The Bhutanese Leading the way.
But the high risk area protocol and JDWNRH testing protocol saved the day
On Friday evening 16th April a 10-year-old student and his 29-year old mother tested positive for COVID-19 as the first two cases in Phuentsholing.
However, in a strange coincidence the first contacts of the the 29-year-old mother which is her sister, the sister’s daughter, husband and a baby had been admitted to the pediatric ward of JDWNRH.
On the late night of 15th April Thursday the sister’s husband and her daughter who came up from Phuentsholing was admitted around 11 pm on an emergency basis in the surgery section of the pediatric ward as the daughter had a gall stone problem.
The father and the daughter did not have to do the 7-day quarantine as this was an emergency medical case and so they did the RT-PCR test in Phuentsholing and came up. One more test was done at JDWNRH and then they were admitted.
Then on the early morning of 16th April Friday the sister and her infant baby also joined the husband and daughter after competing similar testing. JDWNRH allows up to two attendants per patient.
Then news broke on Friday evening of the son and mother testing positive in Phuentsholing and the surveillance team realized that the sister of the mother along with her other family members are already in the heart of the JDWNRH.
Panic broke out as the surgery section of the pediatric ward was screened off and tests were carried out on Saturday.
Eventually the entire pediatric ward which had around 20 plus patients and another 30 to 40 attendants with a team of doctors and nurses was turned into a containment center within JDWNRH.
All the young patients which included many young babies admitted with an array of complications to their parent attendants were all subject to RT-PCR testing.
Then late in the evening the entire ward was shifted out lock, stock and barrel to the old maternity and pediatric ward outside JDWNRH which had been turned into an isolation center.
Meanwhile, there was speculation rife among the ward members and questions among the parents on how this had happened. There was also fear on what would happen if the first contact tested positive.
Attendants remembered how the sister had moved around the ward corridor with her infant child and some remembered how the husband used a bathroom in another section of the ward.
The surgery section of the ward which was more exposed were moved to the first floor of the old maternity and pediatric ward while the others were kept on the ground floor.
There was some degree of discomfort as the old building did not have indoor heating and so heaters had to be resorted too. The medical facilities were also not the same given that this was an older structure.
Some patients who were supposed to be discharged were also held back.
Meanwhile, the sister and her family were taken to a different isolation center to undergo the 21-days quarantine.
In the meantime, the pediatric ward patients, attendants and the health team there were tested again on Tuesday on the RT-PCR under the health protocol and everyone came out negative.
It was only from Wednesday afternoon that those patients who were supposed to be discharged earlier could be discharged.
The Health Minister Dasho Dechen Wangmo said that the sister and her family members had been tested before exiting Phuentsholing and also before moving into the hospital.
Lyonpo said that the testing and the shifting of the ward had been done as a precaution in case the virus was still incubating and some shedding had occurred.
The minister said that the entire ward had been fumigated and cleaned after it had been emptied out and new entry had been allowed from Wednesday onwards.
Those patients who had been moved out will continue to stay in the old maternity building for around 21 days.
Lyonpo said the pediatric ward team had been divided into two and they are looking after both the sections.
JDWNRH earlier had a policy of compulsory RT-PCR tests for all patients and attendants being admitted to the hospital but an official said this was changed to only antigen tests.
Lyonpo said that for patients and attendant being admitted into the hospital the norm is antigen tests, but if patients come from high risk areas then they do the RT-PCR tests.
The minister said that this is where it is important to highlight the no visitors and no food policy of the hospitals as she get 10 to 20 calls a day of such cases making requests to her.
Lyonpo said the health system is very fragile and they cannot have to have the virus within the hospital. She said such rules are necessary to also protect the very vulnerable.
The above incident shows how things could have gone very wrong for the country’s only major referral hospital but at the same time it also shows that the system of 7-day quarantine, RT-PCR tests and non-allowing of visitors do work to prevent potential disasters.
