The Bhutanese Leading the way.
A total of 21 COVID-19 patients are in the isolation ward in the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) and one patient is kept in isolation in Phuentsholing.
There are a total of 20 patients placed in de-isolation ward in Thimphu as of Friday and 17 have recovered of the total 59 cases.
For any infection, the patients are given antiviral and antibiotic drugs. Some patients have hypertension. The two pregnant women patients are doing fine and both are now in de-isolation.
As per the clinical management protocol for confirmed cases of COVID-19, it is categorized into confirmed case, mild illness, pneumonia, severe pneumonia, and following signs of COVID-19, accordingly the medicines are given.
The number of cases is likely to increase and the hospital is ready with another isolation ward in the old KGUMBS with enough accommodation for 52 patients. The same number of nurses, doctors and other health staff will be deployed there to look after patients.
However, if the number of COVID-19 cases keeps on increasing then there may be shortage of health staff, especially nurses. JDWNRH has been managing the cases without any problem till date because when a group of new cases were reported, another group of 5 to 10 patients were sent to de-isolation after testing negative. But now, new cases are reported every week, and with the health staff going for quarantine for 14 days, it might lead to shortage of health staff in the later month.
In order to avoid shortage of staff, the health ministry has planned to mobilize additional health staff and technicians from the other dzongkhags when required.
JDWNRH has identified 83 staff to manage the COVID-19 patients. Staff includes a medical specialists, residents, GDMOs, pediatricians, pediatrician residents, general nurses, laboratory staff, X-ray staff, USG staff, support staff ward boys/girls, wet sweepers, biomedical engineers, plumbers, and electricians.
Medical Superintendent Dr Gosar Pemba said there are repatriation flights on 7, 11 and 12 June coming from the Middle East. The hospital is likely to face some difficulties if there are new COVID-19 cases in the coming weeks. If the cases keep on increasing then there is a chance that the health staff might get infected.
“When the number increase there will be problem, but we are expecting that when the next batch comes, at least five to six patients will leave the isolation ward. So the number might remain manageable,” Dr Gosar said.
The hospital has an adequate number of doctors to look after the COVID-19 patients, and in addition 18 doctors have returned back from training. But there are chances of nurse shortage. Nurses are required more to look after COVID-19 patients. Three nurses look after 21 patients in each shift, and a total of 9 nurses are looking after the patients in a day.
“When 9 nurses go for quarantine for 14 days, another 9 nurses have to take over, so there will be some problems, unlike doctors. If all the cases are not serious, and so far all the COVID-19 patient are asymptomatic except for a few, two doctors can easily manage. We are deploying more nurses for the COVID-19 patients in order to give proper care to the patients,” said Dr Gosar.
In case the 21 patients do not show any flu like symptoms then the hospital might keep less number of nurses or 3 nurses because the hospital does not want the medical staff to go to quarantine or else there will be problem, Dr Gosar reiterated.
He said in other countries around the world, the people who test COVID-19 positive and are asymptomatic without any underlining diseases, are asked to do home quarantine. Only the COVID-19 positive people who require admission are admitted. But in our case, they are put in isolation ward to stop the possibility of the disease spreading.
So far there are no serious case, except for the American tourist. All the Bhutanese patients were asymptomatic except for a few of them. The patients are aged between 20 to 35 years. A few of the patients test negative within a week’s time and are sent to de-isolation for two weeks of quarantine.
Dr Gosar said it all depends upon how long they have been sick. Some people coming from the Middle East might have been sick four or five days ago and then they are asymptomatic. So when they are here, they test negative.
Around 200 nurses and 30 doctors are trained in ICU management so far. JDWNRH will be able manage up to 150 COVID-19 patients.
