Bhutan closely monitoring developments over the new B.1.1.529 variant 

Younten Tshedup 

Just as things were beginning to improve (or at least, that’s what many Bhutanese assumed), a new variant of the SARS-CoV-2 virus of ‘concerning character’ has been identified in at least two countries outside of South Africa where it was first discovered on November 25.

The new variant, B.1.1.529, has been red-flagged by many scientists, given the ‘alarming’ high number of mutations on the virus’s spike proteins that has potentially made the virus more resistant to vaccines, more transmissible, and with greater potential to cause severe disease.

Scientists are calling the B.1.1.529 variant the ‘most heavily’ mutated version of the SARS-CoV-2 virus discovered so far, with potential to be more transmissible than the Delta variant and more effective in evading the immune response provided by the vaccines that are currently available.

Hong Kong and Israel were the first two countries outside South Africa and neighbouring southern African countries to identify the variant. Two cases in Hongkong and a traveller in Israel, all returning from an African country, are reported to be infected with the new variant.

Britain, Israel, and Singapore have restricted travel from the region as of yesterday. The World Health Organisation (WHO), meanwhile, is monitoring the variant. A special meeting with the African scientists was also held yesterday to assess the situation.


What does this mean for Bhutan? 

National Immunisation Technical Advisory Group (NI-TAG) member Dr Sonam Wangchuk said that although the B.1.1.529 variant, for now, has been reported in only a few countries, the possibility of it already having spread to other countries is high. “A new variant of a virus is always more transmissible, if not equally so, to the existing variant. Because SARS-CoV-2 virus has effectively established human-to-human transmission by now, any new variants now will be more transmissible than the previous variant.”

He said that Bhutan was closely monitoring the developments as the WHO assessed the potential threat from the new variant and its implications.

Dr Sonam Wangchuk said that given the stringent and conservative measures put in place by the government, Bhutan is not directly threatened by the new variant for now. “However, this doesn’t mean that we are safe from its implications. Personally, I feel the severity from this variant will be higher if an individual is infected.”

He said that the quarantine protocol for international passengers and those travelling from higher to lower risk areas should be able to filter potential positive individuals.

“My worry is that if this variant escalates and is introduced in India, it will spread like wildfire and it will definitely spill over across the border, given the breach incidents happening along the bordering areas,” he said, adding that given the vulnerability of the people living along the bordering areas, the NI-TAG had recommended providing a booster dose of the vaccine to people in these places.

NI-TAG has recommended booster shots for certain sections of the population in light of the deteriorating situation globally. A Covid-19 booster shot is an additional dose of a vaccine administered after the protection provided by the original shot(s) has begun to decrease over time. The booster is designed to help people maintain their level of immunity for a longer period of time.

Dr Sonam Wangchuk said that evidence in developed countries show that the protection from the vaccine (full dose) starts to decline after about six to nine months. In this light, the US Food and Drug Administration (FDA) has now authorised Covid-19 vaccine boosters for certain vulnerable populations. The US Centers for Disease Control and Prevention (CDC) has also recommended the boosters.

Given the lack of resources, health ministry’s plan to study the level of antibody (protection from virus) among vaccine recipients has been delayed. 

Dr Sonam Wangchuk however, said that the study test kits are expected to arrive soon following which the study could commence.

Dr Sonam Wangchuk said that given the global vaccine shortage, the NI-TAG recommended providing booster doses to certain vulnerable populations, including the elderly (65 years and above), and people with underlying health conditions, especially those with immunocompromised conditions such as people with cancer and HIV. The group also includes health workers and Bhutanese travelling outside of the country.

As per records with the MoH, the country currently has about 211,290 doses of mRNA (Pfizer and Moderna) vaccines in stock. Dr Sonam Wangchuk said that the initial plan was to use the Pfizer dose for children between the age of 5 to 11 years once the WHO gave the vaccine emergency use authorisation (EUA).

However, he said that the Pfizer vaccines on hand are not the paediatric dose authorised by the FDA and recommended by the CDC for children between ages 5 to 11 years.

This means that the 211,000 plus doses of vaccines can be used as boosters for the selective vulnerable groups, which would be enough to cover the population in question. Should the government go ahead with the booster plan, the campaign should tentatively start by the end of January next year.

Edited by Jigme Wangchuk