Despite the Cabinet decision on Monday to make testing and treatment of Covid -19 free, the new arrangement will be implemented only after the Ministry of Health and Population revises its guidelines.

“We have not received a copy of the Cabinet decision yet,” Dr Jageshwor Gautam, spokesperson for the Health Ministry, told the Post. “We have to revise the guideline as per the Cabinet decision and send it to health facilities before starting free tests and treatment.”

As per the October 5 Cabinet decision to test and provide 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 health Ministry had stopped providing free tests and treatments to all.

“We had enforced the October 5 Cabinet decision to stop providing free tests and treatment to all from October 17 revising the guideline made as per March 22’s Cabinet decision,” Dr Samir Kumar Adhikari, joint spokesperson for Health Ministry, told the Post. “We will revise the guidelines once we get a copy of the new decision of the Cabinet.”

The Cabinet on March 22 had decided to provide free tests and treatment to all infected with Covid-19. As per that decision, the government had borne costs of testing and treatment in the state-run health facilities until October 17.

Monday’s Cabinet decision of providing free tests and treatment comes as the Supreme Court last week refused to entertain a review petition filed by the health Ministry over the apex court’s previous ruling regarding free tests and treatment to patients infected with coronavirus.

A source at the Health Ministry said that even if the Cabinet meeting had decided to resume free testing and treatment, all those seeking tests will not get free services.

The Health Ministry had proposed to provide free tests to those having symptoms, elderly people and to those having underlying conditions.

“Yes, the proposal to resume free tests was prepared by the Health Ministry,” said joint spokesperson Adhikari. “But we don’t know how exactly the proposal was passed. The ministry will revise the guidelines as per the Cabinet decision and enforce it.”

It could take upto a week for the Cabinet decision to be implemented and it depends on how long the Cabinet’s decision will take to the Health Ministry, according to officials.

Meanwhile, public health experts say that the decision to provide tests and treatment free of cost was positive, as they are the only way to curb the spread of infections.

“Authorities should not have stopped the free testing and treatment,” Dr Baburam Marasini, former director at the Epidemiology and Disease Control Division, told the Post. “Positive results do not come by making wrong decisions. Testing should be increased, contact tracing should be made effective.”

With the Health Ministry stopping free tests and treatment, local governments have halted contact tracing. After severe backlash from various quarters including from the senior leaders from the ruling Nepal Communist Party, the Health Ministry last week had decided to resume contact tracing.

However, local governments, which are responsible for the job, refused to follow the Health Ministry decision and demanded to declare free testing first to resume contact testing publicly and provide guidelines accordingly.

Some local governments, like Kathmandu Metropolitan City, complained that they have stopped contact tracing, after swab samples of those that came in close contact collected in the contact tracing were returned by the government laboratories.

Despite the formation of a-high level team comprising senior officials from the Health Ministry, contact tracing has not resumed.

Dr Sher Bahadur Pun, chief of Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital, said that along with providing free tests and treatment, authorities should also enforce restrictions in hotspots like in Kathmandu Valley to curb further spread of infections.

“No one knows how much the virus has penetrated the society,” Pun, told the Post. “ I think some kind of restriction is also needed for a few weeks to curb further spread.”

Pun said that free tests for all seeking services is not necessary and the state also may not afford to test everyone. But all those having symptoms, elderly people and those having underlying conditions should be prioritised.

“Those who come in close contact with infected people should mandatorily quarantine and should be tested if symptoms are seen,” he added.

With the government stopping free tests and treatment, deaths from coronavirus infection has also increased. Since October 17, when the government stopped providing free tests and treatment, 433 people have succumbed to the infection.

Infected people have stopped seeking tests and treatment unless they become seriously ill.

Doctors say the case fatality rate has increased, as members of vulnerable groups—elderly people and people with pre-existing conditions are getting infected.

As of Tuesday, 199,760 people have tested positive to Covid-19 and 1,148 deaths have died. In the last 24 hours 2,736 people tested positive and 22 deaths were reported. According to the Health Ministry, there are 38,035 active cases in the country.