The Epidemiology and Disease Control Division of the Ministry of Health and Population has warned that the coronavirus cases could spread quickly in multiple places at once if safety measures are not enforced strictly.

The warning of the division comes as dozens of people including women and children, who do not have a history of travelling to disease-hit areas or came in close contact of the infected people, have been found infected with Covid-19 in some districts that border India. Three deaths were reported from Parsa, Sunsari and Saptari districts in the last three days.

“We have requested the Health Ministry and the Covid-19 Crisis Management Center to ask concerned agencies including the Ministry of Home Affairs to regulate people’s movement, especially at land crossings with India,” Dr Basudev Pandey, director at the division, told the Post. “It will be very difficult for us to control if there are disease outbreaks in multiple places at once.”

The number of people entering Nepal from India has declined several fold in recent weeks, but 700 to 900 people are entering Nepal every day, according to the Home Ministry. The said numbers are the official records of the Home Ministry, but people also enter illegally from the open and porous border.

“We place those coming from legal channels in quarantine but a lot of people also come illegally and go directly to their homes,” Duniya Lal Yadav, chief of District Health Office, Saptari, told the Post, over the phone. “Risk of community spread has increased due to those illegally entering from India.”

Cases of covid-19 have been rising at alarming rates across the border with over 45,000 new cases daily for the last three days. According to Johns Hopkins University tracking data, over 2,39,000 new cases were recorded in India in the past week alone.

The Indian Medical Association on Thursday said the coronavirus situation in India was “really bad” and the fact that the infection was now spreading to rural areas points to community transmission.

Over 32,000 positive cases including 217 deaths have been recorded in Bihar, and over 58,000 positive cases and 1,200 deaths in Uttar Pradesh, which adjoin Nepal.

Earlier, most of the people who tested positive for the virus were male and had a history of travelling to disease-hit areas or those who came in close contact of the infected people arriving from India. Most of those who tested positive in the past were of asymptomatic nature, but people infected recently in the said districts are symptomatic and are also dying from the infection.

“This is different from what we saw in the last four months,” Lila Bikram Thapa, a senior public health administrator at the division, said. “Cases are being reported from the communities, and those who have tested positive are symptomatic and more people testing positive are dying.”

Despite warnings from public health experts including senior officials from the Health Ministry that the risk of Covid-19 transmission has not declined yet, the government ended the lockdown at once.

Residents of Ilam, Jhapa and Morang districts say that a lot of people are entering the country illegally and are also not staying in holding centres and makeshift quarantine set up by the authorities, which has raised the risk of the spread of the coronavirus.

While public transport is still officially limited within respective districts, hundreds of people are travelling to other districts including Kathmandu, according to traffic police. Even Indian nationals are coming to work in Kathmandu, after the government lifted the lockdown, according to a doctor at the Sukraraj Tropical and Infectious Disease Hospital.

According to the Health Ministry, most of the people that have tested positive in Kathmandu of late are from the districts bordering India such as Bara, Parsa, Rautahat and Dhanusha.

“The lockdown was enforced anticipating risks from abroad but the government did not pay heed to the increasing risk from India, where the virus is spreading like wildfire,” Dr Baburam Marasini, former director at the Epidemiology and Disease Control Division, said. “Due to an immature decision to end the lockdown at once, the virus can explode in several places at once.”

Meanwhile, the Health Ministry said that it has been analysing the risk of community transmission and has directed officials concerned to furnish reports on the spread of Covid-19 in several Tarai districts.

“We have never said that the risk of Covid-19 has lessened,” Dr Sameer Kumar Adhikari, joint-spokesperson for the ministry, said. “Rise in symptomatic cases, deaths and infections in women, children and elderly people has alarmed us too.”

Rapid surges of the virus have been reported in various countries including India and the United states, following the end of the lockdown.