50 60 70 80 90 100
Days since 500th Confirm Case

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 1,000
1,200
1,800
2,400
3,000

160
240
320
400
400
600
600

200
800

80

0
100
200
300
500

400
0
0

0
14/04 14/04 14/04 14/04
17/04 17/04 17/04
19/04 20/04 20/04 20/04
23/04 23/04 23/04

14%

6%

6%
64%
24/04
26/04 26/04 26/04
29/04 29/04 29/04

Khulna
29/04

Rajshahi
02/05 02/05 02/05
Dhaka

04/05 05/05 05/05 05/05

08/05 08/05 08/05
09/05 11/05 11/05 11/05

Chattogram
14/05 14/05 14/05
14/05
17/05 17/05 17/05
20/05 20/05 20/05
19/05
23/05 23/05 23/05
24/05 26/05 26/05 26/05
29/05 29/05 29/05
29/05 01/06 01/06 01/06
04/06 04/06 04/06

3 per. Mov. Avg. (Khulna)

03/06 07/06 07/06 07/06

3 per. Mov. Avg. (Rajshahi)

10/06 10/06 10/06
08/06

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13/06 13/06 13/06
3 per. Mov. Avg. (Dhaka)

13/06 16/06 16/06 16/06

19/06 19/06 19/06
18/06 22/06 22/06 22/06
days average per division, 14 April – 10 August July 2020, Bangladesh.

25/06 25/06 25/06

WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU)

23/06 28/06 28/06 28/06

Poly. (Khulna)
3 per. Mov. Avg. (Chattogram)

01/07 01/07 01/07

28/06
04/07 04/07 04/07

Poly. (Rajshahi)
07/07 07/07 07/07
03/07
10/07 10/07 10/07
08/07 13/07 13/07 13/07
16/07 16/07 16/07
13/07 19/07 19/07 19/07
22/07 22/07 22/07
18/07 25/07 25/07 25/07
28/07 28/07 28/07
23/07
31/07 31/07 31/07
28/07 03/08 03/08 03/08
06/08 06/08 06/08
02/08 09/08 09/08 09/08
10 August 2020/Vol. No24

The figures below are showing the daily distribution of reported confirmed COVID-19 cases and rolling three-
 150
200

100
250

120
150
50

30
90
160
200
100
150
200
250

60
120
0

0
40
80
50

0
0
14/04 14/04 14/04 14/04
17/04 17/04 17/04 17/04
20/04 20/04 20/04 20/04
23/04 23/04 23/04 23/04
3%

2%
3%

2%
26/04 26/04 26/04 26/04
Sylhet

29/04 29/04 29/04 29/04

Rangpur
02/05 02/05 02/05 02/05
05/05 05/05 05/05 05/05

Barishal
Mymensingh
08/05 08/05 08/05 08/05
11/05 11/05 11/05 11/05
14/05 14/05 14/05 14/05
17/05 17/05 17/05 17/05
20/05 20/05 20/05 20/05
23/05 23/05 23/05 23/05
26/05 26/05 26/05 26/05
29/05 29/05 29/05 29/05
01/06 01/06 01/06 01/06
3 per. Mov. Avg. (Sylhet)

04/06 04/06 04/06 04/06

3 per. Mov. Avg. (Rangpur)

07/06 07/06 07/06 07/06

10/06 10/06 10/06 10/06

10 | P a g e
13/06 13/06 13/06 13/06
16/06 16/06 16/06 16/06

3 per. Mov. Avg. (Mymensingh)

3 per. Mov. Avg. (Barishal)

19/06 19/06 19/06 19/06
22/06 22/06 22/06 22/06
Poly. (Sylhet)

25/06 25/06 25/06 25/06

WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU)

28/06 28/06 28/06 28/06

Poly. (Rangpur)

01/07 01/07 01/07 01/07

04/07 04/07 04/07 04/07
07/07 07/07 07/07 07/07
10/07 10/07 10/07 10/07
13/07 13/07 13/07 13/07
16/07 16/07 16/07 16/07
Poly. (Mymensingh)
19/07 19/07 19/07 19/07
22/07 22/07 22/07 22/07
25/07 25/07 25/07 25/07
28/07 28/07 28/07 28/07
31/07 31/07 31/07 31/07
03/08 03/08 03/08 03/08
06/08 06/08 06/08 06/08
09/08 09/08 09/08 09/08
10 August 2020/Vol. No24
WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

On 10 Augusts 2020, Bangladesh overall attack rate (AR) is 1,529.6 per 1 million and 100% (64/64) of districts with the
total population of 170,306,468 people have reported confirmed COVID-19 cases. In the reported week (epidemiological
week 32), COVID-19 weekly AR increased by 7.0% in comparison to the previous week (1,513 and 1,414 respectively).

