The Bhutanese Leading the way.
Apart from the biggest outbreak in Wangduephodrang, the border towns of Phuentsholing, Gelephu and Samdrupjongkhar have also seen outbreaks with community cases.
Phuentsholing
Phuentsholing, till 24th January has 173 active cases. It all started on 6 January 2022, with a 37-year-old expatriate woman testing positive for Omicron from Lucky Restaurant and Bar during a surveillance check.
The Southern COVID-19 Taskforce Chairman and Home Secretary, Sonam Wangyel, said they did a small investigation, and except for some call records with her Indian husband across the border, they could not establish if she had violated COVID-19 protocols.
He said that, strangely enough, all her immediate contacts, including her roommate, tested negative.
The Chairman said that the other early case was of a Desuup testing positive from the Phuentsholing main gate, but here, the source was very clear, as he had to physically verify the documents of Indian workers. The Desuup worked in containment.
He said that after that a community case was found from near the MIG cinema, and since then most of the community cases have all been from the core town area. The Chairman said that Lucky Restaurant was located below a quarantine hotel, but while the restaurant faced towards the street, the hotel faced the other way and there was also a physical barrier in between them.
“Since COVID-19 is airborne, I don’t know if the people in quarantine opened the windows the virus spread form there,” said the Chairman. He said there is one theory that the case to Phuentsholing may have come from a low-risk area, like Wangdue but he does not subscribe to that as there is no evidence for it.
The bulk of the Phuentsholing cases this time are from the core-town area and not like the MDP before.
Southern COVID-19 Task Force member, Rixin Jamtsho, said that after the last outbreak in Phuentsholing, frontliners and staff at the MDP are in full PPE, and so this time around, he suspects it was the large numbers of foreign workers, and also local Bhutanese coming into Phuentsholing and staying in quarantine there.
He said normally quarantine cases coming from outside are kept away from the core town areas in Kharbandi, etc., but sometimes large numbers come and some come late at night, and so they have to be kept in the core town area quarantine hotels as others are full.
He said that large numbers of foreign workers were being brought into Phuentsholing since October 2021.
He said that Phuentsholing is also vulnerable, given the import and export that has to happen, apart from the large number of people moving through it.
Rixin said that fully vaccinated people were quarantined for 14 days, which still leaves a 5 percent risk of turning positive, and those who stayed 21 days still had a 2 percent risk of turning positive. He said they tried their best to prevent leakage, but somewhere there was a leakage.
Gelephu
In the case of Gelephu, the vast majority of cases have been from in and around the Throm area, but the surprise came on Thursday morning, when 7 students from the Sarpang Central School also tested positive followed by 21 more students on Friday. More cases followed and the school now has 61 students positive. The school is around 30 km away from Gelephu.
Among the southern regions, Gelephu has been relatively unaffected in past lockdowns.
Coincidentally, cases started arising in Gelephu after a large number of P-II workers who were later found to be positive in Wangdue were processed through the town with document and health checks done on 31 December, 1 January and 4 January.
A local health official said that the green zones of Gelephu have had the maximum cases.
Gelephu has also had to keep a large number of foreign workers and returning Bhutanese in quarantine. Like Phuentsholing and Wangdue, the ball game completely changed when Omicron came on the scene, and caught the town unaware.
However, on the P-II workers’ theory, a Gelephu health official pointed out that, if the leak had happened from them then the health workers and frontline workers who dealt with them should test positive. This did not happen.
Sarpang Dzongda, Lobzang Dorji, said the cases could definitely not have come from a breach at the gate, as the frontliners at the gate including DeSuups, loaders and others should test positive.
He said it is difficult to point to any source. He said, luckily for Sarpang, the cases have been limited to the two main areas of Gelephu Throm and Sarpang Central School, and he said the Dzongkhag would be in trouble if cases had started coming up all over the place.
The Dzongda said that while people from high-risk areas have to quarantine to go to low risk areas, the same is not applied for people coming from low-risk areas.
On the cross border movement, he said that, unlike Samtse and Phuentsholing, there are not many settlements across the border in Sarpang. He also said that while quarantine facilities are being used in Gelephu, he does not feel a leak occurred from there.
He said that on 31 December 2021, Gelephu quarantined 40 P-II project workers, as they did not have a clear vaccine status, which is required to quarantine in Wangdue, but only two of them tested positive.
Samdrupjongkhar
The Eastern COVID-19 Taskforce Chairman and Land Secretary, Dasho Pema Chewang, said that it is very difficult to say how the spread happened in Samdrupjongkhar.
However, he agreed that the spread is happening at a time when Omicron is raging across the border, there are increasing numbers of foreign workers in quarantine in the town, and also an increasing number of Bhutanese in quarantine facilities.
An official in Samdrupjongkhar said that earlier, there used to be a practice of keeping drivers who drive from high-risk areas to high risk areas in containment. This was because they faced a high level of exposure having to drive through West Bengal and Assam.
However, this was done away with. The official said this outbreak is a good lesson, and shows the need to revisit certain SOPs.
The virus and the surge
In all of this, a key role was played by the virus, itself.
TAG member, Dr Sonam Wangchuk, said that the Omicron variant is not only very infectious, but it has a much shorter incubation time compared to Delta variant or others.
So, if a person gets exposed, she or he may start showing signs within one to two days, and thus starts infecting others. Omicron is considered to be twice as infectious as the Delta variant and four times as infectious as the original Wuhan strain.
The outbreak in Bhutan also coincides with an outbreak in India, with record numbers of cases, including in Assam and West Bengal.
India, on Friday, saw 347,254 cases, which is an 8-month high with 703 deaths. Of this, West Bengal saw 10,959 cases with 37 deaths, and Assam saw 7,929 cases with 12 deaths.
Even all the previous outbreaks in Bhutan have been linked to outbreaks or when cases go very high in India.
To add to this, Bhutan’s quarantine system and SOPs had been upgraded to deal with Delta variant, but was clearly not prepared for the infectiousness of Omicron.
A factor may also have been the lack of focus on good ventilation in SOPs, and health advisories even after the WHO acknowledged airborne transmission of COVID-19 last year.
Economic Pressure
The year 2020 saw two major national lockdowns in August and December, with the second one starting from 20 December 2020 going into January 2021.
This was followed by a major outbreak in the south, centered on Phuentsholing that went on till August 2021.
The economy suffered badly with a -10.80 percent drop in 2020.
After January 2021, except for Phuentsholing, the rest of the country was lockdown free and there was an increasing clamoring from contractors worried about deadlines, banks holding contractors’ loans, government agencies with projects, hydro projects, and ordinary people to import foreign workers.
The government was under tremendous pressure as tourism was already down, and it could not afford to let the largest GDP contributor, which is construction, sink, or hydropower, the largest revenue generator, get further delayed.
The government was also banking on government construction projects to give growth a fillip in 2021 and beyond, but this would require foreign workers
In addition, there are porous borders to worry about, which are even more porous during winters due to the shrinking of streams and rivers.
