Nepali man returned from Wuhan lays bare government preparedness to contain deadly virusesEpidemiology and Disease Control Division sought security agencies help to set up isolation facilities.
When a 21-year-old man from Kavre died of flu-like disease in a Capital hospital last March, it took health authorities two and a half months to confirm that the patient had died of bird flu.
It was the first case of H5N1 infection since February 2017, and the incident had exposed the country’s lack of preparedness to monitor and combat infectious diseases.
The Epidemiology and Disease Control Division (EDCD) had formed a rapid response team only after the World Health Organization's Collaborating Center for Influenza in Japan, confirmed the presence of Influenza H5N1 virus.
"A lot of people would have contracted bird flu or died of it if the virus could transmit from one human to another,” Dr Baburam Marasini, a health expert told the Post. "In that case, we must say we were lucky.”
But even after that alarming incident, the country is still not adequately prepared to stave off infectious diseases.
Last week, when a Nepali man who had returned from Wuhan city of China earlier this month visited Sukraraj Tropical and Infectious Disease Hospital in Teku with complaints of fever, sore throat and pneumonia-like symptoms, doctors were worried that he might have contracted the new strain of coronavirus.
Dr Basudev Pandey, director at the hospital, told the Post on Friday that the man was discharged after being put under observation for five days.
But the term “under observation” did not mean that he was kept in an isolation ward. The doctors and nurses constantly came into close contact with the man, who was suspected to be carrying the mystery virus that has already killed at least two people and affected four dozen others.
"The number of visitors at the hospital increased by several folds after the rumour spread that the man had returned from Wuhan, China, where the deadly virus originated," Dr Anup Bastola, the chief consultant on tropical medicine at the hospital, told the Post.
The hospital eventually discharged the man without confirming if he had indeed contracted the mystery virus, as it lacked the equipment to conduct tests.
“We wonder if the man had Wuhan coronavirus and we cannot say if it has been transmitted to others,” said Bastola.
The World Health Organization has already alerted all the member countries, including Nepal, about the possible risk of transmission of the deadly virus.
The hospital has collected specimens—throat swab and blood samples—of the patient and preparing to send them for a test to the WHO’s Collaborating Center in Delhi or Hong Kong.
"We were neither prepared in the past nor at present to handle any untoward situation," said Marasini. "The Nepali man returning from Wuhan has once again exposed our preparedness to deal with emergencies."
The EDCD, which is responsible for containing the spread of the deadly diseases in the country, conceded that it lacked isolation transport ambulance for patients suspected of carrying infectious viruses, treatment facilities, trained human resources and laboratory for conducting preliminary tests.
Meanwhile, most of the health desks, set up at the time of the Ebola outbreak in 2014 in Africa, are out of commision due to staff crunch.
"We lack even the basic facilities when it comes to dealing with emergencies,” said Dr Bibek Kumar Lal, director at the EDCD. "We cannot handle if we face a situation like in China."
According to Lal, none of the hospitals in Nepal has an isolation facility to treat patients suffering from highly contagious diseases.
An isolation ward set up at Sukraraj Tropical and Infectious Disease Hospital at the time of avian flu outbreak in 2010 in financial assistance of the World Bank lacks infrastructure including high-efficiency particulate air (HEPA) filter.
The EDCD had requested the WHO to determine if the ward met the required standards as per the UN health agency’s guidelines in June last year. The WHO had sent its team of experts to conduct a study, but it is yet to submit a report.
Meanwhile, the EDCD has sought help from the security agencies—Nepal Army, Armed Police Force and Nepal Police—to set up isolation wards in the hospitals they run.
"In other countries too, security agencies set up such facilities and offer help to the government for the same," said Lal. "We are ready to provide expertise as well as other assistance if they show readiness to help."
Brigadier General Bigyan Dev Pandey, spokesperson for the Nepal Army, said the Health Ministry had not made any formal proposal to set up isolation facilities.
"We are ready to set up such facilities," Pandey told the Post. "We have been constructing a facility in the airport barracks to quarantine our personnel returning from peace missions."