Not long after the national lockdown, people seem to have forgotten its costs and implications to the country, the community, family and individuals. Recent global news of second (or third) waves and new lockdowns in several countries have instilled some fear but not convinced people that Bhutan is also susceptible to both huge outbreaks and lockdowns, as any other country.
There are already numerous photos and videos of travel, celebrations, gatherings and holidays on social media. Make a quick visit to the Centenary Farmers’ Market and you can see that only a third wear facemasks properly. Physical distancing is forgotten and entry/exits with arrow markings are vanishing fast. Fever screenings are just eyewash. Offices and institutions have their own share of complacency and the preventive measures are almost non-existent. Hand-washing stations are dry. Frontline workers in borders and strategic areas are vulnerable to become friendly and lenient to those whom they are meant to guard. The government and the Ministry of Health are receiving several requests for travel, workshops and meetings, games, hot springs (Tsachus), drayangs, karaoke, discotheques and movie theatres. There are also growing frustrations on the requirement of a seven-day quarantine for travels from high-risk areas (HRA) to low-risk areas (LRA). In short, everyone wants to be safe and normal but not many value what it takes to be safe.
Globally, countries have been affected to different magnitudes by the Covid-19 pandemic. However, as of this week, only about 58 million of the 7,800 million world population (about 1 percent) has been infected with the virus. This still leaves 99 percent of the global population at risk of infection. Without a vaccine, to achieve herd immunity (community protection), at least 65 percent of a country’s (or global) population should be infected and recovered. This also requires that the virus does not undergo significant mutation. Therefore, cases of Covid-19 will continue to increase, probably in several waves and will be around for a long time, unless the much-anticipated vaccines come soon and do their job well.
In Bhutan, of the 382 cases, only 233 were Bhutanese. This means only 0.03 percent of the country’s population is infected and the remaining 99.97 percent is still at risk of infection. In the event of a large community outbreak, the sick, weak and the old will also be affected and there will be complications including death. Hospitals will be overwhelmed with patients, crematoriums will be filled with dead bodies, and there will be shortages of health workers and medical supplies, not to forget these were and still are one of His Majesty’s biggest worries and concerns. Every night when the day’s test reports come out, for the Ministry of health, the most dreaded moment of the day is to see if there are any positive cases from the community or the flu clinics. The wait is especially intense when we have samples from highly suspected individuals and it’s always such a relief when there are no positive cases or when the positives are from the quarantine facilities.
Except for a few unexplainable cases, Covid-19 is still considered a highly contagious virus. Currently, a combination of good public health measures including facemask, physical distancing, hand washing, and comprehensive testing are the most effective measures. At this stage, the government is allowing people to do most routine activities but pleading them to do so with responsibility. However, for things to get better each day, everyone should come together, be more responsible, more reliable rather than being complacent. Following preventive measures should not be merely for fear of health officials, DeSuups or police on duty. Instead, everyone should do it genuinely for the love and responsibility towards oneself, the society, the country and the king. Offices and agencies should also take equal responsibility and accountability without leaving everything to the Ministry of Health.
The recent Kuensel article on some individuals interpreting the mandatory seven-day quarantine before travelling from HRAs to low-risk areas LRAs as “harassment” by the government and the growing frustrations (mostly anonymous) on social media is a bit worrying. Such issues can likely be politicized if not interpreted cautiously at the right time.
Firstly, logically, I don’t see why a politically elected government with numerous pledges to be fulfilled will put such restrictions and “harass” the public instead of reopening and getting back to normal thereby fulfilling its pledges at the earliest. Secondly, even if we have such a government, we should not forget that we have a king who from day one has lived up to his coronation national address: “Throughout my reign I will never rule you as a King. I will protect you as a parent, care for you as a brother and serve you as a son. I shall give you everything and keep nothing; I shall live such a life as a good human being that you may find it worthy to serve as an example for your children; I have no personal goals other than to fulfill your hopes and aspirations. I shall always serve you, day and night, in the spirit of kindness, justice and equality”.
Specifically, during the Covid-19 situation, His Majesty reaffirmed his concerns for his people when he said: “We must exhibit the strength that comes out of our smallness, remain united and support one another. During such exceptional circumstances, the government will take the responsibility of alleviating any suffering to the people due to the virus”.
So, will such a king, who is willing to give everything to his people, allow any government to “harass” his subjects?
What will it take to lift the seven-day quarantine?
There is huge concern at all levels on the inconveniences caused by the seven-day quarantine; families are unable to meet each other, personal plans are deferred, essential training and meetings are hampered, private business are stalled, and individual movements are restricted. The government has incurred heavy cost and developmental activities stagnated. Despite these inconveniences, it is heartening to see that a majority of the people understand the need for this protocol and comply with it for the greater benefit of the country. By virtue of living in certain parts of the country, sometimes you benefit and other times you may be required to make some sacrifices. The choice is between temporary inconveniences to a small part of the country and having to lockdown the whole country repeatedly. Currently, we have no local transmission in the country, but we are not free from Covid-19. The quarantine is enforced mainly for three reasons.
Firstly, the main risk remains across the bordering towns where cases are escalating every day. This is apparent from the daily news reports as well as from the number of positive cases (5-10 percent) amongst people entering the country from our neighbouring countries (India and Nepal). Since a significant number of cases show no symptoms, we may not even realise when an infection occurs. Since people are very mobile, the spread might be huge by the time we detect a case.
Secondly, there is continued breach in protocols across the border and in strategic business locations in HRAs. People still cross the border, exchange goods or smuggle them illegally, despite repeated awareness and requests. The number of cases that we hear and see in the news after being prosecuted is very small compared to the daily happenings across the border.
Thirdly, concerns on lapses in protocol or accidental exposures are still high in strategic locations such as the dry ports and transshipment areas. Any exposure from this setting is a huge risk to import the infection and spread throughout the country.
Due to these ongoing risks, it’s very critical that we take every precaution at all costs. People should take responsibility as individuals, as families and as a community. With the current situation, the government has not yet gained the desired confidence to lift the quarantine requirement. Therefore, the timeline for lifting this requirement will depend entirely on the evolving disease situation and also people’s compliance in HRAs.
His Majesty The King, while appreciating the support of the majority during such hard times, also reminded us that “A careless person’s mistakes will undo all our efforts. It will undo everything we have achieved so far. Please stay alert”. Therefore, it is everyone’s duty not to be that “careless person” and also not let anyone be that “careless person” by staying alert, until the end. We Bhutanese should continue to come together, show solidarity, prove that we are different, and that we can do it, to the rest of the world. With our kings guiding us constantly, we will not fail but we will get out of this pandemic more united and resilient than ever.
Clinical Microbiologist, JDWNRH