Takes total positive cases to nine, five recovered

Younten Tshedup

With the confirmation of two new cases on May 10, Bhutan now has nine Covid-19 positive cases of which four are active.

The 27-year-old man and 28-year-old woman who recently returned from the Middle East, Dubai, have been moved to the isolation ward at the national referral hospital. They both have mild symptoms.

It was learnt that the woman in the first week of April, before arriving in the country had shown some symptoms. However, she was asymptomatic during the 21-day mandatory quarantine period.

The man, however, had developed fever while in quarantine a few days after his arrival. Health officials said that he did not inform officials on duty about his symptom, assuming it was the change in weather, causing the fever.

The duo arrived in the country on April 18. They tested positive on the 22nd day when they were tested before releasing.

A member of the technical advisory group (TAG) with the health ministry, Dr Tshokey, said that quarantine period would be extended for another 21 days for the two roommates of the positive cases. “The roommates would be tested again and if the results are negative, they will have to be in quarantine for another 21 days. If positive, they will move to isolation ward.”

The last day of contact for them according to Dr Tshokey was the day the two tested positive for the virus.

However, he said that quarantine for the rest of the group would not be extended since they have already tested negative on the 22nd day.    

Also because the last day of contact with the positive person was on the day of the arrival, they should have tested positive if anyone of them were exposed to the virus.


Testing protocol 


Except for the two American tourists who tested positive while in the country, all seven cases in the country were detected from the quarantine centres.

Besides screening every individual entering the country by land or air, people are tested at least twice – upon arrival and at the end of the 21-day mandatory quarantine period. For some, additional tests are performed if they become symptomatic while in the quarantine centres.

However, officials from the health ministry said that people are continuing to question the ministry’s testing protocols.

Health Minister Dechen Wangmo said that every test is conducted with different objectives.

The reverse transcription-polymerase chain reaction (RT-PCR) test is conducted on every individual upon his or her arrival in the country, within the first three days. The objective for this test, Lyonpo said was to minimise the exposure to nearby people including those who man quarantine centres. “If we detect early, we can start the treatment early.”

Dr Tshokey said that ideally, a RT-PCR test has to be conducted on every individual immediately on his or her arrival. “We tried to do that but due to logistical issues at the airport, we decided that everyone has to be tested at least once within three days of their arrival in the country.”

The time frame, according to the microbiologist, was also appropriate considering the lag phase, a period when the pathogen had recently infected a person and has not started multiplying. “By the third day, even if a person is infected recently, he or she should test positive on the PCR test.”

The rapid diagnostic test (RDT) is conducted at the end of the quarantine period, irrespective of symptom.

The minister said, “Here the objective is to prevent possible community transmission. We test everybody at the end of the quarantine period to make sure they are safe before we release them to the community. Not many countries do this test but we are being extra careful.”

Lyonpo said people are accusing the ministry of leaving test on the last day. “While all the people in quarantine are monitored daily, those who become symptomatic are tested for the virus at any given time during the 21 days. A final RDT test is conducted before releasing them.”

Citing the example of the 27-year-old man who did not inform officials of his symptoms, Lyonpo said, people must understand that it is important to inform health officials if they develop any symptoms. “While it is inconvenient for people to undergo a series of tests, it is for the greater good of the nation.”

Dr Tshokey said that there are people who due to fear of testing positive does not declare their symptoms. “There is a good proportion of people who without any symptoms can test positive for the virus.”

He said that besides testing people with symptoms while in quarantine, the ministry would also start testing people who have self-perceived risk. “We will test anyone who thinks he or she could have been possibly exposed to the virus given their respective environment. They do not have to necessarily show symptoms.”

Officials said that as Covid-19 continues to spread, claiming lives and threatening economic progress across the world, the race to find solutions is on. In this situation, people’s trust in science is paramount.