Chinese tourist tests negative for Corona virus: Health Minister
There was much panic in the social media on Friday as a screen shot of an email written by a RCSC employee, alleging that a Corona virus infected Chinese tourist had been detected in Bumthang, went viral.
The Health Minister Lyonpo Dechen Wangmo told The Bhutanese that the female Chinese tourist who is from Shanghai tested negative after a gene sequencing test was done in the Royal Center for Diseases Control (RCDC) to check for the virus.
With such a close shave and the peak tourist season about to start there is an increasing chorus in Bhutan to ban the entry of all Chinese tourists and visitors from China. Apart form ordinary people talking about a travel ban, large numbers of Bhutanese have come forward on social media recommending a ban on Chinese tourists and visitors with some even saying all tourists should be stopped.
Others have proposed that Bhutan stop flights to Bangkok given the 19 cases detected in Thailand which has the third highest number of cases.
Given that the virus can take up to two weeks to incubate people have said that even the temperature monitoring systems at the entry points into the country maybe useless.
The speed of spread of the virus can be seen from the fact that on Friday China had 9,809 confirmed cases with 213 deaths and there were around 100 cases in 21 other countries so far.
Four days later on Tuesday morning the China case load more than doubled to 20,438 with 425 deaths. While 26 countries and territories have 185 cases with 2 deaths in Philippines and Hong Kong.
In 2018, the second largest number of tariff paying tourists coming to Bhutan were from China at 6,878 tourists compared to USA which had the highest at 10,561 tourists coming to Bhutan. Bhutan got 71,807 tariff paying tourists in 2018.
A slew of countries has started banning Chinese tourists completely or have put bans on Chinese tourists from the more affected parts of China. Countries have also imposed flight restrictions to China.
According to the news site Quartz, Mongolia has closed Chinese border crossings, Russia has banned Chinese tour groups and closed its border with China, Kazakhstan has closed all transport links with China and and stopped visa issuance to Chinese tourists and North Korea has closed its borders to all foreign tourists.
Singapore, USA, Australia, Israel and Iraq have stopped entry for anyone from China.
Even India has stopped issuing e-visas to anyone in China in an effective travel ban.
Vietnam has closed border crossings to tourists, Philippines and Malaysia has stopped Chinese tourists from affected areas, Taiwan has stopped entry to most Chinese nationals. Even autonomous Chinese territories like Hong Kong and Macau have imposed restrictions in transport and visits.
62 airlines from many other countries have cancelled all flights to China. Lufthansa, Air India, British Airways and Lion Air have suspended all flights to China while others have cut down flights to China.
What has not helped is that the WHO has declared coronavirus as a global emergency, as the outbreak continues to spread outside China.
“The main reason for this declaration is not what is happening in China but what is happening in other countries,” said WHO chief Tedros Adhanom Ghebreyesus.
The BBC reported that the main concern of WHO is that it could spread to countries with weaker health systems.
Three positive cases were detected in Kerala, India and prior to that in Nepal.
The Health Minister said that the World Health Organization (WHO) has not yet recommended an official ban. She said that the government has put in place a travel advisory to avoid travelling to affected countries and avoid unnecessary travel. She said that the travel history of people is also being ascertained. Lyonpo said that the government is working closely with the Tourism Council of Bhutan.
The Prime Minister also announced that there will be no travel ban.
While the government has not said anything officially, two factors could be affecting Bhutan’s decision to not ban visitors from China.
One is that Chinese tourists are the second largest tariff paying group and so this would hit the tourism industry.
The second factor is that China’s Foreign Ministry has been critical of a travel ban on its citizens and has even criticized the USA recently.
While the PM claimed that Bhutan is being ‘professional’ it is being increasingly clear that there are political issues at play too.
It may now be a question of if the government is taking a major health risk to avoid criticism from China.
The main defence of the government to avoid a ban is that WHO has not advised as such.
However, the WHO itself is coming under international criticism for being too slow to declare Corona a global emergency.
According to the Nikkei Asian Review China is the second largest donor of the UN and WHO’s former DG was nominated to the post by China
The article also alleges that China used its diplomatic clout in WHO to block Taiwan’s attendance since 2017. WHO is still refusing to share information with Taiwan on Corona.
The article says China also provides significant aid to Ethiopia, which is the home country of the current WHO DG.
With such issues and given the spread of corona, countries across the world are not waiting for any WHO advisory, but are already enforcing full or partial travel bans on their own.
Measures to deal with coronavirus
In an earlier press conference on Wednesday the Health Ministry highlighted several measures it is taking.
With the recent outbreak Novel Coronavirus (nCoV) in countries around the world, Ministry of Health (MoH) said it has drafted a contingency plan and has put in place various precautionary measures.
The ministry is also collaborating with other relevant agencies to prevent nCoV from entering the country. MoH has also instituted precautionary measures at various points of entries, the primary one being the Paro International Airport.
