Precautions taken for 1% probability: Health Minister

Younten Tshedup

Bhutan’s fight against COVID-19 cannot be more scientific and evidence-based than it is today.

The interventions and measures put in place are based on how the epidemiology of the disease is evolving, said health minister, Dechen Wangmo.

However, Lyonpo said that the ministry’s approach, which changes with the varying situation have received criticism from the public. The ministry was accused of changing their stand on the strategies.

“We are fine-tuning our strategies based on how this epidemic is unfolding. This requires our strategies to be dynamic. If we do not change our plans accordingly, then we are failing in our efforts to fight this disease.”

She said that the current protocol has been crafted carefully to address the need of the hour. However, should the scenario – within the country and regionally including globally change, the plans and protocols would also change accordingly.

Lyonpo said that if COVID-19 outbreak is reported in India, the whole strategy would have to be changed. “This has to be based on science, evidence and not on emotion, political or any other reasons. We have to tackle this disease through science and I don’t see any other alternatives.”

The objective, Lyonpo said, was to prevent any positive cases in the country. 

 “At the same time, we are also preparing for the worst case scenario,” she said. “Should we face the worst case scenario, then the objective would be to minimise fatality.”

The minister, who faced the media alone at a press conference yesterday, explained that while the disease have shown characteristics like that of any regular flu, people with comorbid conditions (underlying medical conditions) and the elderlies required intensive care once infected.

“If this is the case, we might not be able to give the intensive care in all our health facilities given the limited resources,” she said.


Medical facilities

The national referral hospital in Thimphu and the regional referral hospital in Mongar have been identified as the two medical facilities to cater intensive care services.

Lyonpo said that a clinical management protocol that identifies what drugs and treatment has to be given to a COVID-19 patient has been put in place.

“Based on concrete evidence and expert opinions, those patients who require critical attentions would be sent to either of the two hospitals. In the worst case scenario, people would be air lifted to these facilities.”

Five specialists with the national referral hospital will be the focal doctors advising the medical staffs across the country handling COVID-19 patients. The specialists are currently scanning medical literatures and are in consultation with international experts on the disease.

Lyonpo said that early detection would also be critical to fight the disease. “We are enhancing the testing facilities which is why another testing centre would be put up at the Mongar hospital soon.” The second testing laboratory in Phuentsholing was set up within 48 hours after it was planned, the minister added.

As of yesterday, the health ministry has tested 250 suspects for the virus.

Due to international shortage of testing kits, COVID-19 testing elsewhere costs more than USD 3,000, whereas, in Bhutan it is provided freely. 

While all possible measures were put in place, Lyonpo said that there still was a lot that is unclear about the infection. “This is the reason why we cannot stick to a particular guideline. If we do, then we will miss the boat and the epidemic will catch us.”

Bhutan was one of the first countries in the region to respond to the global outbreak, according to the minister. She said that the health ministry’s preparedness plan for COVID-19 began on January 11, 10 days after China reported its first positive case. This according to the minister was key in controlling the spread of the disease.

“WHO guidelines recommend testing and retesting only when a suspect becomes symptomatic. However, we have conducted two tests so far on all those who are under quarantine, although none of them have shown any signs or symptoms,” she said.

Given the precautions the country has taken Lyonpo said that it would be 99 percent safe to say the country, for now, does not have the virus.

“However, for the one percent probability, we are taking extra precautions,” she said. “I’m not even looking at how much it is costing the government. The ministry’s objective is containment, early detection and case management for now.”