As Covid-19 spreads, public health officials consider plans for a worst-case scenario
Department of Health Services has a Plan B for a few infections but its Plan C envisions shutting down all schools, public transport and gatherings in case of a mass outbreak.South Korean soldiers wearing a protective suits spray disinfectant to prevent the spread of the COVID-19 on a street in Daegu, South Korea, on Thursday, February 27, 2020. AP/RSS
With countries like the US sounding the alarm, Nepal, with its frail health system, cannot afford to rest, as public health experts say that it is not a question of 'if'’ the virus comes to Nepal but 'when'.
Amid the growing threat of a possible outbreak, the Department of Health Services on Thursday directed all concerned health agencies to cancel all scheduled meetings and focus on ways to deal with a worst-case scenario.
The department had held a high-level meeting on Wednesday, where it had discussed Plans B and C in case of an outbreak. Plan B envisions the response to the infection of just a few people.
“In such a scenario, we will have to entirely vacate particular hospitals,” Mahendra Prasad Shrestha, director-general of the department, told the Post.
Plan C deals with a worst-case scenario—a massive outbreak
“In our Plan C, we will have to shut down schools, colleges, public transport, and all public functions and gatherings,” said Shrestha.
Wednesday's meeting also decided to increase the number of health workers at the international health desk at Tribhuvan International Airport and strengthen health desks at eight land crossings.
According to Shrestha, the government is in close contact with all UN agencies, including the World Health Organization's country office in Nepal, and other international aid agencies, which have been supporting the country's health care system. Apart from flights from China, the department has also directed the airport health desk to screen air passengers coming from South Korea, Thailand, Singapore and Japan.
While Shrestha said that the department was serious about the threat of the outbreak, he admitted that they had yet to decide which hospital to vacate first, and what exact measures were being put in place to prevent a worst-case scenario.
After failing to procure a sufficient number of masks and protective gear due to global shortages, the department has now asked the World Health Organization for help. The UN health body will be providing a thousand masks on Thursday, said Shrestha.
Dr Bikash Devkota, a spokesperson for the Health Ministry, conceded that the country is at high risk of the outbreak and said that the ministry had asked various agencies to begin preparation accordingly.
“We have offered a budget and have assured help in easing rules and regulations to facilitate a timely decision,” said Devkota.
With temperatures rising, experts had hoped that the outbreak would decline but the increasing number of infections around the world have dashed those hopes. Infections have now been detected in Bahrain and Kuwait, where temperatures are over 38 degrees Celsius.
"The virus has reached America, Europe, Australia, Japan and South Korea,” said Dr Mingmar Gyelzen Sherpa, former director-general of the department. “We are at high risk as a lot of people are coming to Nepal from these countries every day. It is just a matter of time.”
First seen in Wuhan of China in late 2019, the virus has now spread to 47 countries, with the United States and Germany recording the first cases with no obvious source of infection.
Covid-19, the disease caused by the new strain of coronavirus, now dubbed SARS-CoV-2, has killed 2,814 and infected 82,585 people mostly in China.
A study published a few weeks ago by researchers at the University of Oxford, the University of Toronto and the London School of Medicine and Tropical Hygiene had identified Kathmandu as the 11th highest risk city and the third least-prepared country to handle an outbreak.
After recording the first case last month, no new cases have been reported in Nepal, but experts say continued vigilance is a must.
According to Dr Bibek Kumar Lal, former director of the Epidemiology and Disease Control Division, officials should be concerned about possible travel restrictions on Nepalis by other countries but also consider travel restrictions of its own. Nepal is completely dependent on India and China for goods, and both countries could restrict travel if an outbreak takes place
“India has already started screening Nepali passengers and made masks compulsory for all Nepalis,” said Lal. “But we haven’t even considered flight restrictions from any country facing an epidemic.”
The death rate from the Covid-19 coronavirus is around two percent in China but is considerably higher in countries with weaker health systems. Iran had, as of Thursday, reported 22 deaths out of 141 cases.
“Until now, people have not been informed about a possible worst-case scenario, health workers have not been trained, and government officials are unaware of treatment methods and required medicines,” said Sherpa. “It is time to start preparations.”
Frequently asked questions about the coronavirus outbreak
UPDATED as of September 22, 2020
What is Covid-19? Covid-19, short for coronavirus disease, is an illness caused by the coronavirus SARS-CoV-2, short for severe acute respiratory syndrome coronavirus 2. Common symptoms of the disease include fever, dry cough, fatigue, shortness of breath and breathing difficulties. In severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.
How contagious is Covid-19? Covid-19 can spread easily from person to person, especially in enclosed spaces. The virus can travel through the air in respiratory droplets produced when a sick person breathes, talks, coughs or sneezes. As the virus can also survive on plastic and steel surfaces for up to 72 hours and on cardboard for up to 24 hours, any contact with such surfaces can also spread the virus. Symptoms take between two to 14 days to appear, during which time the carrier is believed to be contagious.
Where did the virus come from? The virus was first identified in Wuhan, China in late December. The coronavirus is a large family of viruses that is responsible for everything from the common cold to Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). After an initial outbreak in Wuhan that spread across Hubei province, eventually infecting over 80,000 and killing more than 3,000, new infection rates in mainland China have dropped. However, the disease has since spread across the world at an alarming rate.
What is the current status of Covid-19?
The World Health Organisation has called the ongoing outbreak a “pandemic” and urged countries across the world to take precautionary measures. Covid-19 has spread to 213 countries and territoriesaround the world and infected more than 31,405,983 people with 967,505 deaths and 22,990,260 recoveries. In South Asia, India has reported the highest number of infections at 5,557,573 with 88,943 deaths. While Pakistan has reported 306,304 confirmed cases with 6,420 deaths. Nepal has so far reported 65,276 cases with 427 deaths.
How dangerous is the disease?
The mortality rate for Covid-19 is estimated to be 3.6 percent, but new studies have put the rate slightly higher at 5.7 percent. Although Covid-19 is not too dangerous to young healthy people, older individuals and those with immune-compromised systems are at greater risk of death. People with chronic medical conditions like heart disease, diabetes and lung disease, or those who’ve recently undergone serious medical procedures, are also at risk.
How do I keep myself safe? The WHO advises that the most important thing you can do is wash your hands frequently with soap and water for at least 20 seconds or use hand sanitizers with at least 60 percent alcohol content. Avoid touching your eyes, nose and mouth with unclean hands. Clean and disinfect frequently used surfaces like your computers and phones. Avoid large crowds of people. Seek medical attention if symptoms persist for longer than a few days.
Is it time to panic?
No. The government has imposed a lockdown to limit the spread of the virus. There is no need to begin stockpiling food, cooking gas or hand sanitizers. However, it is always prudent to take sensible precautions like the ones identified above.
Arjun Poudel is a health reporter for The Kathmandu Post. Before joining the Post, he worked for Sagarmatha Television, Naya Patrika, Republica and The Himalayan Times.
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