Younten Tshedup

From being worried if a new person has tested positive to which test or which testing machine and interpreting results, too much technical information could confuse people during the Covid-19 pandemic, according to health officials.

While the level of awareness among the public on the pandemic has improved, health experts say too much of technical information when not completely understood, gives rise to doubts and reservations against measures that have been put in place by experts.

Explaining the testing protocol, Chairperson of the technical advisory group (TAG), Dr Sithar Dorjee, said that the reason for conducting two different tests is not because the tests are of poor quality that it requires the combination of both.

He said that while one of the tests is conducted for screening, the other is used for diagnosis. “Both tests are valid. They are used to compliment each other and not to replace one another. They compliment each other to increase the specificity and sensitivity of the test, therefore increasing the accuracy of the diagnosis.”

Dr Sithar Dorjee, an epidemiologist, said by now the public should understand and have enough trust and confidence in what the health ministry and government are doing to prevent the further spread of disease.   

“Every action the government has taken so far has been very transparent. If ministry was trying to hide anything from the public, there should have been multiple cases including community transmission or no cases at all,” he said. “People must trust in what the ministry and government is doing. The evidence is already there, we don’t have any local transmission.”


Trust in science 

The epidemiologist said that science should be the foundation and basis of all decision-making especially in the current situation. So far all the decisions made have been based on science. “But this doesn’t mean that science is all the time correct. Sometimes its the balancing act, and seeing where the priority is – economic or saving lives. Policy makers would have to take that decision.”

He said TAG members are regularly reviewing literature, updating information and guiding the government with prevention measures and contingency plans.

“Because this is a new disease and is killing a lot of people, the idea globally is to try to eliminate this disease at the earliest through aggressive measures,” said Dr Sithar Dorjee. “And given this objective, science should be the basis of all decisions.”

He said that timely measures such as 21-day mandatory quarantine, flu clinics, border closure and screening at the points of entry have effectively prevented a community transmission. These measures are all based on science.

While the cases are increasing in the country, Dr Sithar Dorjee said that all of them are coming from quarantine centres. “As long as people comply with the regulations and our testing is good and there is no leakage of infectious people into the community, the chances of a community transmission are very low.”

The biggest threat for Bhutan’s containment efforts against Covid-19 would come from India given the increasing cases there. “Despite all adequate measures put in place, compliance from the public will determine the effectiveness of our efforts,” he said.

India has recorded 3,525 new confirmed Covid-19 cases in the past 24 hours taking the total number of cases in the country to 74,281.

However, the epidemiologist said that even if there is a community transmission (in few cluster settlements) within the country, the sanitisation and awareness among the public including tracing mechanisms in place could help contain further outbreak. “We would not face large community outbreak like in Italy and India. The faster we trace the primary contacts, the chances of secondary transmission decreases.”


Tracing mechanism 

Few days ago, when the country detected its eighth and ninth cases, all the primary contacts of the two were called from a retest. The two who had come from Dubai tested positive on the 22nd day of their quarantine on May 10.

One of the primary contacts after testing negative had reached Sarpang. His samples were sent to Thimphu and tested on RT-PCR on May 12. However, he tested negative.

Dr Sithar Dorjee said that primary contacts on a flight would be those who have been anywhere within two metres of the patient. In an aircraft, the close contacts would be those who are sitting two rows up and down from the possible positive person.

Although very unlikely to test positive because all of them would be tested before releasing, he said that all the close contacts are brought back for a retest.

“Since the government is taking the most conservative approach, we test them all. Also anyone who arrive in the country are RT-PCR tested once within three days of their arrival,” Dr Sithar Dorjee said.