By Tashi Lundup and Murtaza Fazily, Stawa 03-20
The otherwise bustling Leh market is empty, Ladakh
The novel coronavirus disease or COVID-19 has been detected in 115 countries and killed 4,000 people around the globe so far. On 7 March, two individuals in Ladakh tested positive for COVID-19. Both of them had returned to Leh from Iran, one of the worst-hit countries outside China where COVID-19 originated.
Chief Medical Officer (CMO), Leh, Dr Motup Dorje said, "Two passengers who returned from Iran tested positive for COVID-19. One patient had returned to Delhi from Iran on 26 February and then flew to Leh on 28 February. The other patient reached Delhi on 22 February and travelled to Leh on 27 February. We received their test results on 7 March and they are now in quarantine."
When asked about the health of the two patients, Commissioner Secretary, Health, Rigzin Samphel, IAS said, "Both of them are recovering well. We will keep them in quarantine till their tests results are negative for COVID-19." The UT administration is trying to reach all the passengers who had travelled on the flight taken by the two patients. Dr Motup said, "They contracted COVID-19 outside the country and so far it has not spread to the community. We have enforced containment measures and are hopeful of containing it. There were 146 passengers on the SpiceJet flight (SG151) on 28 February and there were 110 adults and an infant on the Air India flight (AI445) on 27 February." The UT Administration has so far not managed to reach all the passengers on the two flights. Rigzin Samphel said, "Since we have not been able to reach a few passengers, I appeal to them to undergo self-quarantine at home for 14 days and get checked up if they are unwell."
Rigzin Samphel has been appointed as the official spokesperson on the COVID-19 issue. He said that more than 18,000 passengers have been screened to date. "Around 131 pilgrims from Iran have reached Leh so far. Of this, 100 are from Kargil and 30 are from Leh. All of them are currently under observation, while 28 people are in quarantine at home. We had sent 28 samples for testing and so far two have returned positive while nine were negative. We are waiting for the remaining results."
Both patients are from Chushot Gongma. Another person from the village, who had also returned from Iran, passed away on 8 March. Rigzin Samphel explained, "Mohammad Ali, 75 from Chushot Gongma had gone to Iran on pilgrimage. He returned from Delhi on 28 February and was being supervised by the Block Medical Officer. He was admitted to SNM Hospital on 6 March but unfortunately he passed away. We have sent his samples for evaluation." The samples have tested negative for COVID-19. It is alleged that Mohammad Ali was sitting next to one of the individuals who tested positive for COVID-19 but we have not been able to confirm this.
So far, no COVID-19 cases have been detected in Kargil district. Divisional Commissioner of Ladakh, Saugat Biswas, IAS said "We have no cases of COVID-19 from Kargil. All individuals who returned from Iran have been kept under observation. We are currently following the national-level protocol in both districts."
COVID-19 was first detected in Wuhan, China in December 2019. World Health Organisation (WHO) has since declared it a 'Public Health Emergency of International Concern'. WHO reports that more than 100,000 cases have so far been reported, of which more than 80,000 cases are in China alone. More than 3,000 people, a majority of them in China, have died globally. In Iran, more than 8,000 cases have so far been reported with 290 deaths. In India, Ministry of Health and Family Welfare reports that 47 COVID-19 cases have been detected till 10 March.
WHO states COVID-19 belongs to a large family called coronavirus. These viruses cause illness ranging from the common cold to serious ones such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). The novel coronavirus (nCoV) or COVID-19 is a new strain of the virus that had never been detected in humans prior to this outbreak. Common signs of infection include respiratory distress, fever, cough, shortness of breath, and breathing difficulties. In severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.
An article published in UK-based The Daily Telegraph reports that 'doctors in the erstwhile state of J&K believed the authorities could have facilitated the spread of deadly coronavirus by refusing to carry out tests'. In late January, Dr Tsering Angchuk, Deputy Medical Superintendent of SNM Hospital, Leh suspected that three patients at the hospital had coronavirus. One of them was a 54-year-old patient from Phyang who was admitted on 27 January. Dr Angchuk wrote a letter to CMO, Leh on 18 February titled, 'report regarding the patient who showed coronavirus-like symptoms,' Dr Angchuk requested that samples be sent immediately to India's only coronavirus testing facility in Pune. Somehow, the letter found its way to social media and people responded with panic and anger.
The Daily Telegraph quotes Dr Angchuk as saying, "When you get several patients with the same symptoms, you obviously inform your higher-ups to ascertain the cause of their illness. I had coronavirus in the back of my mind and that is why I asked my seniors to send samples for testing." Hospital authorities did not send samples for testing as they believed that it would be impossible for anyone in Ladakh to be infected by coronavirus. The patient from Phyang died on 5 February. Dr Angchuk explained why he wrote the letter, "I want the maximum number of people to have an idea about the coronavirus so they can be protected from it."