The figure below is showing the weekly COVID-19 attack rate (AR) per 1,000,000, 08 March – 10 August 2020,
Bangladesh.

1,600

1,513
1,414
Weekly Attack Rate per Million

1,312
1,200

1,201
1,079
954
800

809
659
514
400

386
277
0.01
0.02

131

197
0.1

0.3

14
32

56
86
1

0
w10
w11

w16
w17

w18

w24

w25
w26

w31
w32
w12

w13

w14

w15

w19

w20

w21

w22

w23

w27

w28

w29

w30
According to the available data as on 10 August 2020, the highest AR continues to be observed in the Dhaka division
(3,891.2/1,000,000). Within the Dhaka division, Dhaka city has the highest AR (15,904.7/1,000,000) followed by
Faridpur (2,365), Narayanganj (1,730.5), Munshiganj (1,668.6), Gopalganj (1,332.4), Rajbari (1,286.7), Gazipur
(1,088.1), Shariatpur (916.9), Madaripur (897.3), Dhaka District (690.2), Narsingdi (685.4), Kishoreganj (624.5),
Manikganj (550.2) and the lowest AR 438.7 was reported from Tangail district.

The 2nd highest COVID-19 AR is reported from Chattogram division (1,102.4/1,000,000), the AR in all the 11 districts is
over 600 per million. Within the division, Chattogram district reported the highest AR (1,690.6/1,000,000) followed by
Cox's Bazar (1,322.6), Bandarban (1,304.6), Rangamati (982.1), Noakhali (973.1), Cumilla (921.1), Feni (839.1),
Khagrachhari (772.9), Lakshmipur (769.4), Chandpur (674.2) and the lowest AR 602.4 was reported from
Brahmanbaria district.

The 3rd highest AR in the country was reported from Khulna division 766.9/1,000,00 while the highest AR district is
Magura (1,432) followed by Jhenaidah (1,409.6/1,000,000), Meherpur (882.7), Khulna (870), Narail (761.8), Satkhira
(750), Chuadanga (710.9), Jashore (503.6), Bagerhat (484.2) and the lowest 346.3 in Kushtia district.

Sylhet division has taken the fourth highest in the overall AR with (715.4/1,000,000) with the highest AR in Sylhet district
(1,101.4/100,0000) followed by Sunamganj (543.2), Habiganj (504.5) and 475.5 in Maulvibazar district. Rajshahi
division has overall AR 659.9/1,000,000 with the highest AR in Bogura district (1,322.8/1000000), followed by Rajshahi
(1,184.3), Joypurhat (756.2), Sirajganj (436.6), Naogaon (325), Chapainawabganj (322.9), Pabna (293.6) and Natore
district is 272.1/1,000,000.

In Barishal division the overall AR is 649.3/1,000,000 with the highest AR in Barishal district (983.2/1,000,000), while,
Barguna (677.4), Jhalokathi (644.3), Patuakhali (609.6), Pirojpur (594.1) and the lowest 269.0 in Bhola district.

Although Rangpur division reported an overall AR of 400.9/1,000,00, Dinajpur district reported high AR
(606.2/1000000), followed by Rangpur (556.6), Panchagarh (337.4), Lalmonirhat (327.9), Nilphamari (326.9),
Thakurgaon (318.2), Gaibandha (263.1) and 242 in Kurigram district.

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WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

The lowest AR is reported from Mymensingh division (379.9/1,000,000). Mymensingh district having the highest AR
of 486.3/1,000,000 followed by Jamalpur (380.7), Netrakona (245.8) and the lowest 198.6 in Sherpur district.

The following figure is showing the COVID-19 attack rate per 1,000,000 population in selected divisions, 15 April
– 10 August 2020, Bangladesh.

