New testing procedure for emergency cases in high risk areas

Younten Tshedup 

In addition to the two existing tests–rapid diagnostic test (RDT) and the reverse transcription- polymerase chain reaction (RT-PCR)–the health ministry will start conducting rapid antigen tests in the country.

Health Minister Dechen Wangmo said that starting this week the antigen test would be conducted along the border areas, among high-risk populations and in emergency cases.

Lyonpo said that the antigen test is more specific in comparison to RDT that detects the antibody in response to an infection. The antigen test detects the actual antigen, a foreign body and, in this case, the Covid-19 virus.

Lyonpo said that the test was as specific as the RT-PCR with an added advantage of providing fast results. While the confirmatory RT-PCR takes around six hours, the antigen test takes about 30 minutes to show the results.

She said that the test would be most effective during emergencies when the results need to be obtained at the earliest. “Besides some exceptions generally if the antigen test is negative, RT-PRC would also be negative. The test is antigen specific for Covid-19.”

However, compared to the RDT, the antigen tests are expensive with each test costing around USD 30. The provision would be made available in all health facilities across the country in the coming week.

The new testing protocol is a part of the ministry’s community transmission mitigation strategy which has become crucial as community transmission was inevitable. Intensifying testing procedures is one of the four key pillars under the strategy.

The fourth RT-PCR testing laboratory in Gelephu was operational since July 2. The facility will cater to the central dzongkhags. The facility in Thimphu will cover the western region, Mongar in the east and Phuentsholing in the south.

Enhancing surveillance by engaging village health workers and the local government officials to conduct community surveillance and report cases to agencies concerned is the next pillar under the strategy.

Surveillance would also be enhanced in schools and institutions. The school health coordinators would be trained to deal cases should there be a possible outbreak in the schools. All institutions including government, corporate and private will have to identify a Covid-19 safety officer to be the focal point in an event of an outbreak.

Lyonpo said that the objective was to prevent or slow down the spread of Covid-19 in the event of a community transmission through early detection, which would then translate to early isolation and treatment.

The ministry has also identified differentiated management of positive cases to enhance the surge capacity in the event of a local transmission.

People who have tested positive to the virus but if they are asymptomatic, instead of moving them to the hospital, they would be placed in an isolation facility outside the hospital.

For those positive cases that are symptomatic and need clinical support the ministry has arranged 635 beds in the hospitals. And for serious patients there are 54 intensive care unit (ICU) beds with ventilators in the four regional referral hospitals.

Lyonpo said that with no vaccines and treatment for Covid-19, the only best option available for now was to follow the health preventive measures.

She said that regularly washing hands, wearing face masks in the public space, maintaining physical distance and avoiding crowds has been scientifically proven to be effective and should be followed by the public.

She said that promoting a behavioural change among the public and encouraging people to practice the preventive measures was essential in the absence of a vaccine and treatment. This is the fourth pillar of the mitigation strategy.

With a recovery rate of about 83 percent, the minister said that the country’s status for now was “good”. “Our primary objective in the event of a community transmission is to maintain zero deaths.”

For this, she said that the ministry had identified the vulnerable groups including elderlies, people living with comorbidities and disabilities. Schools have been asked to submit the record of students with comorbidities and disabilities.

These groups of people would be evacuated and receive priority if there is a local transmission.

“With His Majesty The King personally guiding us all and with the blessing of our protective deities and the support of all volunteers, we are prepared,” she said. “But in the end it is how each individual takes the responsibility to safeguard the country and its people.”

Lyonpo said that with the experts predicting a spike in positive cases in India in the coming months, the option to reopen the border remained uncertain. There are no reopening options for now.

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