As the number of COVID-19 cases in India continues to rise, people on social media have started targeting the government for failing to address the problem. Diskit Angmo wrote, "Why were the pilgrims travelling from Iran not quarantined in Delhi as promised by the central government? It's really a huge failure on the part of the government of India to allow passengers to travel freely from infected countries."
Tsering Angmo questioned the arrangement made at the airports to screen the passengers. She wrote, "Wondering how they went unscreened at international airports! All the national media seem to repeatedly say that the international airports are fully equipped. Really worrying!"
Meanwhile, passengers travelling to Leh complained about the lack of screening facilities at Leh Airport. Stanzin Palzom said, "I reached Leh on 2 March and there was no thermal screening at the airport. I was only asked to fill a form." When asked about the screening facilities, Rigzin Samphel said that it is a learning process and that the arrangement has improved. "We received feedback that the screening area inside the airport was getting very congested and on 8 March we shifted it outside. The arrangement is much better now. We are screening everyone to ensure that they declare their travel history. We have provided medical staff at the airport with personal protection equipment and thermometers," he added.
Dr Motup Dorje said that earlier the focus was on passengers returning from Iran. He said, "From 7 March, we have now started screening all passengers. Similarly, the army is screening people landing at Thoise airport in Nubra."
When asked about efforts being made by UT Administration to contain COVID-19 in Ladakh, Rigzin Samphel explained that all arrangements are in place. He added, "We have 110 beds (60 in Leh, 50 in Kargil) to quarantine patients. We also have 20 (10 each in Leh and Kargil) isolation beds. For people who test positive we have 20 beds each in Leh and Kargil for their treatment. We have also ordered 2,000 personal protection gear and 20,000 masks." In addition, Ministry of Health has sent a team of doctors to Leh including Dr Jugal Kishore, Director, Professor and Head, Department of Community Medicine, Dr Suneet Kaur, Assistant Director and Dr Mahesh Waghmare, Deputy Director, National Centre for Disease Control, Delhi.
UT Administration has issued order No: DCL/PS/ COVID-19/2020 to seal Chushot Gongma and contain cases of COVID-19. The containment zone comprises of Chushot village and parts of Chushot Shamma. Active house-to-house surveillance is being carried out in the containment zone to detect cases of COVID-19. A buffer zone comprising of Chushot Shamma, Chuchot Yokma and Shey has also been created. The order specifies that a committee of government officials will ensure that all essential/non-essential commodities are supplied to people in the containment zone.
When asked about the sealing of Chushot Gongma, Rigzin Samphel said, "Since all three patients, including the one who died [and later tested negative], are from the same village, we inspected the area and implemented Government of India's containment policy to ban entry and exit from the area for 28 days."
Meanwhile, DC, Leh, Sachin Kumar issued an order (JC-69(1) 2020/903) under Section 11 of Criminal Penal Code asking the admins of social media groups to change the setting for their groups to "only admins can send messages" from 9 March to 10 April, 2020. This has been done to curtail the circulation of false rumours on social media.
As news of COVID-19 cases spread, people flocked to medical stores to buy hand sanitisers and masks. Nitin from Het Ram Vinay Kumar chemist in Leh market said, "We ran out of our old stock quickly. The fresh stock will reach Leh soon. The problem is that people are demanding five sanitisers at a time. Some were even asking for a carton of sanitisers and masks."
Meanwhile, people stood in queue to purchase hand sanitisers and masks when it arrived at Himalayan Chemist near SNM Hospital. Many customers complained that the shop was selling products at a higher price. One customer said, "The surgical mask usually costs Rs 10 but is being sold for Rs 30 whereas a 100ml sanitiser is being sold for Rs 294. We have no option but to buy them."
When asked about it, President of Chemist Association, Sonam Dawa said, "We exhausted our stock of surgical masks and sanitisers soon after the two cases of COVID-19 were detected in Leh. These items are not easily available even outside Ladakh. When we are able to find it, it is overpriced and we also have to pay for air cargo to ship the stock to Leh. Ladakhi chemists are neither engaged in black marketing, nor are they profiting from this crisis."
Dr Motup Dorje appealed to the people to wash their hands with soap instead of buying sanitisers. He explained, "Washing your hands with soap is more effective. Only those who are coughing or sneezing should wear masks. Everyone does not need to wear it. At the same time, people should maintain a one metre distance from someone who is coughing. We should all use our elbow or handkerchief while coughing."
