However, all containment measures in place and second round of mass testing started yesterday    

The ongoing Covid-19 outbreak in Jomotsangkha, Samdrupjongkhar, should be the worst-case scenario for the country, experts say. However, things could worsen.  

The isolated drungkhag in the south-eastern part of the country recorded 79 positive cases, the highest single-day record on May 29. 

Clinical Microbiologist and member of the technical advisory group (TAG) Dr Tshokey said that by any standard, for Bhutan, 79 positive cases in a day was ‘alarming’. 

However, he said that the situation was under control for now as the highest level of precaution and containment measures were taken immediately after the detection of the initial cases in the community on May 21. 

A large number of positive cases were detected from the drungkhag following a mass sweeping of the community. Two weeks after the community was placed under a lockdown, the second round of mass testing began yesterday. 

Based on the results of the testing, unlocking of the villages within the drungkhag would be considered. Dr Tshokey said that there was an opportunity for the ‘green and yellow villages’ to open up if none tested positive. 

The drungkhag has been categorised into three zones — green, yellow and red villages. The green villages are those where there are no cases or primary contacts, yellow villages have certain exposure with the positive cases or their contacts but no positive cases, and the red villages are those with cases and their contacts.

More than 5,000 people would be tested in the drungkhag during the next six days starting from the green villages, said the microbiologist. “Besides children below the age of five, every individual will be tested this time. Based on the results, we can consider relaxations in the villages.”    


Urban vs rural lockdowns     

Dr Tshokey explained that compared to the lockdowns in the urban centres, it was much-relaxed in the rural settings. “Even within the red villages, the lockdown is less intensive, meaning that the people there can come out of their homes and do their regular chores within their compounds.”

This, however, does not mean that the individuals are allowed to mingle with other families within the village. “We cannot practically lockdown a village completely. Imagine if this had happened during the harvest season. People would be locked inside and their crops would rot in the fields.”

Dr Tshokey said that considering all the practicalities, the task force and TAG decided to allow certain relaxations even during the lockdown but with strict protocols in place. “We have never really considered a separate protocol for rural settings as the focus so far has been only in the urban centres and in the bordering towns.”

However, some of the residents said that with the onset of the weeding season, they were concerned about the crops. One of them said that the officials on duty did not allow them to visit or work in their fields.

Jomotsangkha Drungpa, Lamdrak Wangdi, said that in line with the recommendation from the task force and the TAG, people even during the current lockdown, were allowed to come out of their residence and take a walk or work within their compound. 

He said that even some of the positive cases who were asymptomatic were allowed to come out and work in fields near the isolation facility. “These people are not sick and on their personal request, we allow them to work outside as they are already isolated from the rest of the community.”

The drungpa, however, said that the frontline workers did not allow people to travel out of their compound to go to their fields away from their homes. 


Status of the positive cases 

Dr Tshokey said that although more than 150 people have tested positive in the drungkhag, both young and old, no one has reported any severe symptoms so far.      

While the outbreak in Jomotshangkha was detected on May 21, Dr Tshokey said that the transmission could have started at least by a week or two before the detection of the first case. “Looking at the disease pattern, if there were any critical cases in the community it should have been picked up by now.”

He added that with the deployment of additional manpower including doctors, nurses, de-suups, and also medicines and medical equipment, the situation was under control for now in Jomotsangkha.     

“But this doesn’t mean we can relax because with Covid-19 we never know what could happen,” he said, adding that oxygen saturation was one of the most important aspects while dealing with Covid-19 patients. 

“Sometimes a patient may not show any signs or symptoms of respiratory distress and look normal physically, but he or she will collapse due to low oxygen level in their lungs. This condition is called silent hypoxia,” he said.    

In anticipation of such events, he said that oximeters (devices to measure oxygen level in the body), oxygen concentrators, and other basic medicines were dispatched to all the villages.

A pediatrician from Gelephu hospital and a medical specialist from the national referral hospital has been also stationed in the drungkhag to monitor the situation. 

By Younten Tshedup 

Edited by Tshering Palden