How the government got lost in its fight against the pandemicAfter refusing to recognise the risk and failing to come up with right strategies, authorities now have few options left to contain the virus spread, experts say.
As some cities start to reimpose restrictions on people’s movement and contact tracing is becoming increasingly difficult following the lifting of the lockdown, experts say that the government seems to be lost in its fight against the Covid-19 pandemic.
“To start with, the government did not listen to experts’ suggestions since the early days—neither at the time of imposing the lockdown nor while lifting it,” said Dr Baburam Marasini, former director at the Epidemiology and Disease Control Division.
Now with the rapid spread of the coronavirus across the country, restrictions have been reimposed in at least six cities—Birgunj, Rajbiraj, Biratnagar, Dhangadi, Nepalgunj and Janakpur—by the local authorities.
Officials in Kathmandu are now confused about their next steps, as cases continue to rise in the Valley since the lifting of the lockdown.
The number of active cases has crossed 300 in Kathmandu Valley including 31 new cases on Monday, since the lockdown was lifted on July 21.
Experts have long argued that lockdown was never a solution to the pandemic, as it just helps break the transmission chains and provides an opportunity to step up measures like setting up quarantine and isolation facilities, increasing hospital beds, providing training to health workers and expanding tests.
But the government did nothing, say public health experts. From the early days, the government failed to recognise the risk and when the threat level started to rise, it started scrambling and made knee-jerk reactions, according to them.
When the government imposed the lockdown on March 24, the country had seen just two Covid-19 cases. Before that, the government even refused to acknowledge that the virus would enter the country, with some ministers claiming Nepal as being safe from the coronavirus.
A day after Nepal imposed lockdown, India announced its lockdown. Thousands of Nepalis working in India started to return home, but there was no preparation on borders. While the returning Nepalis were not allowed to enter, some crossed the border out of desperation. The government had declared lockdown without taking into consideration the possibility of influx of Nepalis. Quarantine centres were set up in haste, where people were forced to stay packed like sardines. From sporadic cases here and there, the virus slowly spread.
As more tests were conducted, the number of Covid-19 infections rose.
After four months of lockdown, the government started to come under pressure to ease it, as businesses were taking a hit and concerns grew that more people would die of starvation than the virus.
In prioritising socio-economic issues, the government’s focus on fighting the pandemic took a back seat.
At least two agencies were formed to fight the pandemic—High-level Committee to Combat Covid-19 and Coronavirus Crisis Management Committee.
Both were under Defence Minister Ishwar Pokhrel.
But officials who have been part of the government agencies and experts who have discussed Covid-19 issues with both the committees say even though the two agencies were formed to act to control the pandemic, they were not working in tandem.
Pokhrel was even embroiled into controversy for corruption in the purchase of medical equipment to fight Covid-19.
Experts say the government even failed to follow the basic rules.
“There are three aspects to fighting the pandemic—testing, tracing and treating,” said Dr Anup Subedee, an infectious disease expert. “But the government has been stuck with testing which is not our strength.”
The focus now should be on tracing and isolation, according to him. “It just needs the political will,” said Subedee.
Dr Prabhat Adhikari, an expert on infectious disease and critical care at Grande Hospital, told the Post that since the cases have risen after the lifting of the lockdown, the only way to break the chain of infection is effective contact tracing.
“Contact tracing should be done on a war footing to prevent the looming catastrophic situation,” said Adhikari.
As far as tests are concerned, the government now has changed the criteria. Earlier only those who showed all the symptoms were tested but according to the new testing guideline issued on Friday, those with any one symptom can be tested. And those who have come in close contact with an infected person can be tested too.
Experts have welcomed the change in testing criteria.
“The current guidelines should have come a couple of months back,” said Dr Bhagwan Koirala, who has advised the government on its policy and strategy. “The government has been slow to adopt the right guidelines and strategy.”
As per the new criteria, asymptomatic patients can be sent home for isolation rather than keeping them in hospital using up resources needed for others.
“People who have the facilities to self-isolate at home should not be brought to hospitals since they are being overstretched,” said Koirala.
Government officials admit that the situation is taking a turn for worse.
“We have now started to enforce lockdown at the local level,” Dr Roshan Pokhrel, chief specialist at the Ministry of Health and Population, told the Post. “Lockdown may be reimposed in the Valley, if the cases rise in an uncontrolled way.”
Experts agree that the government cannot alone fight the pandemic and that people have to be equally responsible. The government, however, has done little to make the people aware of possible risks. It has invested little in awareness campaigns, except for coming up with rules, including the one which allows authorities to fine those not wearing masks.
The government has also failed to make it clear before the people that the lifting of the lockdown does not mean an absence of the virus and that the threat level is still high.
Experts had suggested lifting the lockdown clusterwise, as per the risk assessment but without paying heed to their suggestions, the lockdown was ended at once throughout the country.
“I think the government has given up in the fight against Covid-19,” a doctor at the Department of Health Services, who did not wish to be named, told the Post. “It might have taken lockdown as a last weapon to contain the spread of the virus but it may not always help.”
Since the lifting of the lockdown, the Capital city seems to have returned to the pre-lockdown days, with increased people’s movement and public places like eateries and local tea shops seeing members of the public in hordes without masks.
“Unfortunately, there is going to be a flare-up of the infection,” said Koirala.