Kelzang Wangchuk | Samdrupjongkhar

A preliminary report of the Covid-19 outbreak in Samdrupjongkhar town has cited the leakage from the facility quarantine hotel as a possible source as both Covid-19 cases from the community had visited the hotel premises frequently.

Residents are questioning having quarantine facilities in hotels that have shops in the same building. “The green net should surround the quarantine facility hotels and develop the proper guidelines and protocols for them,” a resident said.

“We are worried about the increasing community cases in the town because the source of the previous two community cases was unknown and officials could not even establish the source of the recent cases,” another resident, Dechen said.

Breach of protocol 

Three expatriates tested positive after seven days of their arrival at the quarantine hotel on April 22, and frontline workers and hotel management team were briefed to adhere to protocols. Additional police personnel were deployed outside the hotel premises for security.

According to the report by the task force, given the poor compliance on protocol and enhanced surveillance, the entire hotel management team was screened for Covid-19, where four hotel management members tested positive on April 26.

The report states that it was the first case where the hotel staff tested positive and traced many primary and secondary contacts. Thirteen primary contacts tested positive until May 11.

The first community Covid-19 case was detected on May 3, when a 36-year-old woman from Royal Bhutan Police (RBP) colony tested positive. She did not go to work at T-Bank for almost a week before testing as she was sick. 

The report stated that the second community case was detected on May 6, where a 26-year-old police constable tested positive from the police station. Eighteen primary and 82 secondary contacts of the woman, and 16 primary and 46 secondary contacts of the constable were traced.

Three out of the 18 primary contacts of a woman, tested positive in the quarantine facility on May 9. Of the 16 primary contacts of the constable, four tested positive on May 8 and May 10. “The constable escaped the targeted testing on May 4.”   

The woman had no travel history outside Samdrupjongkhar town before April 13, but while commuting from T-Bank to RBP colony after duty, she frequented the paan shop located below the quarantine hotel and hotel on several occasions.

The report stated that since she had visited the three significant places- T-bank, RBP colony and hospital OPD, health officials tested all the residents and OPD staff of the hospital on May 4. All tested negative on the RT-PCR. 

While the constable, the second positive case, also had no travel history and only attended duty at the police station. “But he was on night duty when the three expatriates tested positive on April 22 and night security on April 26 when the hotel management members tested positive,” the report stated.

Since the 36-year-old woman’s husband has travel history to Phuentsholing, it’s still being studied for the possible transmission source as the cases were detected from the places he visited in Phuentsholing though he tested positive on May 9 after exposure to his wife.

“Both the community cases have visited the quarantine hotel premises between the second and last week of April,” the report stated.

The report stated that counting back maximum (14 days), median (seven days) and minimum ( two days) incubation period of the index case who had the earliest onset of respiratory symptoms on May 3, the probable day of exposure dates back to April 20.

According to the report, the possible day of exposure for the second community case dates back to April 23, given the earliest flu symptoms on May 6.

“Going by the circumstantial evidence, RT-PCR report, date of onset of symptoms, and probable date of exposure, the leakage from the quarantine facility is possible, but other possible sources and mode of transmissions such as illegal transaction and frequent travel to the point of entry (PoE) by the police personnel are not ruled out,” the report stated.