India maybe the next global hotspot for COVID-19
Neighboring India crossed a million COVID-19 cases late on Thursday around 170 days after it saw its first case in Kerala. As of today it has 1.115 mn cases and 28,084 deaths.
In addition to this, the neighboring states of West Bengal and Assam have seen an explosion of cases. As of today West Bengal has 44,769 cases with 1,147 deaths and Assam has 25,382 cases with 58 deaths.
Even Arunachal Pradesh is seeing a rise in cases with 790 cases and three deaths until today.
The challenge is not only the COVID-19 cases in Assam, West Bengal and Arunachal Pradesh but the fact that some cases are in districts that directly adjoin the international boundary with Bhutan.
The MoH maintains a daily dashboard of cases in these districts adjoining Bhutan or those with which Bhutan has a lot of human and trade movement.
In Assam as per 14th July Bongaigaon district has 155 cases, Barpeta has 467 cases, Baksa has 85 cases, Kokrajhar has 86 cases, Nalbari has 145 cases and Kamprup Metropolitan has 8,183 cases.
In the the case of Arunachal Pradesh the West Kameng district bordering Bhutan had 29 cases on 14th July.
In West Bengal Darjeeling district has 951 cases, Jalpaiguri has 581 cases, Alipurduar has 206 cases and Kolkata has 10,550 cases as of 14th July.
The actual figures would be much higher given that India is internationally at the lower end of the scale in testing as pointed out in a recent BBC report which also said that India maybe the next global hotspot for COVID-19 with a large population and many people living in packed cities. India already has the third highest number of cases behind USA and Brazil.
The BBC report quoting a sample survey of 26,000 Indians by the Indian government in May says that around 0.73 percent was infected and this extrapolated to the whole population in May would be around 10 mn cases in mid-May which by now would be around 30 to 40 mn cases.
The intimidating figures above is not helped by the occasional case of either smugglers trying to get in drugs and tobacco across the border, people getting workers across the border (Phuentsholing) or simply coming across (Samtse).
So as cases balloon in India the challenge for Bhutan will be to prevent or mitigate community transmission coming across the sealed but still porous international border, and especially so with a country who is Bhutan’s largest trade partner and the source of most of its imports from food to consumer goods and even labourers.
The Health Minister Dechen Wangmo said that as of now Bhutan as a Community Transmission Mitigation Strategy to handle this.
She said that the border will have to remain closed for the foreseeable future.
Lyonpo said that frequent testing is an important tool and so currently anyone coming with flu like symptoms along the southern belt is being tested for COVID-19 as a precaution. There is also proxy community testing along the southern border.
In the rest of the country COVID-19 tests are being done if one has acute respiratory infections like a blocked chest, pneumonia, acute coughing and other strong symptoms.
She said that traditionally acute respiratory infection samples were collected and tested from only 11 centers and this has been increased to 50 across the country.
Lyonpo said that the health workers and those along the borders are being regularly tested in addition to around 8,000 Dessups.
The minister said that the seasonal flu vaccines will be here by around November when everyone will be vaccinated, and so after that even if one has any kind of flu symptoms one will get tested for COVID-19.
RT-PCR testing apart from Thimphu and Mongar is now also available in Phuentsholing and Gelephu.
She said a new antigen testing kit has been introduced which gives results much quicker and that has been introduced in all health facilities like district hospitals, 10-bedded hospitals down to BHU Grade 2 and even BHU Grade 1 in certain instances.
Lyonpo said the temporary flu clinics are being removed and they are being incorporated and mainstreamed into the regular infrastructure of the hospitals.
On the future of COVID-19 in India, Lyonpo said that it will be difficult to predict how it will spread in India. She said that earlier it was said the peak will be in July or August but that does not look like it now.
At the Dzongkhag level and especially in the bordering areas Lyonpo said there was community participation with villagers, health workers, local government, Dessups and others working closely together.
She said that goods coming in are being screened through a systematic process and the government will develop dry ports in Gelephu, Phuentsholing and Pasakha where there will be proper procedures and where they can come and where they would get tested.
On importing labourers Lyonpo said that the protocol is the same for all be it a skilled person or a laborer and so there are no relaxations there.
Lyonpo said to deal with the fall out of the closed borders the government is coming up with a 21st Century Economic Roadmap, Build Bhutan project and restrictions are being eased. She said that MoEA is looking at the supply chain while the MoAF and FCB are looking at food security and related initiatives.
In terms of opening schools at this time the minister said that the MoH has 8 to 9 compulsory requirements like facemasks, ventilation, no mass gathering, COVID focal person, etc. and only schools who can fulfill such conditions can reopen.
In terms of the mental health fall out Lyonpo said most of the callers are still from the quarantine centers and in that way Bhutanese society seems to be quite resilient.
Lyonpo said that each ministry and agency are coming with their own strategies to deal with this.
She said, “There is no post COVID-19 phase or an end to COVID as it is here to stay whether we like it or not and so the ministry is mainstreaming this in its health delivery services.”
She said this is now a new normal and various agencies were looking at ways to adapt to this.