Is Bangladesh prepared for another COVID wave?

After three gruelling years of the COVID-19 pandemic, which claimed over seven million lives globally and caused unprecedented disruption to international trade, it was widely believed that the pandemic had gone, thanks to mass vaccination campaigns and growing natural immunity. However, far from disappearing, SARS-CoV-2 has once again mutated, this time into a new variant known as NB.1.8.1. This strain is driving a rise in infections across China, the United States, India, and several other countries, sparking renewed public concern. While the current level of infections and severity is not yet a cause for widespread alarm, the resurgence serves as a stark reminder that the virus continues to evolve and spread. It warrants continued vigilance and proactive public health measures to prevent a resurgence of the deadly virus.

The symptoms associated with NB.1.8.1 closely mirror those of earlier variants, presenting a range of common manifestations such as fever, cough, chills, nausea, shortness of breath, congestion, diarrhea, headache, fatigue, and loss of taste or smell. While initial observations from countries where cases have been reported suggest that this variant does not appear to cause more severe disease, its genetic makeup is a cause for concern. Specifically, NB.1.8.1 is equipped with changes that allow it to infect cells more efficiently, implying a higher potential for easier and wider transmission among people.

The World Health Organization (WHO) has classified NB.1.8.1 as a "variant under monitoring" due to its mutations and international spread. Although it has been identified in 22 countries, no travel restrictions have been imposed by any country. On June 4, the Institute of Epidemiology, Disease Control And Research (IEDCR) of the Ministry of Health warned of a potential risk of COVID-19 spreading to Bangladesh, as cases continue to rise in neighbouring countries. Health Ministry has advised citizens to avoid travelling to India and other affected countries unless absolutely essential. Indian media reports that India recently recorded over 6,000 new COVID-19 cases within a 24-hour period, with a total of 65 COVID-related deaths reported so far in 2025. In a similar trend, Thailand confirmed 65,880 new cases and three fatalities in the last week of May. Other Asian countries-such as Indonesia, Singapore, and Malaysia-have also seen a significant surge in COVID-19 cases.

The outbreak has been on the rise in Bangladesh since May. Of late, researchers at the ICDDR,B have also identified two new SARS-CoV-2 Omicron subvariants, XFG and XFC, in Bangladesh, with health authorities noting a gradual rise in COVID-19 positivity in recent months. These subvariants are descendants of the JN.1 lineage and were first identified at Chattogram Medical College Hospital in April 2025. Although the overall number of infections remains low, the ICDDR,B considers the recent increase significant, given the near-zero infection rate earlier this year. In recent months, urban areas have seen a sharp increase in flu-like symptoms and respiratory illnesses. Experts warn that low testing rates may be obscuring the true extent of community transmission and have called for strengthened surveillance and monitoring.

The world has largely adapted to living with the virus, but past experience with the pandemic has shown that complacency can be costly. Effective preparedness, including, mask-wearing, timely testing, isolation, robust healthcare systems, vaccination and public cooperation, are essential to mitigating the impact of the potential surge due to the new variants. The government is ratcheting up public awareness campaigns aimed at curbing the spread of the virus. Eid-returnee passengers as well as metro rail passengers have been asked to wear masks. Sick and elderly people have been advised to avoid crowded areas. And the Education Ministry has issued directives to educational institutions, emphasising the need for students, teachers, and guardians to adhere strictly to health guidelines.

While these efforts are necessary, experience has repeatedly shown that awareness campaigns alone are often insufficient once the infection has begun to spread widely within the community. A more comprehensive and proactive approach like a renewed vaccination campaign may be necessary to contain the resurgence of the virus effectively. The WHO says that existing COVID-19 vaccines are expected to remain effective in preventing both symptomatic and severe illness caused by this variant as NB.1.8.1 is a part of the Omicron family. Therefore, individuals who have received initial doses are advised to complete their vaccination series with second, third, and even fourth doses as recommended. Specifically, vaccination is recommended for individuals over 60, those over 18 with weak immune systems, pregnant women, healthcare workers, and people suffering from various pre-existing conditions. Medical experts underscore the critical importance of vaccination for the elderly and those with chronic diseases as the outbreak intensifies.

However, due to the currently low perceived risk of COVID-19, public interest in vaccination remains alarmingly low. Between January 1 and March 8, only 43 individuals received a COVID-19 vaccine-most of them travellers who required it for international trips. While raising public awareness about the importance of vaccination is critical, the government must also ensure the availability of test kits, medical equipment, and vaccines. Reports indicate that COVID-19 test kits are currently unavailable in government hospitals. Meanwhile, according to the Expanded Programme on Immunisation (EPI) under the Directorate General of Health Services (DGHS), 3.1 million vaccine doses are in stock, with 1.7 million set to expire by August. There is also a shortage of test kits. Taken together these issues point to a concerning lack of preparedness.

The emergence of NB.1.8.1 and other Omicron subvariants serves as a reminder that COVID-19 has not vanished; it has just evolved. While the world may be better prepared today than it was in 2020, the fight against the virus is far from over. Without a proactive public health response, including stronger vaccination efforts and improved healthcare readiness, the country risks repeating past mistakes.

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