The second lockdown or lockdown 2.0 as it is fancily called, began on 20th December and is still going on as I write this. It was initially projected to go on for at least 3 weeks, given the gestation period of the virus in a human body. However, we are onto our fourth week of lockdown with no end in sight. Just yesterday, there was a case from the community as one of the shopkeepers tested positive as he was due to open his shop. This points to the ongoing community transmission which is obviously unchecked.
The rational approach, as authorities said they were going to follow, accompanied the testing of the population based on random sampling methodology over and above the testing of the close contacts of positive cases. This they said would give a general sense of how many people were infected. While scientific in their approach, authorities failed to learn from their previous experience that the sero-surveillance (based on the same random sampling methodology) in Phuentsholing just before the first lockdown, failed to unearth any infected cases while community transmission was rife in the border town. The Phuntsholing experience should have given us clues that it was not a way to go if the primary goal was to identify and isolate the positive cases in the shortest time possible. The same methodology which has been followed so far during this second lockdown has not seen the virus relent its onslaught on unsuspecting people.
It is then natural to think of alternative ways we could have followed to nip the bud of the virus before it spread further. The most effective way I think would have entailed the testing of the entire population of Thimphu and Paro from the beginning. While a challenging feat to carry out, it would definitely have been a more effective way had our objective been to have a short and non-disruptive lockdown.
There are about 150,000 people comprising 27,000 households in Thimphu. Let’s assume that about 3 households on average occupy a building/structure for the sake of this calculation. 27000 households would then occupy 27000/3 = 9000 buildings/structures. Let’s add another 3000 buildings from Paro, which would bring the total buildings/structures of the two dzongkhags to 12000. Let’s say that 1% of the population is infected, which obviously is an overestimation.
Household in Thimphu = 27,000 Household in Paro = (3000 * 3) = 9000 (3000 structures with 3 families living in each) Percent Infected = 1%
Given the above-assumed figures, we come up with the following numbers.
Pooling all residents of a building for a PCR test, we would need 12,000 + (.01((27000+(30003))*5.5)) = 31800.0 tests.
I think this is a reasonable number of PCR test kits that we can afford to use. To put this number into perspective, we have already carried out over 50,000 RT-PCR tests since the beginning of the lockdown. Given sound logistical arrangements and proper health staff deployments, we would not only have been able to come out of this lockdown earlier, but we could also have been confident of our containment of the virus.
However, there’s still time to test everyone, otherwise, we risk lockdown 3.0 as soon as this one is over.