Nepal saw its single biggest Covid-19 death toll of eight on Wednesday, taking the total to 91. A majority of these deaths have been reported since the lockdown was lifted three weeks ag0.

Of the eight new victims, two were from Dhanusha district and one each from Kathmandu, Dhading, Saptari, Morang, Kapilvastu and Bara.

According to the Ministry of Health, 51 have died since the nationwide lockdown was lifted on July 21 while there were 40 deaths during the nearly four months of lockdown that was imposed on March 24.

On Wednesday, of the 484 people who tested positive for the coronavirus, 138 were from Kathmandu Valley. With the entry points to the Valley unregulated during and after the lockdown, thousands of people have been arriving in the Valley every day. A significant percentage of the people visiting Sukraraj Tropical and Infectious Disease Hospital for testing are from districts hard hit by the pandemic and even from India, hospital officials said.

With the number of coronavirus cases rising at an alarming rate, the government on Tuesday gave district administrations and local governments the authority to decide on restriction measures. It also pushed back the start of air travel and long-distance travel by 15 days to September 1.

Of late, there have been more symptomatic cases and the number of persons in intensive care is also increasing, according to the Health Ministry.

“Eighty-seven people are in intensive care units and two are on ventilator support,” Dr Sameer Kumar Adhikari, joint spokesperson for the Health Ministry, told the Post. “The number of patients infected with the coronavirus becoming serious and critical has been rising in recent days. The survival rate of those on ventilators is usually very low.”

Public health experts say the virus is spreading fast and the situation is getting out of control. They have also urged the public not to take risks, which would be costly for self and to the family members.

“People should maintain social distancing, wear masks and follow safety rules properly, which can save them and others from the virus,” said Arjun Karki, an expert on internal medicine and critical care. “There is no other alternative to be safe.”

Meanwhile, critics argue that the government’s efforts to control the spread have not been effective.

“It was clear to me right from the beginning that things are not being done right,” Dr Sher Bahadur Pun, chief of the Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital, said. “Only increasing testing will not help after the infections become widespread.”

According to officials at the Epidemiology and Disease Control Division, tracing those who have come into contact has become difficult, which has further raised the risk of transmission.

Meanwhile, there are not enough isolation beds across the country and those without symptoms have been advised to stay at home, say public health experts.

Across the country there are over 10,000 isolation beds and in Kathmandu Valley about 1,000, according to data provided by the Health Ministry.

“The government has been stuck on testing,” said Dr Anup Subedee, an infectious disease expert. “But in case of a pandemic, the need is to test, treat and isolate.”

With the rise in new cases, the Health Ministry has been performing over 10,000 tests every day for the last few days. Doctors, however, said that only increasing the tests will not help in containing the spread of the coronavirus. For that, contact tracing and isolation is equally important, which is not happening.

In Birgunj, the hardest hit city recently, two persons died on August 8 and 9 while in search of hospitals because hospital beds were in short supply, as were health workers because they had been infected.

Earlier this week, the government directed all hospitals to reserve 20 percent beds for Covid-19 patients but doctors warn this could complicate matters as infections could rise further within hospitals.

Except for emergency services, all other services at Narayani Hospital in Birgunj have been halted for an indefinite period. Over 15 percent of health workers tested positive for Covid-19 and over 40 percent others, who came in contact with infected health workers, were sent to quarantine.

As of Wednesday, 24,432 persons have been infected with the coronavirus across the country. Of them, 6,438 got infected after the lifting of the lockdown. Among the 1,450 people who have been infected in Kathmandu Valley so far, 1,068 caught the virus after the end of lockdown.

The lockdown was lifted without proper planning and preparation in terms of increasing testing capacity and isolation facilities. As a result, there was a spike in the number of positive cases throughout the country including in Kathmandu Valley.

“There is a lot that still needs to be done but neither the government nor the public has been doing it,” said Dr Karki. “If we do not take proper steps, there will be nothing left to be done except to regret.”