The Bhutanese Leading the way.
Minister asks people to follow COVID protocols which are becoming lax
Bhutan has seen two national lockdowns due to COVID-19 pandemic, and a 100-day lockdown in Phuentsholing where the Delta variant was detected in the community.
The latest variant of concern, Omicron, contains 32 mutations on the protein spikes which is far more than those observed in other variants. However, the Delta variant, as of now, continues to be the predominant circulating variant, according to the Center for Disease Control and Prevention (CDC).
Health Minister Dasho Dechen Wangmo said people must understand that it will take about another two weeks to actually understand the severity of the new variant Omicron. It has been said that in South Africa, Omicron has hit mainly the younger population, so the population reacts to the virus very differently than the elderly and the vulnerable population. The health ministry is yet to assess the severity of the disease caused by Omicron, and the transmissibility of the disease.
According to the latest information on Omicron by CDC, it is unclear if the infection with the Omicron variant is associated with more severe disease. Due to the small number of cases attributed to the Omicron variant, assessment of disease severity is difficult. Preliminary information from South Africa indicates that there are no unusual symptoms associated with Omicron variant infection, and as with other variants, some patients are asymptomatic.
Scientists are working to learn more about the Omicron variant, to better understand how easily it might be transmitted, and the effectiveness of currently authorized or approved medical countermeasures, such as vaccines, therapeutics, and diagnostic tests, against this variant. New information about the virologic, epidemiologic, and clinical characteristics of the Omicron variant is rapidly emerging. CDC and other federal agencies are working closely with international public health agencies to monitor the situation closely. CDC will provide updates as more information and data become available.
In terms of the possibility of a nationwide lockdown, if Omicron is detected in the community, the Health Minister said it is unlikely to happen. Instead the government will take appropriate measures to mitigate and contain the spread of the disease in the affected areas if the new variant is detected.
As of now, it is fairly good to say that Omicron is not in the community, said the Health Minister, and added that people must avoid mass gathering, wear their face mask at all times, hand wash frequently, and practice other non-pharmaceuticals measures. She said such protection method is proven to protect individuals and it is very easy to do.
“I have observed that there is a little non-compliance towards face mask as well. People are saying now there are no virus in the community. That is my biggest worry. We already have the science and tools to protect ourselves from this disease, and this is our silver bullet and we must use it till this pandemic is either declared endemic or eliminated. We must always be on our guard, as His Majesty says,” she said.
The ministry is also worried about the vulnerable groups of people including young children in the country. She said since there is no concrete evidence on the severity of Omicron, but one thing is confirmed, that Omicron is highly transmissible as compared to Delta, so Bhutan should absolutely worry about the Omicron.
However, the Health Minister is confident that Bhutan will be alright against Omicron, as long as the people follow the COVID-19 protocol diligently.
“If people follow the current measures put in place diligently, it should be fine. The only problem now is the poor compliance. It has been two years into the pandemic, and so it should be natural behavior,” Lyonpo Dasho Dechen Wangmo added.
Bhutan did not detect any COVID-19 cases from the community in the past months due to the stringent COVID-19 protocol measures put in place.
Another concern is whether Bhutan should have additional measures to stop Omicron entering into the country. The Health Minister said compared to a year back, the government has put in a lot of measures, learned from the mistakes, communities and frontliners have learned from their mistakes and going forward Bhutan is much better equipped to handle the pandemic now.
With the Omicron detected in many countries, the health ministry is worried about the unvaccinated children, as they will be going to schools next year. Therefore, the ministry is continuously working through the Ministry of Foreign Affairs and international partners on securing the vaccines for younger children.
So far, only US and Israel has rolled out vaccines for 5 to 11 years old children.
The health ministry is in the direct communication with Pfizer, and is also exploring other options to bring in the vaccines soon.
Meanwhile, the Pfizer vaccine stored in the country cannot be given to children as the pediatric dose is one third of the adult dose, which means the dilution has to be nine times, and there is not enough space for that to be done in the vile. Even if that could be done, the ministry does not want to risk contamination of the vaccine.
CDC recommends that everyone 5 years and older must protect themselves from COVID-19 by getting the full vaccination. CDC recommends that everyone in the age of 18 years and older should get a booster shot, at least two months after their initial J&J/Janssen vaccine or six months after completing their primary COVID-19 vaccination series of Pfizer-BioNTech or Moderna.
Meanwhile, the health ministry has submitted a proposal to provide the booster dose for the elderly and vulnerable population to the government.
“Given that Omicron transmissibility is high, My biggest worry is for the vulnerable population. They are vaccinated, but still we don’t know and there is not enough evidence. The symptoms are found to be mild but in the elderly and the vulnerable group, we are yet to see the studies. My concern is how the reactions would be for the vulnerable population and the children who are not vaccinated,” the Health Minister said.
Omicron has rapidly spread to 57 countries, but the actual countries could be higher as many smaller and poorer countries do not have gene sequencing capabilities.
Bhutan has developed gene sequencing capability at the RCDC lab and so far Omicron has not yet been detected from those people coming in and testing positive.
Researchers at the Africa Health Research Institute in Durban, South Africa, in a study of 14 samples found omicron resulted in about a 40-fold reduction in levels of neutralizing antibodies produced by people who had received two doses of the Pfizer vaccine, compared with the strain detected in China almost two years ago.
In the UK the variant has seen a doubling rate of 2-3 days which the UK government says could lead to a million cases by the end of December.
Meanwhile with early anecdotal quotes of Omicron being ‘milder’ than Delta, international epidemiologist and COVID expert Dr Eric Ding in a Tweet said, “I think there’s a lot of misinformation on the severity, because Delta first of all was much more severe than the original Wuhan strain. So even if it’s not as severe as Delta it could cause an enormous amount of havoc if it’s milder quote unquote like the Wuhan strain.”
He said that what people don’t realize is, when you have two viruses hypothetically with one being more contagious and not severe, and another virus is more severe, and is less or not contagious; Dr Eric said most people think the more severe virus will kill more people, but the exponential math says the more contagious virus that’s not as severe as the other one, will kill more people once you run up, the numbers of infected.
He said that people are too laid back about Omicron and this is concerning not only given its high transmission, but also its its evasiveness against vaccine and natural immunity.
