Before the nationwide lockdown began, the Ministry of Health and Population had decided to purchase ventilators, increase the number of intensive care unit beds and general beds in hospitals for the treatment of Covid-19 patients.

However, nearly two months after the lockdown was enforced across the country, the ministry has neither bought a single ventilator nor set up an intensive care unit to treat people severely sickened by the coronavirus.

"Due to the halt in international flights, we are not able to bring in ventilators," Bhogendra Dotel, director at the management division of the Department of Health Services, told the Post. "We have also been asking UN agencies if their flights could adjust our ventilators."

With a rise in the number of Covid-19 cases around the country, many patients may need intensive care and life support for survival.

According to Dotel, his office has purchased 10 ventilators—eight fixed and two portable—from a German company but due to the halt in international flights, the supplier has been unable to import them.

Requirements for 20-bed intensive care have been purchased so far but neither the beds nor the equipment have been set up.

Of the 1,000 general beds ordered, only 250 are supplied, which too have been gathering dust at the store of the Kirtipur-based National Ayurveda Research and Training Center. Due to the lack of space there, the division has asked the supplier to deliver only 700 beds for now and to make the remaining beds available when asked for.

Dotel said that his office is only responsible for purchasing the equipment, and other agencies under the Health Ministry are responsible for setting them up in required places.

Public health experts say that except enforcing the lockdown, works of all agencies concerned under the federal, provincial and local governments seem ineffective.

"Neither the management of the quarantines set up across the country is satisfactory, nor is testing performed sufficiently," Dr Shyam Raj Upreti, a public health expert, told the Post. "Due to negligence in such works, cases have been rising every day and at an alarming rate."

Hospitals designated for the treatment of Covid-19 cases have been overwhelmed in the hotspots like Birgunj, Biratnagar, Butwal and Nepalgunj. Covid patients are sent to makeshift quarantines due to the lack of beds in hospital isolation wards. The disease has been transmitted among dozens of people placed in quarantine facilities.

"The lockdown was enforced to make preparations for dealing with the epidemic and to prevent the spread of disease," said Upreti. "Neither we succeeded in preventing the spread nor have we prepared properly."

Most of the intensive care beds and ventilators counted by the government cannot be used to treat serious Covid-19 patients, as the equipment at most of the general hospitals is also meant for other cases.

Dr Baburam Marasini, former director at the Epidemiology and Disease Control Division, said that provincial and local level governments are in confusion due to the lack of proper planning and direction from the central authorities.

"How can we expect effective works from only the provincial governments and local level, when the federal government itself has failed to coordinate with them, to remind them of their duties and responsibilities and to provide the resources," Marasini told the Post. "Other than announcing the results of tests, we don’t see any substantial works done by the Health Ministry to contain the epidemic."

Local governments are complaining about the lack of resources to manage their quarantines. Hospitals are complaining about the lack of beds, human resource and personal protective equipment to deal with the growing number of cases.

Officials deployed from the Health Ministry in Province 2 said there is no coordination among the agencies under all three tiers of government.

"Even in sample collection, there is no coordination among the focal agencies," the official said. All are allegedly working on their own, due to which a lot of people suspected to have been infected with the coronavirus go untested and in some places samples of the same suspects are being collected more than once.

Tracing of the people who came in close contact with the infected people is being done by telephone. Due to the delay in contact tracing, officials suspect that the disease has spread in the community even as the Health Ministry denies it.

"The number of positive cases keeps rising unless we change our working style and show seriousness," Marasini warned. "We lost the opportunity to prepare and contain the contagion. Only extending the lockdown won't contain the disease."

So far, 453 people have tested positive for Covid-19, including two deaths related to the disease.