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icddr,b’s response to COVID-19 pandemic

icddr,b has been actively monitoring the development of novel coronavirus disease pandemic since December 2019, with particular focus on the health and well-being of the people of Bangladesh, as well as on the continuity of research, and hospital operations, which treats annually more than 200,000 diarrhoeal disease patients free-of-charge.icddr,b has been providing support to the Government of Bangladesh and its partners, responding to the urgent needs of the country. Some of the key activities are highlighted below.

Support to the Government of Bangladesh and the health system

icddr,b has been working closely with the Government of Bangladesh in its COVID-19 response through various capacities from disease diagnosis to capacity building and research activities.

  • Being a part of the National Technical Advisory Committee (NTAC) on COVID-19, which was formed in April 2020, icddr,b is providing technical supports to the government on the prevention of novel coronavirus infections, improvement of quality of health services in hospitals and vaccine research. Supporting the government with health facility preparedness and readiness rapid assessmentfor COVID-19 response. Also assessing the status of maternal, neonatal and child healthcare at the health facilities in context of COVID-19, and risk assessment of healthcare workers involved in managing COVID-19 cases.
  • Supporting the Ministry of Health and Family Welfare (MoHFW) and the Directorate General of Health Services (DGHS), Bangladeshin the national COVID-19 response as a member of the Public Health Expert Panel where an icddr,b representative is responsible for providing technical assistance to the multi-sectoral COVID-19 response teams at different tiers (division, district and sub-district levels) of Khulna Division. It is also supporting several other technical committees within the MoHFW in discharging their duties.
  • Providing COVID-19 test support to the DGHS and sharing the results with them. So far, more than 27,000 samples have been tested. At the end of May, the DGHS also gave permission to icddr,b diagnostic center to offer COVID-19 testing to the general public commercially.
  • Supporting the DGHS to establish new COVID-19 testing laboratories and strengthen the capacity of medical technologists and biosafety standards of these laboratories. The on-site training of staff have been completed in 9 districts including two laboratories in Dhaka and one each in Barishal, Kustia, Khulna, Rajshahi, Bogura, Rangpur, Faridpu and Dinajpur districts. Planning to scale this up in other testing centres is underway. Additionally, four of icddr,b staff members are assigned to support IEDCR's laboratory in Dhaka and Cox's Bazar to conduct RT-PCR assay.
  • Under the National Influenza Surveillance, Bangladesh, icddr,b is working in collaboration with the government in its Pneumonia Surveillance in nine government hospitals, which has now expanded its scope and included COVID-19.
  • Supporting the Institute of Epidemiology Disease Control And Research (IEDCR)in contact tracing and also jointly implementing a USAID-funded project titled “Transmission Dynamics of COVID-19 in Bangladesh” to investigate transmission of COVID-19 at the community level. It will estimate the proportion of symptomatic and asymptomatic COVID-19 cases; identify the risk exposures related to COVID-19 cases and; determine the 'extent of transmission' of COVID-19 within a household. It will also explore challenges of home isolation and stigma faced by households with confirmed COVID 19 case/cases and estimate the population level sero-prevalence of COVID-19.
  • With funding support from United Nations Population Fund (UNFPA), Bangladesh, icddr,b is undertaking a surveillance project titled ‘Development and implementation of SoPs for management of COVID-19 patients in selective Medical College Hospitals and District Hospitals in Bangladesh’.It will endeavour to support DGHS in implementing the ‘Clinical Case Management’ and ‘Infection Prevention and Control’ guidelines in selected District Hospitals and Medical College Hospitals for COVID‐19 response.
  • The Bio-Medical Engineering Unit (BMEU) of icddr,b in collaboration with Centers for Disease Control and Prevention (CDC), USA and American Society of Microbiology (ASM), USA has been providing technical support to various institutions, which includes repair and certification of Biosafety Cabinet (BSC) as well as capacity building of staff on Standard Operating Procedure (SOP) from different labs involved in testing COVID-19. So far, five biosafety cabinets have been repaired and seventeen biosafety and laminar flow cabinets of IEDCR, Dhaka Medical College and Gazi Group were calibrated. There are several others in the pipeline including Uttara Adhunik Medical College.
  • Healthcare staff working in the COVID-19 designated hospitals have been under extreme psychological stress due to extreme work pressure, high risk of infection, lack of confidence in infection prevention and control measures, and limited scope to spend time with family and friends. icddr,b, in collaboration with University of Dhaka’s Clinical Psychology Department, and National Institute of Mental Health are coordinating support services to improve mental well-being of frontline healthcare workers.

