Nothing to worry about novel coronavirus but be cautious: PM 

Dechen Tshomo 

As the outbreak of the Novel Coronavirus (2019-nCoV) spreads to 14 countries as of yesterday since the outbreak was first reported, Bhutan prepares to prevent the virus from entering the country.

The health ministry assures the public that it has instituted necessary measures at various points of entry, has identified health facilities and response teams in case of an outbreak in the country.

Health Minister Dechen Wangmo, at a press conference yesterday said the ministry assures public that in case of an outbreak, there is a good system in place and the ministry is fully equipped to deal with it. It had also issued cautionary notification and travel advisory to the public and health centres.

Various media platforms were used to disseminate and create public awareness of the infection.

“The information that we disseminate on prevention and travel advisory must be taken seriously,” Lyonpo said. “Please cooperate with us and help us prevent this virus from coming in.”

Jigme Dorji Wangchuck National Referral Hospital has identified patient isolation rooms and critical units. The old Mother and Child Health unit with the hospital has been converted into the isolation unit.

“Isolation rooms and Intensive Care Units will be expanded if required,” Lyonpo said.

Teams consisting of management staff, and health personnel were formed to ensure quick response in case of an outbreak.

Additional personal protective equipment for health workers would be procured for use in case of an outbreak.

Since January 15, infrared fever scanning and respiratory symptom screenings were initiated at the points of entry, the primary one being Paro International Airport.

Chief of Emergency Medical Services, Kinley Dorji said all the health facilities at the points of entry (Paro, Phuentsholing, Samtse, Gelephu and Samdrupjongkhar) have established the team for emergency and triaging, identified isolation rooms, and stepped-up infection control measures.

Hospital contingency plans have been activated. The contingency plans will be strengthened through regular simulation.

Initial rapid risk assessment of 2019-nCoV infection in Bhutan, conducted with the available information indicated that Bhutan is at high risk.

Lyonpo said that the assessment was conducted to identify weaknesses in the existing system so that it could be addressed. “We wanted to assure the general public that we have a contingency plan in place, we are working night and day.”

Kinley Dorji said all health centres have stepped up influenza-like illness and severe acute respiratory infections surveillance and started reporting to the Royal Centre for Disease Control (RCDC) through the reporting system everyday.

Head of the RCDC, Sonam Wangchuk said the centre is prepared to handle the 2019-nCoV in their biosafety level III lab. If need be, samples can be shipped to Armed Force Research Institute for Medical Science (AFRIMS) laboratory in Bangkok, Thailand.

He said the centre is expecting to receive coronavirus test kits by the end of the week from AFRIMS.

Lyonpo said a lot of information is being circulated on social media platforms like Facebook, WeChat and also in the mainstream media about the virus.

“We are worried because in the social media people are claiming that herbal bills (ribs) and talisman (sungkey) could prevent one from the infection and advertising them for sale. That could be well and good but to us, that is the wrong information that is going to the public,” Lyonpo said.

The health ministry is working with its partners like the World Health Organisation regularly. “For us, the source of information is WHO. We are getting case updates from them, recommendations, technical guidelines and subsequently, we are planning our interventions.”

As of now, not much is known about the virus.  Scientists are still working on and trying to confirm the source of the 2019-nCoV, find out how the virus can be tested and the clinical management of the suspected or infected cases.

“As we speak, things are evolving,” Lyonpo added. “Nevertheless, the ministry has been very proactive in terms of trying to scan what is happening and keeping an eye on the epidemic.”

What is Coronavirus

Health Secretary Dr Ugen Dophu said Coronaviruses usually circulate in animals, and some coronaviruses can be transmitted from animals to humans. However, the source of the Novel Coronavirus has not yet been established.

 The virus is a virus more specifically, a coronavirus identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China on December 31 last year. 

Signs and Symptoms

Dr Ugen Dophu said common signs and symptoms of the infection include fever, cough, sore throat and shortness of breath and breathing difficulties.

Severe signs and symptoms of infection include pneumonia, severe acute respiratory syndrome, kidney failure and could be fatal.

Dr Ugen Dophu said the incubation period is two to 10 days meaning once the virus enters the body, it takes two to 10 days to show the symptoms and signs of the illness.

While the virus can infect all ages, Chief of Communicable Diseases, Rixin Jamtsho said people with low immunity like elderly population, infants and children, people with medical conditions and pregnant women are at higher risk.

Treatment and Prevention

Dr Ugen Dophu said that while there is no specific treatment for coronavirus, symptomatic treatment can be provided. “All hospitals in the country can provide symptomatic treatment.”

People are urged to practice good hand hygiene by washing hands with soap and water before eating and touching their mouth and nose, practice respiratory hygiene by covering nose and mouth when coughing and sneezing with tissue or handkerchief, avoiding unnecessary contact with live or dead farms or wild animals.

People are also advised to wash hands thoroughly after contact with an animal, cook meat and eggs thoroughly before consuming.

If possible, people are asked to refrain from unnecessary travel to affected countries.  As of yesterday, the 2019-nCoV has been confirmed in Sri Lanka, Singapore, Thailand and Nepal.

People who need to travel are asked to take precautionary measures.

“If you experience the symptoms and have had a travel history to affected areas or close interactions with nationalities from the affected areas, we request everyone to seek proper and appropriate medical help from professional healthcare providers, and not resort to traditional healers or other religious means,” Lyonpo said.

Lyonpo said the health ministry alone can’t prevent and manage coronavirus. “It should be a shared responsibility.”

Health officials from the Gelephu referral hospital, BAFRA, customs and police among others, held a meeting in Gelephu yesterday.

Several areas of collaboration and strategies to prevent the virus from entering through the border gate were discussed. The meeting decided that health staff starting today would be deployed on 12-hour monitoring and inspection at the gate.  Another round of meeting is scheduled today.

Meanwhile, hand sanitisers and face masks were distributed at the border gate yesterday.

Prime Minister Dr Lotay Tshering also met with the representatives from different agencies and members of the disaster management authority yesterday evening to understand the situation and the level of preparedness to prevent and manage coronavirus outbreak.

People can call 112 or visit the nearest health facility if they have a travel history to the affected countries and are experiencing the symptoms.