Last week, the World Health Organisation said that the Delta variant is a warning that SARS-CoV-2, the virus that causes Covid-19, is getting “fitter and faster”. This comes as a major concern for Nepal where cases have shot up over the past few weeks, with intensive care unit beds filling up fast. As the number of infections rises in Kathmandu Valley, the most densely populated area in the country, doctors say health facilities could be overwhelmed soon.

The two-month-long strict prohibitory orders imposed from April 29 had been crucial in containing the spread after the second wave slid into a devastating crisis, killing around 6,000 people in just nine weeks from April 24 to June 30. With prohibitory orders lifted, people’s mobility has increased. Since members of the public are not following basic safety protocols, a massive surge in cases cannot be ruled out, doctors say. The Delta variant, which is already circulating in the country, can make matters worse.

Here is everything you need to know about the Delta variant and Nepal’s Covid-19 status.

What is the Delta variant?

The Delta variant is a highly contagious SARS-CoV-2 virus strain. It was first identified in India in December. The World Health Organisation has called it a variant of concern (VOC). So far, scientists have named three classes of SARS-CoV-2 variants: Variant of Interest, Variant of Concern and Variant of High Consequences. The UN health agency classifies a variant as a VOC when it is associated with an increase in transmissibility or detrimental change in Covid-19 epidemiology; increase in virulence; or decrease in the effectiveness of public health measures or available diagnostics, vaccines, and therapeutics.

The B.1.1.7 (Alpha), B.1.351 (Beta), B.1.617.2 (Delta), and P.1 (Gamma) variants are classified as variants of concern. No variant of high consequences has been identified as yet.

Is the Delta variant circulating in Nepal?

The Health Ministry last week said Delta variant (B.1.617.2) was confirmed in 47 swab samples of the infected persons collected between early June and mid-July.

The samples were sent to the World Health Organisation-identified Centre for Excellence in Genomics, the Institute of Genomics and Integrative Biology in New Delhi, for whole-genome sequencing.

The Health Ministry urged all to exercise caution, saying the Delta variant was circulating in the country and that a new sub-lineage of it—K417N, also known as AY.1 was confirmed in three of them. The sub-lineage is called Delta Plus.

“Studies have shown these variants are more infectious and could affect people of all age groups,” the ministry said in the statement.

Earlier in June also the ministry said Delta Plus was found in swab samples.

According to the ministry, of the 48 swab samples of infected people, on which whole-genome sequencing was performed, the Delta variant of the virus was detected in swab samples of 47 people. Among the 47, AY.1 was identified in swab samples of nine people.

Why is the Delta variant a cause for concern?

The World Health Organisation on Friday said that cases and deaths resulting from Covid-19 have continued to climb worldwide, fuelled mostly by the highly transmissible Delta variant. According to the UN health agency, the virus has spread to 132 countries.

“Almost 4 million cases worldwide were reported last week to WHO and the agency expects the total number of cases to pass 200 million, in the next two weeks. And we know this is an underestimate,” said Director-General Tedros Adhanom Gebreyesus during his regular Covid-19 briefing on Friday. “Infections have increased in every region of the world, with some even reaching 80 percent more in the past month.”

Tedros blamed the rise of cases on increased social mixing and mobility, the inconsistent use of public health and social measures, and inequitable vaccine use. He said “hard-won gains” are in jeopardy or being lost, and health systems in many countries are increasingly overwhelmed.

“WHO has warned that the Covid-19 virus has been changing since it was first reported, and it continues to change. So far, four variants of concern have emerged, and there will be more as long as the virus continues to spread”, he said.

According to scientists, the variant is much more contagious than the original strain and may cause severe illness. According to a recently leaked document from the Centers for Disease Control and Prevention, the Delta variant is more transmissible than the common cold, 1918 Spanish flu, smallpox, Ebola, MERS, and SARS.

Are vaccines effective against the Delta variant?

Multiple studies show the Covid-19 vaccines, which are listed by the World Health Organisation for emergency use, are effective against the Delta variant of the coronavirus although vaccines may be less protective against Delta in preventing infection and symptomatic illness compared with earlier versions of SARS-CoV-2. But vaccines still largely remain effective and are very good at preventing serious disease and deaths.

The UN health agency last week reiterated that vaccinated people can get infected and transmit the Delta variant, the likelihood of which is reduced after administration of the second dose and full effectiveness is achieved.

What measures have been taken by authorities to prevent the spread of the Delta variant?

No measures have been taken to prevent the spread of the Delta variant of the virus by the authorities concerned despite knowing that the virus is more contagious and lethal than the one seen in Wuhan of China. Authorities have removed the restrictions enforced during the second wave, tests have not ramped up, contact tracing is next to zero, and more importantly, people stopped following the safety measures such as wearing masks and maintaining physical distance.

What would be the consequences?

Public health experts say that complacency from all sectors—authorities and the general public—will invite the third wave early, which could be another nightmare for the infected people and their families.

Health facilities, whose intensive care unit beds and ventilators have been already running in full capacity, will be overwhelmed, and infected patients will be deprived of the services.

What should be done to slow down the spread?

Doctors say basic measures to contain the spread of infection are the same: avoid crowds, follow the safety measures—wear face masks, wash hands or use sanitisers, maintain physical distance and do not come out of the house unless necessary.

Authorities should expand testing, make contact tracing effective and identify the green, yellow and red zones and take restrictive measures as per the risks.

“Vaccination should be sped up,” said Dr Harischandra Upreti, former director at the National Public Health Laboratory. “A lot of lives can be saved if we can immunise the maximum number of people.”

What is Nepal’s vaccination status?

As of Tuesday, 4,254,540 people (14.18 percent of the total population) have taken their first doses and 2,002,703 people (around 6.67 percent of the total population) have been fully vaccinated.

What’s the current Covid-19 status in Nepal?

As of now, 9,922 people have died of Covid-19 since the pandemic began in January last year.

The number of active cases stands at 32,059.

In the last 24 hours, 2,448 people tested positive from 10,638 polymerase chain reaction tests and 935 people tested positive from 6,080 antigen tests.

The positivity rate is over 23 percent.