Title: Simultaneous covid-19 and dengue epidemic impose a double burden in the limited-resource setting country: Empirical evidence from Bangladesh

Abstract

Bangladesh faces challenges fighting against the concurrent COVID-19 and dengue epidemic with limited resources and more than 170 million large populations. As a resource-limited and highly populated country, Bangladesh is vulnerable to simultaneous outbreaks due to its inadequate health systems, low socioeconomic conditions, natural calamities, migrants, refugees, and concurrent infectious diseases like COVID-19 and dengue. Till now, 1,562,958 confirmed COVID-19 cases, along with 27,699 deaths, have been recorded. At the same time, dengue fever adds fuel to the fire to exacerbate the risks of the COVID-19 pandemic. Since January 2021, 20,336 people have been admitted to hospitals with dengue infections, and 78 fatalities were recorded for the mosquito-borne disease. The dengue epidemic amid COVID-19 placed further strain on Bangladesh’s already stretched health systems. Another health disaster could arise if the COVID-19 outbreak continues and the dengue pandemic spreads further. This study aims to assess the preparedness of Bangladesh to curve the adverse effects of concurrent COVID-19 and the dengue epidemic. First, we provide an overview scenario of the concurrent COVID-19 and dengue epidemic in Bangladesh. Second, the comprehensive literature review and analyzed data answers the main research question, “what are the preparedness and gap between curving the concurrent epidemics?” Finally, we propose specific recommendations for managing simultaneous epidemics considering high population density and limited resource setting environment. DEN-1 and DEN-2 variant outbreaks occurred in past years, but DEN-3, a variant of the dengue virus that increases mortality risk, is more frequent this year. In addition, complicating matters is that dengue fever and COVID-19 have similar clinical and laboratory profiles, making it more challenging to identify the two, and hence there will be an increased chance of misdiagnosis. Besides, COVID-19 patients currently occupy almost all hospital beds and Intensive Care Units (ICUs), making it hard for those with severe dengue to get admitted to a hospital. Core findings of this assessment should provide helpful guidelines to government, researchers, and policymakers for further intervention to take effective short and long-term measures.