1200
CTG RNP MYM BSL RSH SYT KLN
1000
Attack Rate/1,000,000

800

600

400

200

0
18/04

27/04

06/05

15/05

24/05

02/06

14/06

23/06

02/07

11/07

20/07

01/08

10/08
15/04

21/04
24/04

30/04
03/05

09/05
12/05

18/05
21/05

27/05
30/05

05/06
08/06
11/06

17/06
20/06

26/06
29/06

05/07
08/07

14/07
17/07

23/07
26/07
29/07

04/08
07/08
Growth factor (every day's new cases / new cases on the previous day) between 0 and 1 indicates a decline; when it is
above 1 it signals an increase, and if is persistently above 1 this could signify exponential growth. Since the beginning
of June 2020, the GF has been within the range of 0.8 – 1.2, and on 10 August 2020, it is 1.17.

The figure below is showing the Growth Factor of daily confirmed COVID-19 cases, 09 March – 10 August 2020,
Bangladesh.

3.0

2.5

Growth Rate 2
2.0
Growth Factor

1.5

Growth Rate 1
1.0

0.5

0.0
09/03

23/03

06/04

20/04

04/05

18/05

01/06
16/03

30/03

13/04

27/04

11/05

25/05

08/06

15/06

22/06

29/06

06/07

13/07

20/07

27/07

03/08

10/08

As of 10 August 2020, according to the IEDCR, 1,273,168 COVID-19 tests with the overall positivity rate of 20.46% were
conducted in Bangladesh by 85 laboratories: 49 laboratories (57.6%) in Dhaka city and 36 laboratories (42.4%) outside
Dhaka. The latest laboratories, which have started the testing: inside Dhaka Bangladesh Specialized Hospital, Shyamoli,

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WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

Famous Specialized Hospital, Meradia and Novas Clinical Research Services Limited. 60% (764,310/1,273,168) of all
samples were tested by laboratories in the Dhaka city.

The graph below is showing the weekly and cumulative numbers of COVID-19 conducted tests and daily number
of samples tested and number of daily confirmed COVID-19 cases, 08 March – 10 August 2020, Bangladesh.

1.2 Million
1,200 T As of 20 July 2020 71,024
87.7K 77.7K
83.3K
1,000 T 94.5K
115.9K

800 T 118.0K

110.7K
600 T 103.5K

89.0K
400 T 65.3K
08 March 2020 68.2K
52.8K Tests N = 1,273,16
First Bangladesh case reported 41.1K
200 T 34.8K
6.5K 14.2K 22.8K
234 368 786 1.7K
Positive N = 260,507
0T
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
Epi Week

COVID-19 testing coverage notably decreased on 2 and 3 August 2020 (most likely due to EID vacation) but recovered
on 7 August to the level of 32 July 2020. The number of confirmed cases per conducted tests decreased to 1 confirmed
case for every 4.89 samples tested, which is 0.05 less the in epidemiological week 31.

The graph below is showing the daily number of COVID-19 conducted tests and daily number of cases per sample
tested, 03 May – 10 August 2020, Bangladesh.

10 20000
Test/Case Daily Tests Poly. (Daily Tests)
9

8 16000
Confirmed Case per Test

7
Daily Tests

6 12000

4 8000

2 4000

0 0
24/05

14/06

05/07

26/07
03/05

10/05

17/05

31/05

07/06

21/06

28/06

12/07

19/07

02/08

09/08

Despite the steady increase of the number of laboratories, a lower number of samples have been tested daily since 02
July 2020. However, COVID-19 testing coverage has been gradually increasing in Bangladesh, reaching 7,485/1,000,000.

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WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

Bangladesh COVID-19 Tests per 1,000,000 now almost reached Sri Lanka (7,783/1,000,000) but is lower than Thailand
(10,731/1,000,000), India (17,795/1,000,000), Nepal (25,906/1,000,000), Malaysia (31,976/1,000,000) and Maldives
(163,228/1,000,000).

The graph below is showing the number of COVID-19 testing laboratories and daily number of COVID-19 tests,
03 May – 10 August 2020, Bangladesh.

100 20000
No. of Lab Daily Tests Poly. (Daily Tests)

80 16000
Number of Laboratories

60 12000

Daily Tests
40 8000

20 4000

0 0
10/05

14/06

28/06

12/07
03/05

17/05

24/05

31/05

07/06

21/06

05/07

19/07

26/07

02/08

09/08
The correlation coefficient (R) is a statistical measure of the strength of the relationship between the relative movements
of two variables. A correlation of 1.0 shows a perfect positive correlation. The analysis of data on the two variables in
Bangladesh showed R between the two variables as 0.9 (positive correlation).

