High percentage of high risk close contacts are testing positive unlike the Phuentsholing outbreak
Says source of outbreak could either be from those coming from the south or from those coming via air to Thimphu
72,000 people had left from Thimphu between 7th and 20th December to all 20 Dzongkhags
The Prime Minister Dasho (Dr) Lotay Tshering said that the COVID-19 outbreak this time seems to be more infectious than the earlier August one in Phuentsholing. As of day nine of the lockdown Bhutan had 172 local cases (see separate story on pg 1).
He said that this anecdotal conclusion is based on the fact that a high percentage of the ‘high risk close contacts’ are testing positive.
A high risk close contact would be the immediate family member, spouse, work colleague or anyone with whom the positive patient spends long hours or engages in activity like eating together, sleeping together, working together etc for a longer duration.
The PM said that if you greet a friend for a few minutes at the bank or just meet someone for a short while then that does not qualify as a high risk close contact.
He said that in the earlier Phuentsholing outbreak in August there were many cases where even spouses and close family members in the same house were not testing positive.
This is not the case this time around.
However, the Prime Minister qualified his statement saying that this is based on observations of the close contact cases turning positive and Bhutan does not have the technology to gene sequence and test the COVID-19 virus to see if it is a more infectious strain.
He said that for an outbreak to be more infectious it has to meet the three criterias of the host, agent and environment. The host will be the human and how susceptible that person is to the virus, the agent is the virus and its virulence and mutations and the environment is in terms of closeness, sanitation, hand washing, facemask etc.
Lyonchhen said that Bhutan has not done the tests for the above three yet.
On the source of the current outbreak the Prime minister said that there are two probable overall sources with it either coming from the travelers from the south under the 7-day quarantine or via the airlines.
Lyonchhen said that in one particularly risky flight on 27th November 60 percent of the passengers including even some of the air crew had eventually turned positive.
The PM said that while the outbreak is more infectious it is a ‘good outbreak’ given that it is confined within an area and the links can be found.
The PM said that geographically the location of the outbreak seems to be mainly confined in the Thimphu and Paro areas.
He said that even in the case of other Dzongkhags were cases had come up these were mainly the close contacts of the cases in Thimphu or Paro. He said the recent Trongsa and Haa cases were close contacts of the Paro cases.
He said the outbreak cases can mainly be seen within certain people and gatherings. The PM said that in terms of events some few archery matches with close contacts are coming up as common venues for the spread of the virus.
Lyonchhen said that with 15 cases coming up in Shabha school they had wondered if there could be hundreds of cases among parents in Paro but not as many positive cases had come up in that area and this is good news.
Within Thimphu, the Prime Minister said that the area below the Ministry of Works and Human Settlement and up to Sabzi Bazar seems to be the main area of outbreak with some cases in the Bhutan Telecom area.
Lyonchhen said that even two vegetable vendors had tested positive and many of their high risk close contacts had tested positive. He said in contact tracing the vendors could only identify people they knew like family or friends, but not customers.
Lyonchhen said the government had deliberately not asked all people who went to the CFM to come forward for testing as this would lead to a ‘super spreader’ event.
He said that the government is anyhow doing ramped up testing and now also a representational household mass testing in Thimphu.
The Prime Minister said that earlier he had talked of 37,000 people leaving Thimphu for 20 Dzongkhags between 7th and 20th December but it was actually 37,000 vehicles and it carried around 72,000 people. He said for quite a few they would have come back to Thimphu.
He said just 17,000 of them had gone to Paro but many also came came back while a few others would have flown out.
Lyonchhen said that only the first case in Lhamoizingkha could not be traced to Thimphu or Paro.
The PM said that in most of the cases there is very little or no antibodies which indicates that the infection is quite new.
The Health minister Dasho Dechen Wangmo said that most of the positive cases are in between the last week of November and the first week of December though they cannot say conclusively that it was then.
The Health minister said that most of the positive cases have symptoms like flu symptoms, fever and coughing. She said it is good that symptoms are there as it means that the virus is just spreading and they are catching it on time.
Lyonpo ruled out that the infection was caused by those who came from quarantine or those who had got the virus and recovered and relapsed again. She said they are tested multiple times before release.
She said if there is a positive case in the family then the family member will be taken to hospital but then those in the same home will have to undergo a 21-day home quarantine.
Similarly, if there is a positive case in a building then the whole building will be in a 21-day quarantine too with DeSuups on duty, she said.
These measures maybe given the more infectious nature of the current outbreak.
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