Ongoing research and trial

  • Multicenter study of nosocomial transmission of the SARS-CoV-2 virus: This project, which is funded by Foundation Merieux, France, aims to describe and document suspected or confirmed cases of nosocomial SARS-CoV-2 infection, the clinical spectrum and the determinants (risk factors/protective) at participant hospitals.
  • Novel coronavirus disease 2019 (COVID-19) among patients admitted with severe acute respiratory infection to the selected hospitals in Bangladesh: Funded by EHD/Concern Worldwide, Bangladesh and UKaid, this project will work on detection of COVID-19 among suspected COVID-19 patients at inpatient and outpatient departments of selected hospitals.
  • Evaluation of saliva as an alternate specimen for diagnosis of SARS-CoV-2: With funding from USAID, the study team will investigate the suitability of saliva over nasal swab and/or throat swab for detection of SARS-CoV-2 from suspected patients.
  • Validation of antibody testing for COVID-19: This study will validate antibody assays to use in COVID-19 related sero-epidemiological studies. It is funded by USAID and the Bill & Melinda Gates Foundation.
  • COVID-19 theraputic trial: The aim of thisrandomised, double-blind, placebo-controlled trial is to evaluate the efficacy and safety of ivermectin in combination with doxycycline or ivermectin alone for the treatment of hospitalised SARS-CoV-2 infected adult Bangladeshis who tested positive for COVID-19. If successful, it may have the potential to play an important role in the treatment of COVID-19 positive patients.  The trial is supported by Beximco Pharmaceuticals Ltd.
  • Clinical evaluation of a point-of-need diagnostic system for detection of COVID-19 towards its deployment at peripheral health care settings: This Sida-funded project will determine the diagnostic efficiency of RPA assay in comparison with RT-PCR in detection of coronavirus from clinical samples. It will also assess the safety and feasibility of the glove box for isolation of nucleic acid in clinical samples collected from the suspected coronavirus patients. 
  • Optimising the treatment of COVID-19 adults with severe pneumonia and/or ARDS in Bangladesh using an adaptive version of locally made Bubble CPAP: The first project, funded by Sida, will test the design feasibility of the device in healthy individuals, then evaluate the safety of the device in COVID-19 adults with severe pneumonia. This is to monitor the SpO2 and other vital signs as well as measure the status of CO2 retention. Finally, the project will evaluate the proportion of treatment failure or death among COVID-19 adults with severe pneumonia receiving adult bubble CPAP, contrasting with WHO standard oxygen therapy. The second project, funded by Global Affairs Canada, will develop rapid training and logistics support and test the safety and efficacy of adult bubble CPAP among hospitalised COVID-19 patients with severe pneumonia and hypoxemia who have failed with WHO standard oxygen therapy.
  • Serosurveillance of COVID-19 and mental health among slum dwellers in Dhaka city and its outskirt: This project will investigate the potential relationship between circulating SARS-CoV-specific antibodies and disease progression/spread in communities in Dhaka and its outskirts. It is funded by Global Affairs Canada.
  • Enhanced COVID-19 case identification using DGHS telemedicine events: This Global Affairs Canada-funded project will track and follow-up presumptive cases of COVID-like illness using the DGHS's free 24/7 telemedicine service from qualified doctors (ShasthoBatayon). The follow-up can be used to direct confirmatory testing, support geolocation of cases, and back the quarantine and isolation strategies. 
  • Food insecurity with the COVID-19 pandemic: The study will assessthe extent of food insecurity and undernutrition among urban and rural people during and after the pandemic in Bangladesh and developing a guideline for providing them a basic food package for maintaining daily dietary requirements to combat undernutrition. The study is funded by Global Affairs Canada.

Humanitarian assistance

  • Supporting the livelihood (i.e. foodstuff) of transgender and sex workerswho are currently under the HIV prevention programme of the Global Fund for AIDS, Tuberculosis and Malaria during the COVID-19 crisis. This is supported by the German Doctors
  • icddr,b staff voluntarily donated cash assistance to Bidyanondo Foundation, a non-profit organisation, which provides support to local, underprivileged communities.

COVID-19 treatment

  • icddr,b has been playing a key role to prevent disease outbreak among the Forcibly Displaced Myanmar Nationals (FDMNs) seeking refuge in Bangladesh and supporting the Government in disease surveillance. Since the first influx arrived in Cox’s Bazar in September 2017. It has worked alongside partner organisations to respond to the health needs of this population. It is currently working in collaboration with UNICEF to setup a 200 bed COVID-19 hospital for the vulnerable FDMN population at icddr,b’sTeknaf field site in Cox's Bazar.
  • Providing capacity development assistance to local health service providers on critical case management of patients suffering from COVID-19; rational use of personal protective equipment (PPE) and infection prevention control;and ensuring adequate and appropriate medical equipment, supplies and logistics are provided for the isolation and management of the patients suffering from COVID-19.
  • icddr,b’s clinical response team has been phenomenal in providing COVID-19 care to all staff, their dependents and family members living with them. So far, 1,800 staff and family members, and several members of third party staff have been tested. All individuals tested positive regardless of their service contract status received treatment and follow up care. Specialised tents have been erected to take care of critically ill staff and hospital patients. The Day Care Centre has been converted into an Isolation Unit with separate wards for male and female staff. The Cafeteria has been converted into a makeshift ward to accommodate staff who are ill, in case the tents run out of capacity. Thus far, icddr,b has provided preventive treatment to more than 230 staff at risk.

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Read more:

- icddr,b diagnostic centre begins COVID-19 testing.

icddr,b begins clinical trial of Ivermectin to treat patients with COVID-19.

Unilever Bangladesh supports icddr,b’s ongoing COVID-19 emergency response.

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Published on May 24, 2020, Updated on June 24, 2020