ITANAGAR: Amidst the nationwide lockdown and news of the first positive case of COVID-19 from a person residing in Arunachal Pradesh, a slew of concerns and questions began arising from healthcare workers and citizens alike.

A 31-year-old man was put in isolation at the general hospital in Tezu, headquarters of the Lohit district, after he tested positive for the disease. The man, a migrant manual labourer, had attended a religious event in Delhi’s Nizamuddin area which has seen a cluster of COVID-19 cases.

Till Friday evening, at least 22 people across the Northeast who were present at the Nizamuddin markaz had tested positive for the novel coronavirus (20 in Assam and one each in Arunachal Pradesh and Manipur).

The central government’s exertions in tracing and testing those who attended the event, and the people they came in contact with since, have led to a large proportion of COVID-19 cases in India being linked to the event held between March 13 and 15.

Besides the positive case in Lohit, six more attendees from the neighbouring Namsai district have tested negative. In Tezu the man and his family have been quarantined, and he remains asymptomatic.

However, state officials’ work is far from over.

Dr Tumge Loyi, media spokesperson for the State Task Force for COVID-19, told The Citizen that apart from the shortage of personal protective equipment, there is also a shortage of staff in the field survey teams.

“Since one person has tested positive, we need to conduct contact tracing to find out who has come in contact with him,” he said, adding that logistical challenges outside of the state capital, Itanagar, are another issue.

While a new consignment of PPE has arrived and will be distributed across the state, controlling the disease remains a formidable task for doctors, nurses, and others.

A source said that the PPE that arrived are not in sufficient numbers and more will be required.

India’s first COVID-19 case was recorded on January 30 in Kerala. According to reports the union commerce ministry’s Directorate-General of Foreign Trade didn’t stop exporting personal protective equipment till March 19, and ventilators till March 24.

Loyi said that another major issue is the absence of testing facilities in the state.

Samples of suspected cases are collected and sent to either the Regional Medical Research Centre in Dibrugarh or the Gauhati Medical College in Assam.

Collecting samples is yet another challenge as the state has an insufficient stock of virus transport media, where cotton swab samples are collected and shipped. At last count the total number of VTMs was around 700.

Medical guidelines dictate that a person must be tested at least twice; Loyi said that the man who tested positive had come in contact with at least 40 people since returning to the state.

If samples are to be collected from each of those 40 people, 80 VTMs will be required for just that one case.

He and other medical experts say the priority should be to test as many people as possible, and by identifying and quarantining them control the virus’ spread.

Till recently TRIHMS (the Tomo Riba Institute of Health & Medical Sciences) in Naharlagun near Itanagar had no ventilators in its intensive care unit. The state government has designated TRIHMS as a COVID-19 hospital which will exclusively deal with any cases related to the disease.

A senior doctor said that ventilators are for the final stages and that the government’s priority should be to prevent the virus from spreading.

A doctor on quarantine duty in Namsai district who has been in close contact with people who had travelled to Nizamuddin and others who came in contact with them, said medical workers have been doing their job without PPE.

“I just have my gloves and an N95 mask,” the doctor said.

A nurse on quarantine duty in Naharlagun said that “frontline health workers have not been provided with N95 masks either”.

News of the state’s first positive case was followed by stigmatisation.

Even before the state government had made an official announcement the test result of the man had been leaked, revealing his identity.

Dr Raja Dodum of the State Task Force for COVID-19 said this is a breach of patient privacy.

“How are the testing centres releasing this information without officially sending it to us first?” he asked.

Residents in and around the state capital began to panic about the infection spreading from quarantine centres to their residential colonies.

On Thursday evening, at the entrance to the Polo Colony in Naharlagun, residents engaged in a “lively” conversation with additional district magistrate and chief estate officer Talo Potom, asking him to move those housed in the quarantine facility in their locality, elsewhere.

Residents said they did not feel safe. “Our water supply comes from near the quarantine centre… what if they contaminate it,” said one man in the crowd, his mask doing little to hide his anger.

Eventually Potom had to assure residents that the quarantined persons would be moved.

Across the state, the gates of residential colonies in urban centres and villages have been barricaded. By good-intentioned people but in the process barring the entry of government inspection groups including doctors in some cases.

The Itanagar deputy commissioner had to issue an official communiqué asking for the barricades to be dismantled to allow the regulated movement of essential services.

In the absence of credible information, rumours about the disease and how it spreads have caused panic and fear among sections of the public.

Some landlords have exempted their tenants from paying a month’s rent. Many of those who continue to work are reportedly being subjected to suspicion.

Dr Lobsang Tsetim, president of the state chapter of the Indian Medical Association, said that several healthcare workers have been told by their landlords and neighbours not to venture out to work.

Many have allegedly even asked nurses staying in rented accommodation to vacate their apartments.

As people begin to turn on each other, pets and stray animals have become unlikely victims of the pandemic.

The lockdown has changed people’s consumption patterns, and stray animals that often scavenged food thrown out as garbage are finding it difficult to scrape by.

The problem was noticed by a number of young animal lovers who have since mobilised and taken it upon themselves to ensure the furry four-legged friends don’t starve.

Kobyum Zirdo has been doing daily rounds covering at least 60km of the capital and adjacent areas looking for strays for almost a week.

Tending to a puppy outside of a privately owned veterinary clinic, Zirdo said some pet owners were abandoning their dogs if they appeared to show signs of illness.

On Friday afternoon she rescued a puppy with a collar around its neck that had developed a severe rash.

Because treatment is difficult during the lockdown period, she’s had to euthanise four dogs in five days.

Not an easy task for someone who has over a dozen cats and dogs at home.