American tourist- stable, the first coronavirus patient in Bhutan who visited India

Agencies and KalimNews: Detailed itinerary of 76-year-old American tourist, who became the first person to test positive for coronavirus in Bhutan states that he had entered the South Asian country on March 2 of this year and had previously been in India since Feb. 21. The man started his journey in Washington, D.C., on Feb. 18. He enjoyed a long and relaxing vacation with his partner in India, especially in Assam, before heading to the Himalayan Kingdom, said sources from the Airports Authority of India (AAI).  

The patient has been isolated in the COVID-19 hospital at Thimpu. He is kept on oxygen support considering his age and underlying conditions.

According to AAI sources, the tourist took off from Washington DC in the US on February 18. His journey started with one night in London, followed by his arrival in Mumbai, while his partner started her travel from Los Angeles, US to New Delhi on February 17. She stayed in Delhi for three nights.

On February 21, he travelled from Mumbai to Kolkata, and his partner joined him via an Air India flight on the same day.

The very next day, the duo took a 9.45 am Indigo flight to Jorhat. From February 23, they took a seven-night cruise by MV Mahabaahu Brahmaputra River Cruise in Assam. 

The 7 night/8-day downstream cruise starts from Jorhat covering Sivasagar, Majuli, Eastern Range of Kaziranga, Bishwanath Ghat, Kaziranga National Park, Peacock Island, and the revered Kamakhya Temple in Guwahati.It included a stay at a resort in the Kaziranga National Park.

The couple arrived in Guwahati on March 1 and checked-in to Hotel Radisson Blu for one night, and the next day, they took a flight for Paro from Guwahati Airport.

While the director of Guwahati Airport, Ramesh Kumar, has said that five CISF officials in Guwahati Airport are under observation as a precautionary measure.

“There were two other foreigners with the U.S. couple on the ship that sailed on February 24 with 35 crew members, none of whom showed any signs of infection. The other two foreigners returned to their country. The ship was fumigated once the group checked out and the new group of 22 foreigners checked in to start sailing on March 1,” said Sanjay Basu, who heads the firm that runs the cruise Mahabahu in collaboration with the Assam Tourism Development Corporation.

The patient tourist with his partner, aged 59 along with 10 passengers on board (8 Indian nationals) had entered Bhutan from Paro International Airport, after embarking Drukair flight KB241 from Guwahati in Assam on March 2. 

At the Paro International Airport, the American patient’s health declaration form was assessed. He had indicated “negative” against all conditions. He did not have a sign of fever. 

However, upon reaching Thimphu, around 3pm, he visited the medical OPD at Jigme Dorji Wangchuk National Referral Hospital (JDWNRH), complaining of bloaty abdomen (dyspeptic symptoms) and nausea. The patient was suffering from chronic hypertension and is on medication. However, even at that time, he did not have any flu symptoms. The patient and his partner stayed at Le Meridien on the first night.

The following day, he stayed indoor most of the time and went to the hospital again around 3.30pm for stomach upset and diarrhea. The next day he went for a trip to the country’s Punakha with two stops on the way for tea and lunch. He had stayed at Densa Boutique Resort. That evening, he had walked until the Bazam next to Punakha Dzong, and returned to the room. The next day, upon returning to Thimphu, he visited JDWNRH again. He was found to have fever, sore throat, cough and shortness of breath. 

He was kept under observation at the flu clinic (designated COVID-19 hospital) and samples were collected and sent to Royal Centre for Disease Control (RCDC).

On confirmation, he has been isolated in the COVID-19 hospital. The patient is on oxygen support.

Health ministry has asked the four crew members of the particular flight, and the hotel staff at both Le Meridien and Densa Boutique Resort to "home quarantine". Which means they should stay home and maintain distance from people, including family members. Until all suspicions are ruled out, health officials will closely monitor and provide all services at respective homes.

People he met and travelled with, at all the points and stops along the way, starting from Paro airport to Thimphu, to Punakha and back included tea stops at Druk Wangyal Cafe, and lunch at Punakha High School park.

His close contacts were his partner, the driver and the guide, are asymptomatic for now, they have been quarantined at the designated COVID-19 hospital.The eight Indian passengers have also been quarantined. The government is closely working with the Indian Embassy.

So far over 90 persons who might have come into his contact have been traced. Health officials and other relevant agencies are in the process of carrying out primary disease management and contact tracing.None is currently showing symptoms.

Royal Centre for Disease Control declared all the 39 samples of people, including those of the partner of the tourist, the driver and the guide, who had direct contact with the 76-year-old American tourist were found negative.

Those who had direct contact with the tourist were from Thimphu and Paro which included hotel and restaurant staff, emergency ward doctor who treated him twice, guide, driver, and co-passengers, among others. 

The individuals would now be monitored for the next 10 days, and samples tested again if any of them show any symptoms,” Prime Minister Dr Lotay Tshering said.

“They will now be placed under watchful waiting, meaning they will still have to avoid crowds and take necessary precautionary measures.” Prime Minister said. Prime Minister said that doctors treating the American at the isolation unit observed that his general health conditions were improving. Doctors started feeding the patient who has been admitted with severe diarrhoea and bloated stomach since yesterday.

“He called his relatives and even talked to his family doctor in the US,” he said. According to the Prime Minister, the patient could not move around much since he was unwell which limited him from making contact with a lot of people.

A Bhutanese woman who had recently returned from Kuwait is quarantined in Kanglung basic health unit with fever. The RCDC will test her for COVID -19. Prime Minister said that clinically it is not so much of a risk but the government is not taking any chance.

“Since she has come from an area affected with COVID-19 we want to carry out the test,” he said. “That’s the only reason.”