The Bhutanese Leading the way.
The Prime Minister Dasho (Dr) Lotay Tshering announced that the lady (50-year-old) who was identified as suffering from an auto-immune disease and who had come back from Kolkata after treatment had passed away at 3 am on 25th December.
Lyonchhen said that the lady had initially tested positive for COVID-19 but she had already been cured of COVID-19 when she later succumbed to the severe nature of her autoimmune disease.
The PM said that she had Neuromyelitis Optica or NMO which affects the spine and vision nerves and as a result her immune systems attacks everything in the body.
A Technical Advisory Group (TAG) Member Dr Tsokhi said the patients spinal cord and visual nerves were degenerating and her immune system was causing problems to the extent that even her heart was affected among other parts of her body.
He said that her condition due to the autoimmune disease had become so severe that she had difficulty breathing and like any other terminally ill patient she was put on ventilation.
Dr Tsokhi said that the lady and her husband both tested negative on 19th December and in the case of a normal patient she would have been kept in a hotel for isolation for two weeks and then released.
However, since she had difficulty breathing and was on ventilation and so she could not be released from the ward. Dr Tsokhi said that the Kolkata hospital could not do much for her autoimmune treatment and had sent her back.
Lyonchhen said as per the WHO there are two criteria which is ‘death due to COVID-19’ and ‘death with COVID-19’.
Lyonchhen said that death due to COVID is a death caused by COVID and death with COVID is a patient who dies due to some terminal illness and who would have anyhow died, but just happened to have COVID. The PM said that only people who die due to COVID are counted as COVID- deaths under the WHO classification.
The Prime minister said that the lady did not even fit in either of the above categories as she had already tested negative on the RT-PCR a while ago. He said that even if she had tested positive for COVID-19 on her death she would still not be counted as a COVID death under the WHO classification as her death is due to her severe autoimmune condition.
The lady was part of a group of patients and custom officials on a 27th November flight where around 60 percent of the passengers including some air crew eventually turned positive.
Lyonchhen said that the entire group had been placed in Terma Linca initially.
He pointed out that the lady had tested negative several times but since many in the larger group had turned positive, as a precaution, she was not placed in the general ICU but the COVID-ICU when she needed treatment.
When the lady was intubated to assist her with breathing, due to her terminal condition, a sample was taken from her lungs for testing and that was when a positive result for COVID came. Lyonchhen said that the virus must have been hiding in the lungs.
The PM said that even though she had tested negative for COVID initially if she had been placed in the general ICU then there would have been chances of COVID spreading to other ICU patients. He said it was due to the caution exercised that she was kept in the COVID ICU.
Lyonchhen said that even other kinds of terminal patients like those suffering from cancer, accidents, suicide attempts etc are all put on ventilation for assisted breathing because they are too weak to breathe by themselves.
He said that JDWNRH always has one or two deaths in a day and the lady above would be a part of that.
The Health Minister Dasho Dechen Wangmo said that the lady had tested negative for COVID-19 and was considered recovered from COVID-19.
The minister said that the elderly gentleman with the heart condition has also tested negative twice as per the protocol. She said both of them have terminal diseases and were sent back from Kolkata for palliative care.
According to medical literature Neuromyelitis Optica has a five-year life expectancy or mortality and death normally occurs due to cardiac arrest or respiratory failure.
International case studies in Italy and New York have show that people with the range of auto-immune diseases are not any more susceptible to catch COVID-19 or die from it than a normal person.
Meanwhile a female lung cancer patient who had come back from Kolkata but was negative for COVID-19 also passed away on 23rd December due to her terminal condition. The lung cancer patient and her husband tested negative for COVID-19 on the RT-PCR but they both had antibodies which meant they had got COVID and recovered from it too.
