Don’t let your guard down, experts say amid vaccination halt and second wave loomingDoctors call on authorities to start active case finding, strictly enforce safety measures, expand testing and step up surveillance along the open border with India.
Nepal did not record any new Covid-19 deaths in the last 24 hours. The country reported just 77 new coronavirus infections in the period. The number of active cases across the country currently stands at less than 1,000. Nepal has already launched its vaccination drive against Covid-19 and by now a little over 1.7 million people have been inoculated. Things do not look bad going by the numbers. But public health experts say there is no room for complacency, as the Covid-19 battle is far from over yet.
According to them, the pandemic has been dragging on and no one knows when a second wave starts to form.
“The risk of the spread of infection has not gone down; it’s rather going up due to negligence, slow-paced immunisation and possibility of new variants,” said Dr GD Thakur, former director of the Epidemiology and Disease Control Division. “The next six months will be more critical and crucial. It’s just a matter of days if our country witnesses a second wave, as several states of neighbouring India are already witnessing a surge in new cases.”
India on Sunday recorded 43,846 new cases, the highest daily spike in nearly four months, according to media reports.
Indian states like Punjab, Maharashtra, Madhya Pradesh, Kerala, Karnataka, Gujarat and Tamil Nadu have been witnessing a surge in new cases, prompting the authorities to enforce school closures, restrictions on public gatherings and to put in place virus fighting measures including lockdown in the worst-hit districts.
Nepal shares an 1,800-kilometre-long open border with India through which people’s movement is unhindered.
Thousands of Nepali workers are crossing the border to India while migrant workers from India in similar numbers and those working on cargo trucks enter Nepal from India.
Authorities concerned have not paid attention to enforcing safety measures at land crossings or starting active case hunts.
“If we cannot put people into quarantine or perform tests on them, we can conduct active case findings and make the surveillance system more active and expand testing,” said Thakur. “We are not even following safety measures, as the number of new cases has started to decline in recent days. We should not forget that we are in the stage where European countries were some six months ago.”
Active case detection means that health staff reach out to the community and systematically screen the population to find coronavirus cases. All suspected cases–those having Covid-19-like symptoms–are tested in the active case findings.
Doctors say active case search is an essential component of lessening the infection rate.
Authorities currently are relying totally on the data of people seeking tests voluntarily. The majority of people seeking tests at present are healthy people, planning to go abroad either for employment or study.
Similarly, daily test numbers have not risen since the government stopped performing free tests to those not having symptoms.
Wednesday will mark one year since the country went into lockdown.
The government imposed a countrywide lockdown on March 24 last year when a second coronavirus infection was detected. By the time the lockdown was lifted on July 21, the number of infections had crossed the 17,000 mark. Forty deaths were reported until then.
The government then authorised district administration offices to impose restrictions based on cases. However, these restrictions were lifted before the festive season in October when the country saw a sudden surge in infections. Daily cases rose to 5,743 in October while the fatalities stood at 30 in November.
Then there was a sharp decline in caseloads and fatalities, making even public health experts and doctors wonder. Some even presumed herd immunity.
So carefree people have become now that they have even stopped wearing masks, which could be a recipe for disaster, say public health experts.
“It seems we are in a denial mode. We are not learning anything from our past mistakes and weaknesses,” said Dr Sher Bahadur Pun, chief of the Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital. “Sooner or later, a new wave will start in our country too and we will be in the same position as we were one year before.”
What could also have made people complacent in Nepal, according to experts, is the early launch of vaccination.
Even as various countries in the world, including developed nations, struggled to vaccinate their citizens, Nepal began vaccinating people on January 27 with the one million doses of vaccine provided by India under grant assistance. Nepal received another million doses—of the two million doses for which the government signed a deal with the Serum Institute of India–on February 21. The COVAX facility has provided 348,000 doses.
After vaccinating a little over 1.7 million people, or about 5.7 percent of the total population, the government currently has 600,000 doses in its stock.
Now that there's uncertainty over the vaccine arrival, as one million doses for which Nepal has already paid have yet to be delivered and there’s no response from the Serum Institute of India to the government's plan to procure 5 million additional doses, the Ministry of Health has suspended the immunisation campaign for an indefinite period.
“The ongoing pace of immunisation cannot stop the new surge in infections,” Dr Anup Subedee, an infectious disease expert, told the Post. “Until the majority of the population gets immunised, we should not give up safety measures. It [safety measures] is still relevant and everyone must follow it strictly."
Safety measures like wearing face masks, washing hands and maintaining social distance are the proven ways to lessen the risk of infection, which should be continuously followed in the coming days and years, according to Subedee.
Officials at the Health Ministry said that they have directed agencies concerned to set up health desks at the land crossings and make the surveillance system effective.
‘We have directed the Epidemiology and Disease Control Division to make the surveillance system effective and ensure health workers at health desks set up at the land crossings with India,” Dr Samir Kumar Adhikari, joint spokesperson for the Health Ministry, told the Post. “We have never said the risk has lessened. Everyone should follow safety measures until the risk of infection comes down to zero.”
Meanwhile, the Health Ministry on Sunday urged all not to hold meetings, assemblies, public gatherings, seminars and refrain from doing businesses that invite the crowds, saying the risk of Covid-19 is still there.
The ministry has called the public to follow safety measures, maintain social distancing, wash hands with soap and water or use sanitisers to lessen the risk of infections.
Experts say Nepali authorities have the tendency of not paying attention to preparedness and they often react when the situation starts aggravating.
The Health Ministry statement on Sunday appears to have come because it has halted the vaccination drive. There are a few things which are very basic and doable and the government must focus on those, according to experts.
“We can increase tests, make the surveillance system more effective and implement active case finding,” said Pun of the Clinical Research Unit of Sukraraj hospital. “That way, we will have the knowledge about the situation, and we can make our plans accordingly to fight the virus.”