The graphs below are showing the daily number of COVID-19 conducted tests and daily number of confirmed
cases, 08 March – 10 August 2020, Bangladesh.

21000 7000
# Daily Tests # Cases
18000 6000
Poly. (# Daily Tests) Poly. ( # Cases )
Number of Tests (N=1273168)

Number of Cases (N=260507)

15000 5000

12000 4000

9000 3000

6000 2000

3000 1000

0 0
08-03
13-03

22-04
27-04
02-05

11-06
16-06
21-06

31-07
05-08
10-08
18-03
23-03
28-03
02-04
07-04
12-04
17-04

07-05
12-05
17-05
22-05
27-05
01-06
06-06

26-06
01-07
06-07
11-07
16-07
21-07
26-07

Available data allows us to see how quickly the number of confirmed cases increased in Bangladesh and some other
countries in the WHO South-East Asia region: India, Indonesia, Thailand and Sri Lanka. As of 10 August 2020, the overall

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WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

case doubling time in Bangladesh has slowed to 13.5 days this week (1.0 days more in comparison with the
epidemiological week 31).

The figure below is showing the growth of COVID-19 confirmed cases in selected South East Asian countries
starting from the day they reported 500th confirmed cases, 10 August 2020.

5000000
D1 D2 D3 D4 D5 D6 D7 D8 D9 D10
India Indonesia
D12
Malaysia Sri Lanka
500000
Thailand Bangladesh D15
Number of Cases

50000 D20

5000 D40

500
0 10 20 30 40 50 60 70 80 90 100 110 120 130 140
Days since 500th Confirm Case

The death doubling time in Bangladesh as of 10 August 2020 is 19 days (1.0 day more in comparison with the previous
epidemiological week). It is 1.0 day more than in Indonesia. India had the shortest among other countries death doubling
time of 12.8 days.

The figure below is showing the growth of COVID-19 confirmed deaths in selected South East Asian countries
starting from the day they reported 50th confirmed cases, 10 August 2020.

50000
D1 D2 D3 D4 D5 D6 D7 D8 D9 D10
India D15
Indonesia D12
Number of Deaths

Malaysia
5000 Sri Lanka
D20
Thailand
Bangladesh
D30 D30
500
D50

50
0 10 20 30 40 50 60 70 80 90 100 110 120 130
Days since 50th Confirm Death

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WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

4. Contact Tracing, Points of Entry (PoEs) and Quarantine

According to DGHS, as of 10 August 2020, the current institutional quarantine capacity in the country is represented by
629 centres across the 64 districts, which can receive 31,991 persons. A total of 26,542 individuals were placed in
quarantine facilities and of them 21,557 (81.3%) have been already released. Over the same period, total of 57,482
individuals were isolated in designated health facilitates and of them 38,501 (67%) have been released.

The figure below is showing the number of individuals in hospital isolation and released, 06 May – 10 August
2020, Bangladesh.

60,000
Presently in Isolation Hospital Isolation Released from Isolation

50,000

40,000

30,000

18,825
19,132
18,988
18,970

18,940
18,796

18,651
18,612

18,581
18,568
18,498

18,455
18,029
17,660
17,319
17,192
16,856
16,839
16,449
15,755
15,147
20,000 14,523
13,800
13,155
12,467
11,915
11,026
10,302
9,758
9,012
8,243
7,552
7,162
6,754
6,240
5,794

10,000
5,140
4,994
4,653
3,897
4,305
3,616
3,248
2,748
2,435
2,236
2,017
1,771

0
18/05

24/05

17/06

23/06

17/07

23/07
06/05

12/05

30/05

05/06

11/06

29/06

05/07

11/07

29/07

04/08

10/08
In the reported week (epidemiological week 32), the number of international flights has decreased by 30.8%, in
comparison to the previous week (45 and 64 respectively) leading to decrease the number of passengers by 39.4%
(8,233 and 13,593).

The figure below is showing the weekly incoming international flights and number arrived of passengers through
PoEs, 27 April – 10 August 2020, Bangladesh.

