Concerns grow as cases soar, red home is removed and testing only for symptomatic

While a few weeks ago people were angry with the government for not unlocking fast enough, there is now growing alarm with the sharp increase in cases across the country, that are coming up with growing relaxations and doing away of earlier protocols.

There is also alarm over the government not testing even the first contacts in the same family and a suspicion that the aim may now be to suppress the real numbers of infections.

Earlier in the week, the government did away with the system of red homes whereby earlier if a family member tested positive then the whole family in the apartment would be sealed in for a week.

Now the person who tests positive is only advised to stay at home for seven days, the family contacts in the same apartment are not tested unless they turn symptomatic and there is nobody to monitor the movement of the positive case. 

The Health Ministry recently issued a warning against people who are positive from moving outside, but it appears that this is a lot more common now.

Dhendup from Thimphu said that after learning a family member is a primary contact, he immediately took her for testing and she turned out to be positive on 16 March.

He said he called the surveillance team 112 and 1010 several times to come and cordon his house but they never turned up.

He said he was told he could move out after 7 days but he refrained and on testing again he found himself to be positive even on day 11.

Norbu also from Thimphu had a similar story. He said his brother tested positive and so he took his mother who is 83 years old, sister and nephew for testing as they all stay together in one house, but he said the medical staff flatly denied them tests saying it’s the Prime Minister’s orders.

He said on one hand the Health Ministry on 27 March issued a notification asking positive people to not move around and that they would be penalized, but on the other hand tests are not being given and positive people are being allowed to move about.

He said his brother tested positive on 26 March and on 29 March he was let free with no Desuup. “He was told he can go around anywhere. He’s still positive,” said Norbu.

He accused the government of purposely spreading the virus.

“I called my brother who was in town requesting him to please go home and stay home. My brother was telling me other positive types were also there in town roaming around like him,” said Norbu.

There are also cases coming up where people who have undergone the 7-day quarantine or home isolation for domestic travel arrive in Thimphu and tested positive later. Now even this 7-day home quarantine is lifted

Explaining why the MoH is not testing first contacts even in the same house, the Technical Advisory Group (TAG) member Dr Sonam Wangchuk said that the virus is already there in the community and so it makes no sense to do contact tracing as preventing infections is no longer the aim.

He said that on the other hand the reason they are testing symptomatic people is to ensure that they do not fall seriously ill and can be monitored if they get worse. He said the aim is now preventing deaths and severe cases.

He also said that the requirement for a red home is removed and now it is the responsibility of the person testing positive to stay indoors and follow protocols.

Dr Sonam said that while they are no longer focused on stopping community spread they still do not want a surge in cases which is why some restrictions are still in place.

In a set of questions sent to the MoH they said that as per the new testing protocol of phase 2 only symptomatic individuals will be tested as they are more likely to test positive and infect others compared to asymptomatic individuals.

On stopping contact tracing the MoH said that they have graduated from the elimination phase to the protection phase.

On why people are not tested after the 7 days isolation the MoH said, “Because the infected individual would have already cleared the virus or become non-infectious therefore there are no added benefits of testing.”

Meanwhile the positivity rate in Thimphu and also across the country is going up with it rising more sharply in Thimphu.

On 30th March Thimphu had a positivity rate of around 11 percent which means 11 in every 100 people testing positive.

On 31st March this positivity rate spiked to 15.69% as 343 people tested positive against 2,185 tests. Of the 343 cases in Thimphu 297 were community cases.

The majority of testing is still for people wanting to travel while a smaller number are symptomatic cases.

The reporter asked Dr Sonam if the positivity rate is 15% then does it mean that of the around 100,000 people in Thimphu around 15,000 are already infected. Dr Sonam said that such extrapolations cannot be made.

Dr Sonam said that while they have not seen a big and alarming surge, but it is still early days as they may get the true picture only two or three weeks later.

He said that the situation is going well so far with only a small number of severe cases and none of them requiring Oxygen.

He said the large scale vaccination and booster dose is now playing its role. He said this maybe why even when people are exposed they are not turning positive easily. Giving his own example he said he had been exposed to two positive people repeatedly but here has not turned positive himself.

He said that the fact that he does not stay 24/7 with them maybe a factor too. He said it also depends on the immune system of people.

On the example of people testing positive even after 7 days he said these could be outliers as in around 90 percent of the cases people either recover or become non infectious within 7 days.

Dr Sonam also explained that most tests are now done with antigen as the problem with the RT-PCR is it even detects dead or inactive viruses in a person after recovery.

Dr Sonam said that when a person tests positive and they have a vulnerable person in the house they can opt for reverse isolation and the surveillance doctors should be informed the moment there are symptoms. 

On when a lockdown would happen the MoH said it would happen in the worst case scenario where a lot of people are getting infected resulting in hospitalizations which would cross the hospitalization threshold of 70% for enforcing lockdowns.

They said this would result in causing numerous undesired psycho-social and economic impacts to the residents of Thimphu Throm.  So, therefore, it is critical for everyone to continue following the COVID-19 preventive measures at all times.

On 3 April there were 1,384 COVID cases nationwide with 6,351 active cases of which 7 are severe. The total case count is 31,437 cases with 12 deaths.

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