RIF to protect lives of vulnerable people, not to prevent infection, officials

Nima Wangdi

Forty eight Bhutanese in  Reversed Isolation Facility (RIF) beneficiaries have tested positive to Covid-19 as of Thursday, April 14.

Thimphu dzongkhag has the highest with 35 followed by Mongar and Trongsa with five each. Trashigang and Samtse also have two each according to RIF’s record.

RIF officials said that with the whole community already infected with the virus, some were detected positive on the admission day to the facilities while some tested positive during their initial phase of seven days at the buffer facility. “May be some got infected from their community or family members and some could have been infected during the process of dialysis.”

All staff working at the RIF are negative and they work in high alert mode like during the initial pandemic time.  They (staff) stay in the facility and don’t even go to their families including the drivers, according to officials. 

“While we try to protect them from being infected, it is not the priority. Our priority is to have them recover from the virus if contacted and manage them well to fight the virus better, particularly in terms of their immunology,” officials said.

Officials said that there are 297 patients suffering from Chronic Kidney Diseases (CKD) across the country of which 189 tested positive to Covid-19 either during their seven-day observation at the buffer facility or after being admitted to the RIF. Some 119 have already recovered.

However, two CKD patients, one each in Thimphu and Phuentsholing died due to other health complications after testing positive, according to the RIF officials.

“All critical cases are referred to the Covid Hospital in Taba since the RIFs do not have the required facilities and manpower to cater to severe or critical patients,” officials said. “RIF is instituted to take care of those who will need routine medical services such as dialysis and chemotherapy, amongst others.”

There are 67 RIFs across the country of which 57 are activated and nine on standby. Officials said they also have mobile health teams catering to those who have opted to stay home. The team has catered to about 1,493 individuals as of date and services include basic health checkups such as blood test, blood pressure and others.

There are 495 RIF beneficiaries as of today. Of this, 294 are with comorbidities and 155 are elderlies.


Why RIF?

The facility is to protect the lives of vulnerable people during the peak of the virus spread in the community and not to protect them from getting infected.

RIF officials said the lives of the vulnerable people could be saved through different ways and if possible, by not letting them get infected. “One of the main aims of the RIF is to make people who are more prone to the disease stronger so that they can withstand and fight the infection better,” an official said. People who are nutritionally bad will be given necessary supplements including  vitamins and protein supplements.

Officials said that they ensure all beneficiaries are screened to  identify underlying conditions and then treat all the treatable issues.

Citing an example, he said every CKD patient will have low hemoglobin which means high infection susceptibility. For such patients, blood transfusion or iron tablets are given. There are  dietitians to design diets in the RIFs.

The officials said they also provide physiotherapy and breathing exercises in the RIFs. “If they wish, beneficiaries can go home once they are prepared and ready to get infected.”

He said the CKD patients usually have dialysis twice a week, but are provided three times a week so that they are able to fight the disease better if infected with coronavirus. “Many of the vulnerable people would have died already by this time without the RIF.”

“We are comfortable now. Now we are going all out to make sure that they are all fit and prepared,” the official said adding that vulnerability is minimised to the possible extent. Diabetics are considered vulnerable but diabetic with liver diseases, diabetic that is uncontrolled and diabetic with heart diseases are more vulnerable.

In the RIF, all diabetics are controlled, hypertensive are reviewed and blood pressure is controlled, CKD patients are given dialysis every second day. “This is why they are able to fight stronger”.

Reverse isolation facilities were initiated under His Majesty The King’s Kidu.

Lyonchhen Dr Lotay Tshering had earlier said that, in the past, with the aim to maintain zero Covid-19 in the community, those who tested positive and primary contacts were isolated. “Now with the concept of Zero Covid in the community changed, through His Majesty The King’s Kidu, we are isolating the vulnerable population.”