Lockdown, for now is the only solution 

Younten Tshedup 

Upon the command of His Majesty The King, the government, considering the risk from the first positive case (in Gelephu) outside the quarantine facility, enforced a lockdown on August 11. This was before establishing the presence of local transmission in the country.

On the first day of the lockdown, a 25-year-old man from the RRCO’s mini dry port (MDP) in Phuentsholing tested positive to the virus. Twelve of his primary contacts also tested positive on the following day in Phuentsholing.

However, local transmission was confirmed in the border town only after the detection of four individuals including a minor (five-year-old) outside the MDP facility on August 15.

 

Advantage of lockdown

A lockdown – the most extreme form of social distancing has proven effective in slowing the spread of the pandemic globally.

According to the World Health Organisation (WHO) early estimates of the basic reproductive number – R0 (R-knot) of Covid-19 ranged between 2.23 to 4.82. A later estimate of the R0 was about 6.47.

This meant that a single positive person could infect at least 6.7 more individuals. In absence of an effective vaccine, social distancing measures were needed to prevent the transmission of the virus.

The city of Wuhan in China enforced a complete lockdown of the population starting 10am on January 23, 14 days after the WHO confirmed the outbreak in the city was caused by a novel coronavirus.

Following the interventions in Wuhan, estimates according to WHO show that the median daily R0 value of Covid-19 declined from 2.35 on January 16 to 1.05 by January 30.

WHO representative to Bhutan, Dr Rui Paulo de Jesus said that a lockdown when well coordinated and implemented, has proven to control the further spread of Covid-19 transmission in many countries around the world.

“It’s also an opportunity to further strengthen the interventions put in place by the government and strategically deal with the situation,” he said. “Bhutan must and is using the window of opportunity provided by the lockdown to trace, track, treat and isolate all positive cases.”

He said the health ministry is carrying out proactive surveillance including contact testing. “The massive testing being initiated clearly shows the seriousness the government is taking to address the situation. However, as we deal with this disease, we are learning and adopting as per the need of the situation.”

While it has caused inconveniences, clinical microbiologist with the national referral hospital Dr Tshokey said that the only effective and efficient way to control the spread of the virus is by adhering to the lockdown protocol.

He said that a direct and immediate benefit of lockdown could be seen in the number of positive cases in Paro and Phuentsholing. “There are just five cases so far in Paro and 34 cases in Phuentsholing. If there was no lockdown, these infected individuals could have spread the virus in the community.”

Dr Tshokey said that compared with the first day of testing in Phuentsholing where 12 positive cases were detected, the number of new cases has been declining daily. “Simply put, the chain is broken when there is no movement of people.”

He said that during a lockdown if people develop symptoms they would be immediately tested and if found positive, moved to the hospital. Their primary contacts (family members) would then be tested immediately.

Asymptomatic individuals, the microbiologist explained, become non infectious after staying home for 14 days (arbitrarily) at the end of the lockdown. “According to data, by the time lockdown ends, if someone is infected unknowingly, he or she becomes non infectious to the community. This is the true benefit of lockdown.”

However, he cautioned that the intention of the lockdown would fail if people in the same building started interacting with each other without De-Suups to monitor their movement.

“Stay inside your homes with your families. Respect the lockdown rules because for now it is the only way to break the chain of transmission of the disease.”

Meanwhile, besides following the lockdown protocols experts also urge the public to strictly follow preventive measures like hand washing, wearing face masks and maintaining physical distance to stop the spread of the disease.

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