In the case of Paro airport there is some misunderstanding as people expected to be checked with hand held devices, but the health minister clarified that the entry gate into the terminal had an automatic sensor above the door that would detect high body temperature and it would alert the health staff deputed there.
They have identified health facilities and response teams in the case of an outbreak in the country. Even regular staff will be trained to handle the outbreak with some extra information dressed in fully protective gear.
However, it was learnt that whenever there is a newer outbreak, World Health Organization (WHO) will come out with a training module, and as soon as they get the module, staff will be trained with support from WHO.
Lyonchhen (Dr) Lotay Tshering met with representatives from different agencies and members of disaster management authority for better collaboration and response, in case of an outbreak.
He said, “We are equally worried and MoH is putting in everything to prevent nCoV from entering the country. This is not something to worry about, however, we have to be extra careful and be cautious.”
He also said Bhutan cannot remain ignorant just because the virus is spreading in other countries. It is time for all the agencies to come together, to ensure better coordination and efficient response in case of an outbreak in the country, he added.
“We have to be prepared to the extent that we have the capacity to handle without any confusion in case of an outbreak tomorrow,” he said.
He said that a person with a good immune system can actually resist the viral attack. Deaths are caused to those who have a history of chronic liver and lung diseases, diabetics, extremes of ages, etc. “Ideally if a person follow normal personal hygiene steps, they need not worry, and that, itself, is the biggest medicine to fight against nCoV,” he added.
Meanwhile, the representatives recommended for preventive measures, such as the need of immediate stepped up surveillance in every southern border area, as the border extends from Tendu to Jomotshangkha, 700 km of open cross border where thousands of movements happen.
The surveillance mechanism is expected to ease the burden on immigration personnel as they check every individual coming in so far. Lyonchhen has directed MoHCA to lead a surveillance team all around the borders, mainly in the south.
Advisory measures are called for people who have a history of travelling to affected countries to come and do a health screening.
JDWNRH now has identified patient isolation rooms and critical units. In addition, all the health facilities at the points of entry (Paro, Phuentsholing, Samtse, Gelephu and Samdrup Jongkhar) they have established teams for emergency and triaging and identified isolation rooms.
Lyonchhen said, “If the identified isolation rooms are not sufficient, and if required, we need to have a plan of vacating Gidakom hospital where the whole space should be used for that purpose.”
Lyonchhen also emphasized on who, and where patients can be quarantined. “We must do something on quarantine because no matter how much travel advisory we give, they would still come through. So I want to urge relevant agencies to look upon this and have something in place.”
A place in Paro is being looked into, where TCB can inform all the travel agents to inform their guests on this, he added.
Lyonchhen also said that MoH can plan and distribute essential gadgets to all relevant agencies and all the medical pharmacy shops should have enough stock and different portals are to be used to inform and alert people to wear the protective gears.
The Health Minister, said that a detailed contingency plan is being drafted. “We would like to request the public to practice good hand hygiene, and if possible, refrain from unnecessary travel to affected countries,” she said.
She also said that if anyone experience symptoms outlined in the health factsheet, and have had a travel history to affected areas or close interactions with nationalities from the affected areas, MoH requests everyone to seek proper and appropriate medical help from professional healthcare providers, and not resort to traditional healers or other religious means.
While putting in place certain plans, the ministry has come across numerous challenges, an official from public health said. Some of the challenges are too many entry points from the south where they have to screen thousands of people in an hour and any outbreak in India where there is free movement of people around the borders.
He also said that high mobility of Bhutanese on holidays, pilgrimage and business is another challenge. Likewise, direct flights from affected countries, coordinating with other stakeholders, limited contingency funding, quarantine and procurement of additional equipments are other challenges faced.
MoH has initiated infrared fever scanning and respiratory symptoms screening at the airport, health screening of passengers arriving from China and passengers with travel history to Wuhan, China (including affected countries) and RCDC is prepared to handle the 2019-nCoV in their BSL 3 lab and expected to receive nCoV test kits by the end of the week.
nCoV is a large family of virus causing respiratory illness from common cold to severe diseases similar to Middle East Respiratory Syndrome coronavirus (MERS-nCoV) and Severe Acute Respiratory Syndrome coronavirus (SARS-nCoV).
It can be transmitted from human-to-human through droplets while coughing. Fever, cough, sore throat, shortness of breath and breathing difficulties are some of the symptoms of CoV while pneumonia, severe acute respiratory syndrome, kidney failure and death can be some of the severe symptoms.
There is no specific treatment for nCoV but symptomatic treatment can be provided, and all hospitals in the country can provide symptomatic treatment.
The first outbreak of 2019 nCoV was reported from Wuhan City in China on 31 December 2019.
Note: The story has been updated with new figures and facts.