80 16,000
Passenger through Landport
Passenger through Airport
70 65 14,000
Number of Flights 61
60 12,000
Number of Passengers
Number of Flights

47
50 45 10,000

40 34 8,000
13,593
13,172

28 28
30 6,000
23
9,731

20 21
19
8,233

17 17
20 4,000
7,469

14 13
5,878
4,176

3,800

3,707

10 2,000
3,183
2,807
1,117

1,701

3,508

2,250

3,551

3,303

1,509

1,137

1,613
2,316
1,295

1,607

1,827

2,336

2,654

1,500

1,892

1,675
368

0 0
w18

w21

w24

w27

w29

w32
w19

w20

w22

w23

w25

w26

w28

w30

w31

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 WHO Bangladesh COVID-19 Morbidity and Mortality Weekly Update (MMWU) 10 August 2020/Vol. No24

5. Case Management and Infection Control

The Directorate General of Drug Administration (DGDA) has issued specifications and testing parameters regarding non-
medical fabric masks for community use, following four consultative workshops with stakeholders inc luding
manufacturers, testing laboratories and development partners. In the revised guideline, DGDA specified that the non-
medical fabric mask is not intended for use by health workers; the guidance is non -binding and not a regulatory
requirement from the DGDA; concerned manufacturers may use the guidelines to seek confirmation that their product
complies with the requirements in the guideline. This action comes as an important attempt to ensure market access to
different types of fabric masks, while providing a basis for manufacturers and buyers to ensure optimal effectiveness of
the available commercially produced masks for protection against COVID transmission in general public. The document
is available on the DGDA website at http://www.dgda.gov.bd/index.php/news/item/58.

6. Risk Communication and Public Awareness

Risk Communication and Community Engagement (RCCE) partners continue to roll out public information campaigns
and community engagement activities for strengthening protection measures, especially mask wearing together with
observation of hands hygiene and physical distance. Over 500 000 posters and leaflets have been produced by UNICEF
and distributed countrywide through Civil Surgeons’ offices and partner NGOs. Additional information materials have
been also produced and disseminated through social media, radio and TV stations, including public service
announcements. Moreover, WHO has launched the global challenge #WearAMask that has been translated and is being
rolled out in Bangladesh through social media. Furthermore, Interpersonal Communication training tools have been
developed and field staff and volunteers are trained for advancing on engaging with communities in dialogu e, not only
offering information but also gathering feedback.

RCCE partners also collaborate with Community Support Teams (CST), a field-level initiative partners aiming to slow
COVID-19 spread in the community by ensuring quarantine/isolation of confirmed cases and persons with symptoms as
well as to reduce burden on the healthcare system by supporting home-based treatment and management of mild to
moderate cases through telemedicine and medication support of low-income households. CSTs activities are currently
being implemented with preponderance in Dhaka North City Corporation, with the prospect of further expanding the
services in other areas.

7. Useful COVID-19 links:

WHO Bangladesh COVID-19 Situation Reports: https://www.who.int/bangladesh/emergencies/coronavirus-disease-

(covid-19)-update/coronavirus-disease-(covid-2019)-bangladesh-situation-reports.

COVID-19 Situation in the WHO South-East Asia Region: https://www.who.int/docs/default-

source/coronaviruse/situation-reports/20200727-covid-19-sitrep-189.pdf?sfvrsn=b93a6913_2.

Latest global WHO Situation Report # 102 as of 9 August 2020: https://www.who.int/docs/default-

source/coronaviruse/situation-reports/20200809-covid-19-sitrep-202.pdf?sfvrsn=2c7459f6_2.

WHO Bangladesh awareness and risk communication materials in Bengali:

https://www.who.int/bangladesh/emergencies/coronavirus-disease-(covid-19)-update.

WHO COVID-19 Online Training: https://openwho.org/channels/covid-19.

COVID-19 updates from the Directorate General of Health Services, Ministry of Health and Family Welfare, Government
of The People’s Republic of Bangladesh: https://dghs.gov.bd/index.php/en/home/5343-covid-19-update.

Institute of Epidemiology, Disease Control and Research (IEDCR): https://www.iedcr.gov.bd/.

Contact: Dr Bardan Jung Rana, WHO Representative to Bangladesh, ranab@who.int

Dr Hammam El Sakka, Senior Medical Epidemiologist, COVID-19
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IM, WHE Team Leader, WHO-BAN, elsakkam@who.int