The Bhutanese reporter Usha Drukpa interviewed the WHO Representative to Bhutan Dr Rui Paulo de Jesus. He said the people of Bhutan should be concerned but not be too worried and there is no need to panic, as there is no widespread community transmission, with only one imported case, so far.
Q. Do you think the Bhutanese government, or the health system is adequately prepared to handle a possible worst-case scenario?
A. The disease can be controlled with appropriate containment measures, if taken on early. Half the battle is won if the government takes the preparedness seriously and responds on time. This is indeed the case in Bhutan, appropriate actions were planned well in advance and interventions initiated as and when situation arise in the field. So, timeliness is also key.
I would also like to point out that Ministry of Health has been preparing for disease outbreaks long time back. Health contingency plan was in place, WHO supported simulations exercises, the most recent one being in November 2019 at the Paro International airport, MCK tents for field hospital have been supplied by WHO and prepositioned in strategic locations, FETP trainings were conducted to help with epi-analysis in such situations.
Bhutan has been preparing for various scenarios as reflected in the stages of response in the National Preparedness Plan (currently orange). Currently, lots of efforts are going into running through various worst-case scenarios so that the government will be ready to respond to incase we do go into the Red zone. However, for Bhutan there is still the window of opportunity since we still don’t have any local transmission within the country. But I would like to reiterate, that is not job for the Health Ministry or the government alone. The whole of the society, every individual has a role to play and if everyone cooperates and follows the guidance from the government – we will be able to avoid the worst-case scenario.
Q. What kind of resources would be required to contain or to slow down the spread of the virus?
A. In terms of resources, we need to mobilize adequate human resources with the capacity to respond, health workers need to be mobilized to be made available where they are needed the most, trainings for the health workers needs to be conducted. We need to ensure that the health workers have the adequate stocks of PPEs and basic medical equipment to treat cases if the number of cases does rise in the country. Logistics system needs to be in place so that the required equipment and drugs are procured and made available. And of course, financial resource will be needed to make all the above possible. If containment measures are put in place that affect travel and trade, then this would have significant impact on the economy of the country. While resources are very important, the current outbreaks in some of the advanced countries show that it is not the central to controlling the disease.
The solidarity and the cooperation of every individual, as exhibited during the past few days, is an essential ingredient if the government is to succeed in keeping COVID-19 at bay.
Q. Many people in Bhutan seem to be confused about the severity of the situation. What do you have to say at this?
A. In situations that are uncertain and evolving, such as this, and with the infodemic on disease and the quickly changing situation, it is understandable to feel anxious and could result in some confusion. As the Director General of WHO said “This is a time for facts, not fear. This is a time for rationality, not rumors. This is a time for solidarity, not stigma.”
What is critical at this stage is that everybody join the efforts and do their part. Educate yourself and your families. Right information should be accessed from the right source. In particular, I encourage everyone to follow guidance from health authorities and instructions from the government.
Q. Should the people be worried?
A. I would say, be concerned but not be too worried, and there is no need to panic. There is no widespread community transmission, only one imported case so far.
Therefore, it is good to be concerned, so that people are not careless and are mindful of the happenings in the country and the region. People should be alert and take basic preventive measures.
Q. How is WHO Bhutan supporting the Ministry of Health to tackle the virus from spreading?
A. WHO Office in Bhutan has been and will continue to work hand-in-hand and in coordination with the Ministry of Health. Given that this is a new virus, our main role is to channel as much information and evidence from the experiences of WHO in tackling past outbreaks and from the current regional and global experiences in dealing with COVID-19. Our key support is in sharing guidance and recommendations with the country in key areas, such as in surveillance, diagnosis and capacity building initiatives for the health system. We have been also supporting the country financially and in providing much needed supplies of health equipment, lab, reagents and PPE items.
WHO also has identified experts on standby to be mobilized into the country in case the need is felt and the government request for it.
Q. Would there be a long-term repercussion to Bhutan’s public health because of COVID-19?
A. Given that Ministry of Health has to divert its time and resources from its routine activities, there might be some implications, in terms of delay in implementing some of the public health interventions. However, the implications will be far more significant and disastrous if we don’t attend to COVID-19 now
Actually, I see a lot of advantages from the experience with COVID-19. Hand washing is one of the basic and simple public health measures that can prevent several diseases in the community. The current focus on hand washing and hygiene will benefit, not only for preventing COVID -19 but also many other diseases. Similarly, the preparedness exercise enables us to look at the health system at a very holistic way and the experience with COVID-19 will contribute in many ways in strengthening the health system. The lessons learned, and the experience gained in coordination, cooperation, system review, mapping of resources would go a long way in making Bhutan’s health system stronger and resilient.