The Prime Minister Dasho Dr Lotay Tshering announced that restrictions will be relaxed once the children from five to 11 get fully vaccinated by mid April 2022.
The relaxations which will come phase wise will avoid lockdowns even with cases.
What is being relaxed and with what conditions
The 7-day internal travel quarantine will also be relaxed and changed to either a few days or home quarantine. The 21-day for unvaccinated to 14-day quarantine for the vaccinated for those coming from outside will also be relaxed and changed. There will also be changes in the quarantine location and duration of those who test positive.
Even if there are cases lockdowns will not be imposed from mid-April on.
The issue of labour import was discussed in the National COVID-19 Taskforce. The PM said that one in every two labourers could be positive. “We will plan and allow import of labourers but only once we vaccinate our children. We need 20,000 to 25,000 more workers,” said the PM.
The details on the above will come out in the coming days and weeks.
After the relaxations, lockdowns will happen under two conditions. One is if we there are too many cases and patients do not fit in hospitals, then there be complete two-week lockdowns where nobody will be allowed to come out at all.
“We will develop a trend that by 70% to 75% to 80% beds being filled we will lockdown. We will have a reporting pattern. The moment that it hits the benchmark (which can be flexible depending on the severity) we will make an announcement for lockdown. We will have enough time of three or five days to know about the coming lockdown,” said Lyonchhen.
The second condition is if a new variant comes that kills a lot of people, then lockdowns will again happen.
The Health Minister Dasho Dechen Wangmo said relaxations will happen with three Cs. It will be Conditional on the vaccination of the vulnerable people as vaccines give maximum protection, there will be a Cautious reopening of relaxations and there should be Control over the number of cases as high cases will lead to high mortality.
Going forward testing maybe for only those who want testing or are symptomatic.
The PM said that the surveillance pattern will have to change. “We know the disease is there. Another is on managing positive cases and primary cases. All need not be picked up. Travel pattern will have to change. We will go with average incubation period on travel quarantines. It is okay one or two leaking as community is not zero.”
He said that now that the community is not zero they don’t have to be on a high alert mode.
“Our relaxations while coming in will also focus on keeping the cases and deaths lows,” said the PM.
The current Thimphu restrictions will continue till the examinations are over and there will be separate announcements.
Lyonchhen said the biggest risks are for the elderly, co-morbid and the unvaccinated as internationally it is these people who mainly fall sick or die. “We have avoided the high number of severe and death cases due to our high vaccination rate,” said Lyonchhen.
Around 710,000 Bhutanese are yet to be infected and around 100,000 are co-morbid with around 300 on dialysis, around 90 are on chemotherapy.
He said if the virus spreads widely then 100 to 200 of these people will immediately die.
“Please note that more people are being killed by Omicron than Delta due to the higher spread. This is why we cannot completely do away with all restrictions,” added Lyonchhen.
He said if numbers of cases pick up and is unmanageable numbers for hospitals then there will be a lot of preventable deaths due to lack of oxygen, infections etc.
“We must live with the virus as humans live with various diseases but the tradeoff is that there will be disease within the community and if there are more number of cases then there will be deaths,” said the PM.
Lyonchhen said we must control the number of cases and not allow it to ravage through the community.
“We managed a 103-year old woman at her home since she could not come to the hospital.
So far recoveries have happened even to people in their 90’s as the health services could be given to them,” said the PM.
He indicated all bets are off if the cases go up too high at a time.
The PM said if there are no restrictions in Phuentsholing then within 2 to 3 weeks 15,000 to 16,000 will be infected and it could result in around 500 being hospitalized. He said His Majesty was worried about more cases and this is why RIGSS was converted into a hospital with more medical staff.
“His Majesty said that as we go for more relaxations there will be more cases and patients and so the frontliners will have more work. His Majesty has commanded placing a helicopter for the JDWNRH hospital, one for Mongar and one for Gelephu to ensure that medical airlift is not restricted by the weather. We will be buying one or two new helicopters and in the meantime will lease them,” said the PM.
“We are nowhere near ready to let our guards down. We are just talking of around 12,000 infected. We still have 708,000 not infected. We are not going to let the virus rampage through our communities. Once hospital admission goes to 60 to 80% it will be a lockdown like a military curfew,” added the PM.
Lyonchhen said they have been planning the way forward around a month ago on the command of His Majesty.
Lyonchhen said while lockdowns have been used to control the spread of the virus there are a majority of Bhutanese whose livelihood is impacted. For these people Kidu has been given. Lockdowns also impact school children. People have not been able to travel in time.
“The earlier attempt was to prevent community cases but people said they are having problems due to lockdowns and so when risk to life is coming down and livelihood risk is going up then we cannot have lockdowns,” said the PM.
The PM said they are worried about the impact of lockdowns on the exams of 10 and 12 and so have come up with various solutions. Around 149 students with the virus are also giving exams in isolation.
While Thimphu has had 50 to 60 cases a day we have not had any severe cases. We are hoping the situation still stays the same. Once the exams are over and the 5 to 11 get fully vaccinated then the lockdowns will be relaxed even if there are cases.
“As an example the situation in Gelephu is improving but in the near future there could be new cases. People are worried about new lockdowns when such cases come up,” said the PM.
Lyonchhen said that some countries have restrictions while some have no restrictions at all.
He said while studying countries with no or low restrictions they have found a few doing okay, but there are others who are having a difficult time and are being forced to build extra hospitals and even reject patients with more deaths and cases.
“We don’t have enough doctors and medical staff. You all know even during normal times there is a long waiting list for CT Scan, surgeries etc. His Majesty is concerned that such services are not available or people don’t come forward,” said the PM.
Vaccine for Children and protecting those below 5
The Pfizer vaccine for children of 5 to 11 arrived today and it will be distributed to Dzongkhags today through refrigerated vans. The PM said the vaccine is very useful to protect children.
The Health Minister said the registration rate for the vaccines of children of 5 to 11 is only at around 50%. “Please register for us to prevent wastage of vaccines,” said the Health Minister.
On the ages of two to four the PM said we have provisions to get the vaccines as soon as approval comes as payment is already being made.
As of now those below five to the new born numbering around 60,000 are not protected.
Lyonchhen said, “By now the more that are protected the vulnerable will also get proportionate protection. What if the next variant has immune escape but if there is better protection for those who got Omicron,” asked the PM.
Lyonchhen said that they could give COVID-19 booster doses every year and it could be given every six months.
What if doctors and health staff get infected
A big worry has been the impact of the virus on the health system if it spreads widely and infects doctors and nurses.
The Foreign Minister Lyonpo Dr Tandi Dorji said that people who get infected mostly recover within 7 days or at the maximum of 10 days.
“All doctors will not get ill at the same time. Doctors and nurses will use PPEs and even if they infected they can still work. There will not be mass absence of health workers,” said Lyonpo.
The Health Minister said that every hospital has contingency plan. “JDWNRH has team A and B and if both teams get infected then we will have full PPE in which case doctors giving the virus chance will be limited. We will do virtual consultation like in RIGSS,” said Lyonpo.
The PM said that they could collect very good medical data and other figures in the last two years on people.
Lyonchhen said till now the government system like like COVID-19 Taskforce, MoH, TAG etc was used to to prevent community cases, but now if we do not want lockdowns we will have diseases in the community and so people should know about their responsibility.
Lyonpo Tandi claimed that the government is not pressurized to lockdown or open up.