In the current global pandemic scenario of coronavirus disease, better known as COVID-19, Professor Samir Kumar Saha, Head of the Department of Microbiology at Dhaka Shishu Hospital and Executive Director of Child Health Research Foundation (CHRF) shared his views with News Hour and enlighten the direction of handling the epidemic. The over the phone discussion explored the depth of the situation in the local (Bangladeshi) context and what we need to do in the long run.
Professor Samir Saha is an eminent Bangladeshi microbiologist and a public health expert. He is known for his research on pediatric infectious diseases specializing in pneumonia, meningitis and enteric fever. He is focused on finding the true burden of these diseases, their causative organisms, drug resistance patterns, and serotype distributions.
In 2017, Prof Saha was the first scientist from a developing country to receive the American Society for Microbiology (ASM) award for his outstanding research in Clinical Microbiology. Following which he has been elected to Fellowship in the American Academy of Microbiology. The same year he received the UNESCO Carlos J. Finlay Prize in Microbiology for research and work in the field of microbiology.
Microsoft Corporation’s co-founder Bill Gates applauded Bangladeshi microbiologists Samir Saha and his daughter Senjuti Saha for their research to reduce child mortality in Bangladesh and other countries.
“Together, the father-daughter team is a dynamic duo of global health. They are working to close the gap in healthcare delivery between low-income countries, where child mortality is high, and wealthier countries, by using data, state-of-the-art diagnostics, and vaccines to battle infectious diseases,” Bill Gates wrote in his personal blog ‘Gatesnote.com’ on January 14, 2020.
News Hour: Tell us about the virus – there is a lot more confusion about it.
Prof Samir Saha: Let me give you the background of the Coronavirus. We know really very little about this virus. Every day, new things are getting unfolded. If you just look behind, the Coronavirus is not really new, but this COVID-19 is new.
Coronavirus was there in this world for many years. Some people worked on this, but unfortunately, not many people showed much interest in it. Coronavirus are many. This is called the novel Coronavirus because this is a new Coronavirus.
Susan Weiss has been working on this virus for around 40 years. When she was working, people were looking at her and thinking she might be working with something which was completely backdated and which had no importance for human beings. But now people now realize that we might have missed some opportunities to know the virus. We could have learned more about the virus.
The virus has even only 10 genes. With these 10 genes, this virus is really showing how it can dominate human beings globally. Although, the lower number of the gene does not necessarily give any advantages. The Dengue virus has a lesser number of genes, but it causes much havoc to us. It is also important how we adapt, how the virus is adaptive itself to survive in human being and cause the disease.
In the previous days, Coronavirus was only considered for very minor sickness just like sneezing, or maybe a cough, and not even that cold or something. But now it is familiar to cause severe respiratory infections.
The virus has been changed over the time, going through different animals like birds, especially, bats and some other hosts.
News Hour: What is the current situation of coronavirus in Bangladesh?
Prof Saha: I think, the whole world is thinking about the virus and Bangladesh is possibly on the brink of the disaster. Maybe a very big wave is coming at us, and we don’t know really what’s going to happen. I think the next few weeks will be very critical. Because now we can see that the virus infection has moved to the community level. So, we are not really sure how it will behave in the next few weeks.
We do not really know the situation, because we really could not screen a large number of cases in Bangladesh. There were the instructions from the upper level of the government, the resources were there, the funding was available, in fact. The government also poured money to do something. But I’m not sure that all those were being implemented properly.
The reason is we do not have the infrastructure to do the tests. At the same time, we could not really involve more and more laboratories to do these. If we could have done someting, maybe a little earlier, that would be one important thing!
I’m optimistic that maybe, we will be not having an Italy scenario, we’ll be having a much better scenario and we’ll be saved. I’m optimistic about it.
News Hour: What are the reasons of low number of cases in Bangladesh? Is it due to the scarcity of test kits or the testing facilities?
Prof Saha: I’m not sure – maybe, chicken and egg! I don’t know whether there was a scarcity of kits because, we never even tried to test this. For example, now we have kits, we have now labs, we hardly have any specimen to test and we hardly have people who are really coming to us and giving the specimen. Because people are stigmatized and hide it. There are the panic of examining patients, even who are having minimum, not even it is a case of COVID. The pneumonia complications arenot really being treated well now.
All these are problematic. That is the reason we do not know why we have less cases. But if we look at this, I believe we really have missed cases. For example, when we had 45 positive cases, we had 5 deaths. That means, we had almost 10% deaths. That means it is one of the highest number of deaths. It is not the number, it is the proportion.
That means, if we could have screened more, we could have found more. We could have really singled out there as the South Korea did. I mean, each and every individual case was being tagged and was being followed – not only to make sure that the particular cases were remaining isolated, almost like the index cases to confine to a place and also followed these cases very carefully.
They also gained the knowledge by observing the cases how the disease was behaving. Bangladesh is one of the most populous countries in the world.
News Hour: What are the kits we are using right now in Bangladesh?
