6 months after detecting the first positive case, the last patient at the JDWNRH isolation ward was moved to de-isolation on September 14  

Younten Tshedup 

After 194 days of serving as the busiest centre dealing with positive Covid-19 cases, the isolation ward at the national referral hospital in Thimphu finally saw its last patient leave the facility on September 14.

The last patient, a 23-year-old de-suup, who tested positive in Gelephu earlier, was moved to the de-isolation facility after testing negative twice within 24 hours.


What does this mean?   

Since the detection of the first positive case on March 5, the eye hospital at the JDWNRH was the primary centre handling all the clinical treatment and management of positive cases.

As of yesterday, with zero active cases inside the isolation ward, the facility and the team manning the patients inside could finally take the much-needed breather.

Clinical microbiologist with the national referral hospital, Dr Tshokey said: “We really wanted this break because people there have been working continuously over six months.”

He said that the much-needed break was required to regroup, readjust and review the arrangements inside the ward to better prepare the system in the future. It was also an opportunity to analyse and strategise the health protocols and address any technical issues going forward.

JDWNRH’s Medical Superintendent, Dr Gosar Pemba, said that it was a good opportunity for the health staff who have been on their toes since the detection of the first case to take a breather.

He said that working inside the ward was a stressful experience. “You have to be there in full PPE and even if there is not much of a work, people are stressed. While not compromising the safety of the patient, you are constantly worried of getting infected yourself.”

It was also a time for the isolation facility to be sanitised and cleaned after running continuously for more than six months.

With the command from His Majesty The King to provide the best of the treatment and accommodation for Covid-19 patients, the newly inaugurated eye hospital was converted into an isolation ward.

The Royal Guest House in Mongar and the Royal Institute for Governance and Strategic Studies (RIGSS) in Phuentsholing were both converted to Covid-19 wards upon the command of His Majesty The King.

Dr Tshokey said: “We are not celebrating anything yet. The battle is far from over. For now, we are just happy that we could get this break after a very long time. We really hope this would be a long gap until the next positive patient is sent here.”


The isolation experience 

The eye hospital, manned by multiple security personnel, housed the first ever Covid-19 positive case in the country and also the largest number (29 patients at a time) so far.

The health staff and the patients inside the ward also had their own share of bitter-sweet experiences.

Dr Tshokey said that during the initial days, it was difficult for the patients to comprehend that they tested positive for the virus. “Besides the patients, their family members were equally worried. But after a few days as they recovered from the shock, they all adjusted well.”

He said that most of the young patients were engrossed in playing online games. Whenever someone tested negative, all the staff partook in the joy and happiness. “Everyone equally shared the sorrow when individuals failed to recover after repeated testing.”

However, the biggest concern for the health staff manning the isolation ward was when elderlies and pregnant woman were admitted at the facility.

The eldest Covid-19 patient, a 68-year-old man after completing the two-week de-isolation period was released for home on September 14. “While this is a very good news for all, people must not misunderstand. Not all 68-year-old would recover if there is a large outbreak. People should continue to follow the preventive measures.”

Dr Tshokey said that people’s complacency could lead to outbreaks. The increasing number of cases could in turn increase the risks of complications, including mortality.


Covid-19 management teams  

So far, all the four Covid centres in the country—Thimphu, Phuentsholing, Gelephu, and Mongar—have had experience of managing active cases.

Dr Tshokey said that as of yesterday, a total of 348 health workers including drivers, cleaners, ward boys, nurses, X-Ray technicians and doctors, among others were involved in active case management. The isolation ward at JDWNRH has involved about 224 health workers and support staff.

Gelephu and Phuentsholing each have involved 40 and 72 staff, respectively. Mongar currently has involved the dzongkhag’s first 12 health workers at the isolation ward.

But behind these frontline workers, there are teams of experts led by the medical and nursing superintendent of the respective Covid centres. Departmental in-charges who tirelessly worked to keep all services running at all times wholeheartedly contributed to the success story so far.

Dr Tshokey said: “We have managed to is keep all our health staff safe and uninfected. This is one of our biggest achievements so far. And this was made possible because of stringent protocols that we follow.”

Dr Gosar Pemba said that given the possibilities of health workers contracting the infection inside the ward, the management made sure that there was minimum contact between the patients and staff. “We do bundling of works, whereby, if a nurse wants to go check on the patient, he or she should compile and do all the tests and inspections together at a time. This is to avoid frequent contact between the health worker and the patient.”

He said that after six months of having dealt with active cases at the ward, there were no major issues. “This is also because most of our cases besides the American were all mild. We had no Bhutanese patient placed on ventilators so far.”

As of yesterday, Gelephu and Mongar Covid centres had one and four active case, respectively. Of the 68 cases in Phuentsholing, 34 were in de-isolation.