Bhutan has successfully managed to prevent community transmission of COVID-19 so far
Thimphu: Bhutan has successfully managed to prevent community transmission of COVID-19 so far. But the growing complacency among the public amidst increasing cases within and globally is a major concern. This is, according to Dr Rui Paulo de Jesus, the World Health Organisation (WHO) representative to Bhutan.
He said, “Despite the fact that there is zero community infection in the country, it is no time to be complacent. It is no time for us to celebrate and claim a victory.”
The fight against COVID-19 will go a long way, particularly because there is not yet a vaccine or a drug that could treat the infected, he said.
“We don’t know much about the virus yet, so the WHO together with its member states, continue to learn about the attitude of the virus. And accordingly, with the knowledge we have gathered so far, we have prepared these preventive measures.”
Dr Rui Paulo de Jesus said that the best remedy, for now, is to adhere to the health advisories that include frequently washing hands with soap, practising physical distancing and cough etiquette.
He said that keeping the body healthy by maintaining a healthy lifestyle would also help in preventing other diseases.
“If a patient has a fever, they are given paracetamol. They are provided with good food and air so that they can recover early. In other words, doctors help strengthen your immune system, which will then kill the virus.’
He said that this method had been proven effective, and even without a specific drug human immune system can kill the virus. With drugs, he said that it would help fast-track the treatment process.
However, the country representative cautioned that if the immune system of a person is weak, the drug will do more damage than good.
“A vaccine is not a drug, per se, but it is either an element of the same virus or a weakened form of virus (attenuated) which will trigger antibody generation against a particular virus and prepare the body in the event of a real infection.”
He said the primary objective of experts across the world currently is to produce a vaccine. However, for a vaccine to be tried on humans and authenticate its effectiveness would take a long time.
“Although the process has begun, it won’t come to us in the next one year or one and a half year or even more than that.”
Dr Rui Paulo de Jesus said that a drug or any medicine for that matter that is given to a patient, to some extent, is like a double-edged sword. “Therefore, the safety and efficacy of a vaccine or a drug are of the utmost concern of experts and to the WHO.”
On the affordability and availability of vaccines, once it is produced and certified, Dr Rui said that it would be made available to all irrespective of the country’s economic status.
Dr Rui said, “Bhutan is not just lucky, Bhutanese are blessed.”
He said that one crucial component without which any operation would fail is the leadership.
“His Majesty The King has spent a lot of time and personally provided guidance to the whole nation including the health ministry on how to respond to the pandemic,” he said. “This kind of commitment from the highest authority is something extraordinary.”
Having health professionals in the Cabinet – the Prime Minister, health, foreign and finance ministers, Dr Rui said that under the leadership of His Majesty, the government successfully managed to gain support from the entire society in addressing the pandemic together.
“This whole-of-the-government and the whole-of-the-society approach is unique to Bhutan and is the key to where we are at the moment.”
“No countries are spared, big or small. It’s about the determination to fight against this disease together that has to continue if we need to get through this pandemic.”
Importing positive cases
Among others, a response to COVID-19 that has worked well for the country is the 21-day mandatory quarantine system, said the representative. He said that the government’s move under the guidance of His Majesty to bring back Bhutanese from abroad had been facilitated with this effective system.
Except for the two first cases (case number one and two) all the positive cases so far are imported and detected in Bhutanese returning from abroad.
Dr Rui said that the government had prepared a shield, a filter to make sure that the returnees are safe when they join their community. “The one thing I’m privileged to witness in Bhutan is the expression of the love of the leaders to its people. I’m learning a huge lesson.”
While there are criticisms against the move, he said that based on scientific evidence, there should not be any reason for the public to be worried.
“There is no need to create an unnecessary stigma against those returning. We have to rather, as a good citizen, encourage them. Only by working together, we can address this pandemic successfully.”
Dr Rui said that preparations for a health emergency by the government with support from WHO started before the COVID-19 outbreak was announced in China.
He said that in November last year, a simulation (mock drill) was conducted at the Paro international airport. A hypothetical situation was created where a passenger who had arrived in the country was exposed to a coronavirus.
The objective was to see how multiple stakeholders involved responded to the situation. “The idea was to identify our weaknesses and strengths in times of such health emergencies.”
WHO has also trained health workers at the airport, supported the up-gradation of the laboratory at the Royal Centre of Disease Control to a biosecurity level III from level II. Test kits and reagents were also provided.
Officials were also trained on pitching the medical camp kit (MCK) from where the flu clinics are operated.
For COVID-19 specific response, Dr Rui said that guidelines for surveillance and tests, including clinical management of patients were also shared with the health ministry after contacting the regional head office.
“Because we knew that the government would need immediate funds to ensure proper function and operation during the pandemic, fund mobilisations were also facilitated,” he said.
WHO officials also work in close collaboration with the technical advisory group of the health ministry in helping the ministry and the government develop strategies and plans.
“While the focus currently is on COVID-19, we are not relaxing our preparedness and response for other diseases like dengue,” said the representative. “We have reviewed the guidelines, including community mobilisation and vector control measures along the border areas.”
WHO is also donating treatment and diagnostic kits for non-communicable diseases which would last for six months for 10,000 people. “So there is no relaxation in these essential services for other health conditions.”