In anticipation of a second wave of Covid-19 

Younten Tshedup 

When the next influenza (flu) season, October and November, sets in, the government would be ready to provide the influenza (flu) vaccine to all Bhutanese.

In anticipation of a second wave of Covid-19, which officials fear may coincide with the flu season, the government has approved the procurement of flu vaccines for all.

With approval from the Prime Minister, the health ministry has completed the technical feasibility and finalised the price projections.

Health Minister Dechen Wangmo said that there was growing evidence that suggested that flu vaccines might protect the population should there be a second wave of Covid-19. Protection primarily means reducing the strain on the health care system and hospital resources.

Lyonpo said that simultaneous outbreaks of seasonal flu and the novel coronavirus would put considerable pressure on the country’s health system. “There would be a double burden on the health care system as hospital visitation would shoot up,” she said, adding that many countries are now opting to make flu vaccination readily available for the population.

Clinical microbiologist with the national referral hospital, Dr Tshokey said that in the absence of a vaccine for Covid-19, preventing people from getting flu, which could then turn into severe cases could be avoided with the introduction of the flu vaccines.

With multiple flu cases coming to health facilities there would be pressure on the rate of testing, he said. “The idea is to reduce the number of flu cases even if we don’t have a vaccine for Covid-19.”

People visiting hospitals, today, are also tested for influenza like illness (ILI) and for severe acute respiratory illness (SARI).

Cost

For an estimated coverage of more than 65 percent of the population, the initiative would cost the government more than Nu 120 million (M).

Lyonpo said that while the objective was to provide mass immunisation of the entire population, no country could achieve 100 percent immunisation coverage.

She said that four decades after the introduction of the infant immunisation programme in the country, the coverage rate is still around 97 percent today.

Because the flu vaccine is a time-bound vaccine and had to be given within a span of a month, the minister said reaching the entire population would be difficult.

However, last year, the ministry started introducing flu vaccines for five priority groups – seniors above 65 years, children under five years, people with comorbidities, pregnant mothers and health workers.

The coverage so far has been about 85 percent in these five groups.

Lyonpo said that as a resource-limited country and with the current economic challenges, finance is a major concern for the procurement of vaccines currently. “For now we are looking for budgets and I’m confident we will find it. We will make sure we get the flu vaccines.”

UNICEF will facilitate the procurement.

What is second wave?

While people across the globe are wondering when the pandemic would end, there are warnings of a second wave of the pandemic with the rising cases in some parts of the world after initially witnessing a decline.

While there is no formal definition, like the waves in the sea, the number of cases going up and then dropping and again going up – each cycle is one wave of the new coronavirus.

The health minister, a public health expert, said that a second wave in general could come in either of the two phases – when the virus mutates and starts re-infecting the population or when lockdowns and restrictions are lifted too far and rapidly.

She said that reopening of anything has to be thought through very well and strategically planned so that there is no compromise on the health of the population. “That is why we have been saying that reopening cannot be in piecemeal.”

Lyonpo said a second wave could be more deadly than the first mainly because the exposure is not known. “This is why we need a long term vision and a roadmap. Our community mitigation strategy has to look at things holistically.”

She added that as a nation, given the current global scenario the country couldn’t afford to let its guards down. “Complacency is a major challenge for us. When people become complacent and when the virus hits us, it would hit us very bad,” she said.

“This is not a sprint. It’s a marathon where we have to strategies, keep our eyes on the target and then, move cautiously.”