Should the quarantine period be increased?

Kuensel online poll and people Kuensel talked to say “yes”

MB Subba

Following the recommendation of the joint parliamentary committee on Covid-19 to increase the quarantine period, a debate has ensued over whether or not a person can be declared free of the virus on completion of 14 days in the quarantine.

Most people Kuensel talked were in favour of increasing the quarantine period as some cases were detected after two weeks from the day the person was exposed to Covid-19. 

However, health experts both in the country and outside say that those cases were outliers. According to the World Health Organisation (WHO), the upper limit of the incubation period of Covid-19 is 14 days.

The second Covid-19 patient in Bhutan tested positive 28 days after she had come in contact with her 76-year-old infected partner. The two had met on February 22 but she tested positive only on March 20.

The guide and the driver of the American tourists, who were released upon completion of the 14-day quarantine period, were also re-quarantined at a quarantine facility in Motithang after the second Covid-19 case was confirmed.

An overwhelming  88 percent of Kuensel viewers on Facebook voted in favour of increasing the quarantine period from 14 days to 28 days. As of 10pm yesterday, more than 22,200 Facebook users had participated in the poll.

Executive director of the Association of Bhutan Tour Operators (ABTO), Sonam Dorji, said that suspected contacts and contacts could be asked to stay at on home quarantine after the 14-day quarantine period as a preventive measure.

“They can be kept in home quarantine after the completion of two weeks depending on the status of the person,” he said.

Samtse’s Dzongkhag Tshogdu chairman, Nima Dukpa, said that the quarantine period should be increased to make sure that the person is not infected when he or she leaves the quarantine. He suggested that given the way the virus was behaving, the quarantine period should be increased to four weeks.

“We have heard of cases where persons tested positive after completion of the quarantine period. They were not sent to isolation since there were no symptoms,” he said.

Branch manager of RICBL in Pemagatshel, Soenam Tshewang, said that the quarantine period needed to be increased in spite of experts saying that the incubation period of the virus is 14 days.

He said that increasing the quarantine period was required as a preventive measure, adding that the economic impact of a Covid-19 outbreak in Bhutan would be more costly than the cost of maintaining the quarantine facility.

There are also concerns about the pressure on the national exchequer. 

As of yesterday, there were a total of 2,091 people in various quarantine centres in the country. The government spends about Nu 1,000 for food and other facilities per person on a daily basis.

However, secretary general of Druk Nyamrup Tshogpa (DNT), Phurba, said that the quarantine period should be increased only if it was scientifically justifiable. “It has to scientifically approved. During the pandemic, going by public views, could create lot of problems.”

Chairman of the joint parliamentary, Dorji Wangdi, said that 14 days was a minimum period recommended by WHO.

“The recommendation is based on the evidence that the partner of the American tourist was detected positive after 28 days and she is still asymptomatic. All efforts and resources spent in 14 days will be rendered null and void even if one person spreads the virus,” he said.

The country, Dorji Wangdi said, was at a preventive stage and that the committee had recommended extension of the two-week period in facility quarantine rather than in home quarantine. He said home quarantine was difficult to monitor.

The committee made the recommendation in view of the existing epidemiological evidence about the Covid-19 having shown that it is difficult to confirm within two weeks if a person was infected with the virus.

Health experts Kuensel talked to said that the two-week quarantine was scientifically adequate. But the fear is about the outliers spreading the virus. 

An epidemiologist and professor at Mercy College in Dobbs Ferry in New York, Rossi A. Hassad (PhD), wrote on MedPage Today (health website) that the two-week quarantine period was actually observed for a small proportion of cases of SARS.

“In the context of an accelerating COVID-19 epidemic and growing uncertainty, a higher upper limit (possibly 21 days) for the incubation period seems reasonable and warranted in the interest of adequately protecting the public,” he wrote.

The health minister and other members of the cabinet could not be contacted for comments.

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