Open and porous border stretches about 700km

Dechen Tshomo

The country preparedness to prevent a coronavirus outbreak is challenged at several fronts.

Managing porous entry points in the Southern part of the country was one of the main concerns raised by representative from agencies during a meeting to understand the situation and preparedness of the country against coronavirus outbreak at the National Emergency Operating Centre in Thimphu on January 29.

Medical services director-general Dr Pandup Tshering, presenting the situation update on Coronavirus, said that too many entry points in the southern part of the country was one of the challenges.

He said while surveillance has been set up at the entry points, thermal scanner alone cannot prevent the infection. “If the outbreak is reported in India then people freely move in and out so it is quite a challenge.”

High mobility of Bhutanese on holidays, pilgrimage and business to the neighbouring countries where the outbreak has been reported is another challenge. Monitoring the movement of these people is difficult, he added.

Dr Pandup Tshering said this is the first time a public health outbreak is being discussed with the Disaster Management Authority because public health outbreak is never considered a disaster. “But, here I think we need coordination support with the stakeholders to prevent the infection.”

Health Minister Dechen Wangmo said while there is urgency, it is not a crisis.

Lyonpo requested all other sectors to come together and work towards preventing the infection from entering the country. “We never know. If we are bordering with countries with strong surveillance system, we should not be this worried.”

Lyonpo said a lot of people are travelling so it is important to be prepared. “Only this morning, we realised about the porous border in the north. I feel from the contingency planning and the epidemic management, Paro International Airport is easier.”

One of the representatives said there is not much to worry about the porous border in the North as the border is not accessible because of snow. “There could be some desperate folks trying to go across. We can request the armed force to step up vigilance.”

He said the biggest concern is on the Southern entry points because the penetration level extends from Tendu to Jomotsangkha for about 700 kilometres of open and porous border. “How do we address this challenge?

He suggested setting up and strengthening surveillance immediately at these areas in collaboration with other agencies like the law enforcement, forest, Road Safety and Transport Authority among others.

Prime Minister Dr Lotay Tshering asked the home ministry to set up surveillance team across the border immediately.  “It will not be possible to set up surveillance at all the formal and informal entries, but it should be there at all the major entry points.”

Quarantine could be another challenge.

While hospitals have identified isolation cabins and management teams to handle cases, the country has not done quarantine as of now. A 20-bed patient isolation unit has been identified at the national referral hospital in Thimphu. Lab and nursing staff were already trained in handling highly infectious sample collection and transportation.

Dr Pandup Tshering said large number of quarantine could be a challenge. “Only if a case is detected then they will be kept in isolation. However, if the infection becomes rapid then we may have to quarantine.”

The Prime Minister said quarantine has to be done because despite the travel advisory, some people travel. Prime Minister suggested that if required, the Gidakom hospital in Thimphu should be used as an isolation unit. Further, Paro hospital could also be used for the same if required.

Following the procurement system during emergencies and limited contingency fund are some of the other challenges highlighted.

The Prime Minister said in emergencies, it is okay to be flexible in procurement rules. The health ministry, who will lead to monitor, prevent and prepare responses was asked to procure the necessary items including personal protective equipment required for the preparedness measures. The finance ministry would later reimburse the fund.

The representatives recommended intensive awareness about the infection.

Prime Minister urged the people not to panic. “Idly if we follow normal personal hygiene protocol, it will help prevent one from the infection.”