Contact tracing of all who got close with Covid-19 patients continues but time is fast running out
Authorities have traced just 11 of the more than 30 people the third Covid-19 patient came into contact with, but none has been tested yet. Passengers walk past a thermal scanner installed at the Tribhuvan International Airport following the global coronavirus outbreak. Kiran Panday/TKP
Authorities have said that they have managed to get in touch with 11 of the at least 15 individuals who had come in close contact with the third Nepali national infected with Covid-19.
The Health Ministry said on Wednesday that a 32-year-old Nepali man who had returned from Sharjah of the United Arab Emirates on March 19 had tested positive for the coronavirus.
The man, who hails from Dhading district, had stayed in a hotel in Kathmandu and gone to the Sukraraj Tropical and Infectious Disease Hospital in Teku on Monday night after coming down with a fever, chest pain and a sore throat. The National Public Health Laboratory confirmed on Tuesday night that he had tested positive for the virus.
An official at the Health Ministry said that the man had come in contact with at least 15 people at the hotel as he had invited several friends to have dinner with him.
“We found that the man first stayed in a single room and then shifted to a double room,” Dr Basudev Pandey, director of the Epidemiology and Disease Control Division, told the Post. “Our health workers have been working to contact all the people, including the owner of the hotel and his wife, who came in contact with the patient.”
According to Pandey, health workers have been assigned to reach out to all the people who came in contact with the man at the hotel as well as those who travelled with him on the Air Arabia flight from Dubai to Kathmandu. Officials have said there were 133 passengers in the plane.
Authorities, however, have yet to trace passengers from the Air Arabia flight and the Qatar Airways flight that the second Covid-19 patient travelled on. A 19-year-old Nepali student returning from France via Doha had tested positive for Covid-19 on Sunday night. She is also being treated at the Teku hospital. Of the 158 passengers in the Qatar Airways flight, 125 were Nepalis.
Officials said that though they have obtained the passenger manifests for both flights, they have yet to contact the passengers as many are missing their contact information while others have filled out fake phone numbers.
“Their contact numbers are wrong,” said Dr Roshan Pokhrel, chief specialist at the Ministry of Health and Population. “We are trying to track them down with the help of the address on their passports.”
But according to preliminary investigations, of the 125 Nepalis on the Qatar Airways flight, 34 are from Province 2.
On Thursday, Dipendra Jha, chief attorney for the Province 2 government, said that allowing those passengers to leave without a strict quarantine was an irresponsible act.
“Of the 125 passengers who flew to Kathmandu on March 17 on the Qatar Airways flight, 34 are from Province 2. They should have been quarantined or put under medical observation. But they were directly sent to the province,” Jha wrote on Twitter. “This has put the country as well as the province at risk.”
Public health experts who have long been calling to expand the scope of tests say that the authorities’ lackadaisical approach to contact tracing could lead to rapid spread of the virus.
“Scientific research has proved that patients can spread the disease in asymptomatic stages,” Dr Sher Bahadur Pun, a virologist at Sukraraj Tropical and Infectious Diseases Hospital, told the Post. “Failing to trace those who came in contact with the patient and conduct tests on them can prove to be risky.”
According to Pandey, the Epidemiology and Disease Control Division has sought help from chief district officers and public health officers from respective districts as well as other concerned officials serving at the local level to help trace the people who travelled with the two patients.
Health officials say as far as plane passengers are concerned, around 15-16 people sitting around the person must be tested, not everyone on the flight.
But at a time when authorities are facing criticism for not disseminating information on time, they are also unwilling to conduct tests on those who have come in close contact with the patients. According to Pokhrel, no specimens from any of the people who came in close contact with both positive patients have been tested yet.
Six family members of the 19-year-old student have been asked to remain in self-quarantine, according to officials.
“The ministry has no plans to conduct tests unless those people who have come in contact with patients develop some symptoms,” said Pokhrel.
But public health experts say that if the government wants to lessen the risk of transmission, it needs to conduct more tests.
“All those who have come in contact with the infected people and all those who returned from abroad should be tested,” said Pun.
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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