Younten Tshedup

At a time when major parts of Europe are in second lockdown as new wave of Covid-19 infection sweeps through the continent, Bhutan, fortunately, still has not experienced the effects of a full-blown first wave of the pandemic.

All the confirmed cases so far have been recorded among those who have come in from abroad. Localised outbreaks in Phuentsholing, including those in Gelephu and Samdrupjongkhar, have also been contained successfully.

However, in absence of an effective vaccine, Bhutan remains highly vulnerable to the virus as close to 230 of the 700,000 plus Bhutanese have been infected so far.

This vulnerability comes as increasing new cases are being reported daily in the region and across the world.

Clinical microbiologist and a member of the health ministry’s technical advisory group (TAG), Dr Tshokey, said that although the number of Covid-19 cases in the world was very large, in comparison to the global population, the infection rate ranged between 1 to 8 percent.

“Looking at this, almost 92 percent of the world’s population is still vulnerable to the virus. And with no effective vaccine and the minimum level of herd immunity, the number of cases could increase.”

The second wave of the pandemic which is beginning to take a toll in Europe and America was triggered mainly by people when they started letting their guards down. 

Dr Tshokey said that as some of these countries started observing a decline in the number of cases, lockdowns were immediately relaxed and businesses returned to normal; adherence to public health measures such as mask wearing in public and practising physical distancing were forgotten.

He said that although there was no universal definition for a second or third wave, a surge of new infection following an initial decline in the number of cases was called a new wave of an epidemic or a pandemic.

The Spanish flu of 1918, Dr Tshokey said, had three successive waves which infected over 500 million (M) people – about one-third of the world’s population then. “The second wave was more severe and deadlier than the first wave because the virus had mutated and there were several new infections.”

The same could also happen with the novel coronavirus as several scientific reports now claim that the SARS-CoV-2, the virus that causes Covid-19, is mutating.

Dr Tshokey said that the count of reinfection among people and cases of virus mutation were limited.

He said that so far, about five to seven cases of infection through mutant virus have been reported in Hong Kong, Europe, the USA, and India.

One of the biggest concerns with the mutation is that it could possibly render the current testing kits, including the potential vaccine candidates that are in clinical trial phase, ineffective.

Dr Tshokey said that the test kits detect the major proteins of the virus and should there be significant mutation in the genome of the virus, there was a possibility that the existing test kits might have to be changed. Vaccine also works on a similar mechanism, whereby it targets the protein of the virus.

He, however, said that the mutation level as yet was minimal with not much changes to the protein except for a few changes in the genetic sequences of the virus.

However, he cautioned that with several festivals and holidays approaching, gatherings could trigger outbreaks in the country.

“Elsewhere in the world people are gathering to protest but here we gather to celebrate. But whatever the reason, if people come together and someone in the group is infected, the risk is the same.”

In the light of growing cases, the health ministry is planning more surveillance programmes.

“We might not have experienced a full-blown impact from the first wave yet but we are still very much at risk,” Dr Tshokey said. “People cannot afford to be complacent. Everyone must act responsibly.”