The fear of the virus is palpable in Leh and the market has been deserted since the news of the two patients became public. Most shops remained closed. Stanzin Motup, a resident of Skampari, explained, "I am scared to go out in large gatherings. My family will also suffer if I get infected by COVID-19. That is why we prefer to stay indoors." Others have stopped using public transport for the same reason.
UT administration has closed schools and colleges in Ladakh till 31 March as a precautionary measure. Several events such as the launch of Poshan Pakhwada and the celebration of International Women's Day have been cancelled. People flocked to SNM Hospital and private clinics for check-ups. Leh-based Paediatrician, Dr Spachen Gonbo said, "Parents are bringing their children for check- ups even for minor ailments. It is good to be alert but please do not panic. Children will not get infected by COVID-19 at home but in public places where they may be exposed to someone who has the virus."
Religious organisations across Ladakh have restricted congregations. President of Ladakh Buddhist Association, P.T. Kunzang said, "It is a holy month and people want to offer prayers but we advised people to avoid mass gatherings." Similarly, Additional District Magistrate, Kargil issued an advisory order (No: DMK/ COVID-19/01/2020) on 7 March asking religious organisations to restrict religious/social gatherings.
There are palpable fears on how this will impact tourism in Ladakh. Rigzin Samphel, who is also Commissioner Tourism, agreed that this was a challenge. "A few days back, we called all travel and hotel association members in Leh and Kargil to take them into confidence. We already have a lot of visitors visiting Ladakh and we are developing precautionary measures for such tourists."
Government of India is now preparing to bring back Indian pilgrims from Iran, including 1,200 pilgrims from Leh and Kargil. There have been reports that DC, Leh has been directed to accommodate the pilgrims at 16 community halls in Leh town. People have responded to this report with concern. For instance, Municipal Committee, Leh (MCL) wrote a letter to DC, Leh (No: PMCL/82-85/2020 of 6 March, 2020) in this regard. The letter reads, "MCL ward members and other representatives want incoming pilgrims from Iran belonging to Kargil district to be transported to Kargil from the airport and arrangement for pilgrims from Leh to be made in Leh."
Nambardar of Housing Colony, Stanzin Otsal called a meeting on 8 March to discuss the issue with the residents of Housing Colony. He said, "We will protest if the administration forces us to keep the pilgrims from Iran in our community hall. We are a small community and it will be catastrophic if even one person gets infected." When asked about this issue, Rigzin Samphel said people should not believe such misinformation. "People should believe reports only when the government issues an official statement. Such rumours impact the work of health workers. The pilgrims from Iran will be brought to Leh only after they have been cleared."
This was echoed by CEC of LAHDC, Kargil, Feroz Ahmad Khan. He said, "COVID-19 is a global crisis and precautionary steps are being taken. We are spreading awareness through the media and socio-religious institutions. People must not panic. They should follow advisories issued by Government of India."
CEC of LAHDC, Leh Gyal P Wangyal too appealed to the public not to panic. "We are screening all incoming passengers. In addition, an expert medical team from Delhi and our team of doctors are monitoring the situation. Three quarantine centres have been established in Leh at SNM Hospital, Mahabodhi Hospital, and Ladakh Heart Foundation. If needed, the facilities at Army and ITBP will also be used," he added.
Meanwhile, a video has surfaced on social media of Indian pilgrims in Iran expressing their resentment against the delay in their evacuation. A joint association of all socio-religious organisations in Kargil under the chair of the LAHDC, Kargil held a press conference on 9 March to declare that all stakeholders of Kargil have unanimously agreed to demand the immediate evacuation of the pilgrims stranded in Iran.' They requested Government of India and UT Administration to resolve the issue and assured all 'necessary cooperation regarding the screening'. They stated that the delay is causing pilgrims in Iran and their family members in Ladkah to panic.
Government of India has responded positively and initiated the evacuation process. Kargil CEC Feroz Ahmad Khan welcomed this news. "We are happy that the airlifting of pilgrims has started. The major issue is that most Ladakhi pilgrims in Iran have not been screened yet as the process is very slow. This is creating fear among them, which needs to be mitigated by Government of India."
When asked about the evacuation process, Member of Parliament from Ladakh, Jamyang Tsering Namgyal said, "The evacuation from Iran has started. They will be screened at Tehran airport and those whose reports are negative will be airlifted in batches of 65. They will be rescreened at Delhi airport. Those who are suspected of having COVID-19 will be kept in quarantine and passengers who test positive will be kept in isolation in Delhi. I appeal to the relatives of the pilgrims to remain calm and support the administration."