Prof. Saha: Now, we are using the Polymerase Chain Reaction (PCR). We are using different kinds of kits in different places, but I just want to say that we should standardized or even synchronize in a way that we all know who is using which kits. Then we will be getting the reports perfectly. But, I think, most of the kits are very same. The rapid tests are not yet being used here in Bangladesh.
News Hour: Why the CHRF did not do the tests in spite of having PCR machine before?
Prof Saha: The kit is one thing which is really Coronavirus specific. We are working on the respiratory virus for the last couple of years. So, we had everything, but, we only did not have the Coronavirus specific primers and probes. Now we have large number of labs in the country. I hope that lots of tests will be done now.
News Hour: There are some other labs in Bangladesh who have PCR machines. But they are not capable of testing Coronavirus cases. What are their obstacles?
Prof Saha: I think just having the PCR machine is not everything. It needs to understand the purpose of those PCR machines, how they are being used, and what the experience of that particular lab. I’m sure that there are many labs in Bangladesh who are having Real Time (RT) PCR, like in the fisheries and agriculture departments, I’m sure they will be able to do it. But they will require at least some orientation. Moreover, the virus is extremely contagious. You have to know what specimens you are dealing with and how are you going to deal with. Those are important points.
Obviously, all these arrangements will take time, and we do not have time now. We really want to start now. The questions we should ask when we go to a lab with PCR machine is – did you really work with the respiratory viruses before, or the viruses before? What is the safety of your own lab?
News Hour: What should we do now for the protection of the nation? What could we do more? Did we do anything wrong so far?
Prof Saha: I think, we should really screen more and more cases, and immediately, we should really isolate them. If we don’t do this, we will be at risk. And maybe, we don’t have the cases. I think what we could have started these a few weeks before what we are doing now.
When the people started coming back to Bangladesh from abraod, we really could not anticipate possibly that how many people will be coming and how to accommodate them. And also, whatever instructions were being given to these incomers or to these expats, those were not really followed properly. Either, maybe, we could not instruct them properly, or we could not be more regimental.
I think if you consider China – that is one way of really controlling everything. If you look at South Korea, that is another way of looking at this. If you go to the US – the first in this Coronavirus infections started in the West, however, it is declined significantly. And now you look at the East. So, California and New York – what a contrast!
So, that depends how disciplined we are, and how really we are maintaining everything what is being said by everyone. So, we need to follow the social distancing, but we do not do that. So that is a very big problem and that is making us really scared.
News Hour: Globally, there are so many things going on for developing a vaccine against Coronavirus. What is the situation of vaccine development?
Prof Saha: Globally there are many industries, many universities are trying to develop a vaccine against Coronavirus. But most of the time, these are confidential. And we really do not know how much the progress is happening really. Someone says one year, someone says six months – but I am not sure whether there will be a vaccine in a short period of time.
In case, even if there is any development of the vaccine within six months, for example, it will take maybe another one year to come to us. Because, the discovery of the vaccine and then producing it in bulk, is not really very simple. It requires more time and many industries to be involved to generate millions of doses.
News Hour: What could be the natural course of disease like be? How long that spell might continue or how long people should remain isolated. Can we predict anything?
Prof. Saha: I can only predict based on the knowledge of other diseases. For example, that the way it is going as we know that about 80% of the cases are not really very severe. They are having the exposure that they are carrying it – so that means, they are getting some immunity and if it is going on, that way it is going on all over the world.
If it spreads out, we do not know how much immunity it will be giving with this exposure. But even if it is giving some exposure, then the most of the people will be immunized and that will really help us to stop. That may require months over. It depends on how it will be behaving in the coming days. That is the most important thing.
News Hour: Is there any mutation of Coronavirus now anywhere in the world?
Prof. Saha: There are some changes, but it is not really anything very significant, which is really making itself more different. I mean, there are not a lot of strains
are not being sequenced but the cases who are being sequenced are not really significantly different. They are still behaving in the same way with some changes in the mutant gene, but, not really anything remarkable.
News Hour: We have talked so much about the technical and scientific aspect of the virus itself, let’s talk about some psychosocial consequence of this disease in the society or or the behavioral aspect.
Prof. Saha: I’m gradually thinking more of about this topic than that of science. In pandemics, wwhen people may start really continue to remain isolated for several more weeks, that would be a very, very big problem.
Also the panic that we are having all together makes it a very different scenario. I am just feeling that this Coronavirus infection all over the world will be telling us that human beings cannot live alone. They should live together and they should help each other and that is the only way they can survive.
It is no matter how strong you are, whether you are in US or whether you are in Bangladesh, you cannot really protect anything. This small virus, we cannot really do anything almost against this virus! Look at Italy, look at Spain, look at Iran – what is going on there? So, we should really realize it and this realization will be helping us to be the true human being in the coming days.
News Hour: Well, we hope that the situation will be much more manageable in Bangladesh.
Prof. Saha: I hope it will change. I believe, we need more and more hospitals to be ready. I wish that we’d be not needing them, but we should make them ready.
News Hour: Thank you, Prof. Shaha for your valuable time. We will get back to you in future to know more about the disease. Thank you for now.
Prof. Saha: Okay, thank you.
