Sukraraj Tropical and Infectious Disease Hospital at Teku, Kathmadu, issued a notice on Sunday asking Covid-19 patients to pay and make cash deposits at the hospital for treatment.

The hospital is the latest to issue such notice since the government decided not to provide free tests and treatment for Covid-19 on October 18.

“We have to either shut down our hospital or charge the patients for us to continue the services,” Dr Sagar Raj Bhandari, director at the hospital, told the Post. “We did not charge any patient earlier because the government used to reimburse us. The government stopped reimbursing from October 17 and directed us to start charging the patients.”

A Cabinet meeting on October 5 had decided to perform tests and provide free treatment free of cost to only those who cannot afford to pay and to the single women, disabled people, frontline health workers, security personnel and cleaning staff. The decision was enforced by the Health Ministry from October 17.

“Hospitals have followed the Health Ministry’s decision to charge the patients,” Dr Samir Kumar Adhikari, joint spokesperson for the Health Ministry, told the Post. “Hospitals should get money from somewhere to continue the services. When the Health Ministry is no longer giving grants, they have to charge the patients.”

Officials at Sukraraj hospital said that they have to pay salaries to the staff, provide safety gear, manage the laboratory and buy medicines with their own resources. Without the government grant, they said the hospital cannot sustain by offering free tests and care.

Raj Bhandari, the hospital director, said that the hospital would not charge the poor, elderly and disabled patients, health workers and security personnel deployed in the frontline as per the government decision.

“Like private hospitals we will not charge additional amounts to the patients,” said Rajbhandari. “We will only charge the amount fixed by the Health Ministry.”

The Health Ministry on Sunday, however, reversed its decision of not performing free tests, which had not only reduced testing but also halted contact tracing.

According to Mahendra Prasad Shrestha, chief specialist at the Health Ministry, the ministry formed three high-level teams on Sunday for contact tracing, case management and logistic support.

Shrestha himself will oversee the contact tracing team while a team lead by Dr Roshan Pokhrel will oversee case management like coordinating the arrangement of beds for patients, increasing intensive care unit beds and arranging oxygen supply and other equipment. A team led by Dr Dipendra Raman Sing, director general at the Department of Health Services, will oversee the logistic support.

A source at the Health Ministry said that the three high-level teams will directly oversee works of agencies under three tiers of governments—federal, provincial and local—and give instructions.

“Tests will be done for free of cost on those people who have come in close contact with the infected people or have been identified through contact tracing,” Shrestha told the Post. “Local governments will be asked to trace and collect samples of the people suspected to have been infected with the virus.”

As of Sunday, 173,567 people have tested positive for Covid-19 across the country with 960 deaths. In the last 24 hours 2,824 people tested positive including 1,622 in Kathmandu Valley. Twenty-three people succumbed to the virus in the last 24 hours.

Public health experts say chaos and confusion have gripped the Health Ministry due to the lack of stewardship over the management of the Covid-19 crisis. The government itself is responsible for the current spread of the coronavirus, they say.

“When suggestions of experts are ignored, scientific data are overlooked, we cannot expect better results than this,” Dr Baburam Marasini, former director at the Epidemiology and Disease Control Division, told the Post. “If the Health Ministry has decided to continue free testing, contact tracing is a positive thing, as there is no other option.”

Infected people have stopped cooperating with officials after the Health Ministry decided to charge for tests and treatment. The decision also led local governments to stop contact tracing while laboratories have stopped free testing.

With a rapid spike in serious Covid-19 cases, which caused acute shortage of beds in hospitals, officials also stopped responding to distress calls of the relatives of seriously ill patients.

The World Health Organization’s director general Dr Tedros Adhanom Ghebreyesus recently said that when leaders act quickly and deliberately, the virus can be suppressed but , where there has been political division at the national level, where there has been blatant disrespect for science and health professionals, confusion has spread and cases and deaths have mounted.

Dr Bhagwan Koirala, chairman of Nepal Medical Council, the national regulatory body of the medical doctors, said that there is no alternative to testing, tracing, isolating and treating, which national and international experts have been advocating since the beginning.

“Fundamental principles for prevention and control and mitigation of the infection have not changed,” said Koirala. “It will be suicidal if we let the disease spread without doing anything.”

Authorities had been making ad-hoc decisions for months, without paying heed to expert’s suggestions for months and realising the looming risks that lay ahead.

Dr Mingmar Gyelgen Sherpa, former director general at the Department of Health Services, said that he could not comprehend the government’s decision to discontinue free tests and treatment.

“Authorities should not give up the fight against the virus. They must pay heed to the expert’s suggestions,” said Sherpa. “Funds should be diverted to Covid programme, from other non-essential health programmes to continue the test and treatment services.”