Surveillance stepped up as more positive cases emerge in Phuentsholing

19 new cases detected from the community  

Younten Tshedup 

Vehicle movement to and from Phuentsholing is stopped for the next three days to step up surveillance in the border town following the 19 new Covid-19 cases in the last 24 hours.

The new cases were detected through the active community surveillance in Phuentsholing.

Health Minister Dechen Wangmo said that because the new cases were detected from the community, to rule out the risk of a wider spread of the virus, the intervention was put in place since the night of August 25.

Lyonpo said that the movement of vehicles and people in and out of Phuentsholing would be restricted until the surveillance team completes the secondary level of contact tracing.

With about 80 immediate contacts of those who tested positive already traced, contact tracing of the 19 individuals is underway. Lyonpo said that although the contacts would have been tested, they might not have been picked up immediately by the tests given the incubation period.

“Therefore, once we identify the contacts we will do a risk assessment and then test them again. Three days would give us a fairly good time to reassess the risk and feel the pulse of the epidemic.”

Lyonpo said that the Covid-19 task force in Phuentsholing would also test everyone under Chukha dzongkhag (till Chudzom) starting today.

How did the 19 individuals test positive?

Despite the nationwide lockdown since August 11, the 19 individuals who are not the contacts of the index case from the RRCO’s mini dry port (MDP), many have questioned how these individuals were infected.   

The health minister explained that a lockdown is the most effective means of breaking the chain of transmission of the infection. However, she said it does not guarantee ‘no transmission’.

“People could have been carrying the virus prior to the lockdown and then they become symptomatic. Through our surveillance, we are picking up the cases now. It is possible that people would have had the infection before the lockdown.”

Lyonpo said that community surveillance does not mean randomly testing the population. “There is a certain protocol that we follow including a sampling frame of a cluster,” she said. “We define geographically different clusters and collect data from each household. Only then we start the test. The idea is to test everyone.”

She said that of the five clusters identified in Phuentsholing, most of the cases were from the core town and the school area. The school is close to the RRCO and MDP cluster.

Meanwhile, seven of the 19 individuals had mild symptoms of the infection. However, Lyonpo said that looking at their history they already had symptoms such as runny nose but couldn’t connect it to Covid-19.

“Our request is that if anyone develops symptoms like fever, chills, diarrhoea or loss of smell, please visit the flu clinic. This is the way of picking positive cases especially during the lockdown.”

Aggressive testing  

The minister said that a very aggressive contact tracing was initiated in Phuentsholing after the first positive case was detected from outside the quarantine centre on August 11.

She said that 34 confirmed positive cases were traced and isolated in Phuentsholing. Recognising the importance to reassess the risk in the town, community surveillance started from August 15 to 24.

More than 27,134 samples were collected during the 10-day community surveillance. A total of 25 people tested positive from the community through the surveillance.

Lyonpo said that the entire population in Phuentsholing has been tested except for children below the age of 14 years, as it was a painful experience to collect swab samples from children.

“We initially started with two members in a household but when five people from the community tested positive, we began sweeping the entire population,” she said. “If there are still people who have not been tested, please contact us.”

While the community surveillance ended on August 24 the minister said that a mopping surveillance would be started to test all those who have missed the initial surveillance.

Except for Paro, none of those who came in contact with the cases and those who had visited Phuentsholing on or after August 1 tested positive so far.

Over 2,000 and 5,000 people were tested in Paro and Thimphu respectively as of yesterday.

Lyonpo said that globally cases have spiked after a lockdown was lifted which is why the government is trying to prevent any such events in the country.

“In the absence of a treatment or an effective vaccine, it is the collective responsibility of individuals to follow the health preventive measures and adapt to the new behaviours.”

“For us, the battle is not over yet. We have just started and if we want to stay ahead of the pandemic, individuals must take responsibility. Let us all make a bubble of health preventive measures around us and our country.”

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