In May, at a meeting of the National Immunisation Advisory Committee, Dr GD Thakur, former director at the Epidemiology and Disease Control Division, stressed the need for creating a national strategic reserve to deal with the possible Covid-19 third wave, which experts say could be far more devastating than the previous two waves.

Thakur was not alone to stress the need for such a reserve. Other members of the expert group also suggested taking lessons from the devastating second wave of the pandemic and starting preparations accordingly.

“We discussed and gave suggestions, but neither the officials participating in the meeting took the issue seriously nor the government started preparations to deal with the possible devastations,” Dr Thakur told the Post. “Our suggestions are still relevant, and we will go through the same crisis again if we do not make preparations for the worst-case scenerio.”

The National Immunisation Advisory Committee is a panel of experts and former bureaucrats from the Health Ministry and is mandated to provide evidence-based suggestions on vaccination.

The Health Ministry said that it has taken experts’ suggestions into account and started preparations to create a national strategic reserve of human resources, medical gears and oxygen, among other things.

“We have decided to maintain a stock of essential medicines, human resources and other supplies sufficient for at least three months,” Dr Roshan Pokhrel, secretary for the Health Ministry, told the Post. “This is being done in coordination with the Health Ministry and the Covid-19 Crisis Management Centre.”

For that a committee has been formed under the Department of Health Services to recommend the amount of critical care medicines, medical gears including personal protective equipment, masks, gloves, face shields and shoe covers the government needs to stock up on.

The committee has also been tasked with estimating the total number of health workers needed to be trained for the care of infected patients including at intensive care and critical care units, and the number of doctors needed.

“We held the meeting of the committee a few days ago. The committee is working to prepare a detailed report on the resources,” Dr Krishna Prasad Paudel, spokesperson for the Ministry of Health and Population, told the Post.

Paudel refused to divulge the details of the committee and its work and its findings and suggested approaching the Covid-19 Crisis Management Center for more information.

“Yes, the concept to create a national strategic reserve is ours [Covid-19 Crisis Management Center’s],” Nurhari Khatiwada, spokesperson for the Center, told the Post. “Preparations will start for creating a reserve after receiving the report from the committee.”

Khatiwada said that a national strategic reserve is required to prevent a repetition of the situation experienced during the second wave of the pandemic, which killed more than 6,000 people and infected hundreds of thousands.

It had been reported that some patients even died in hospitals due to oxygen shortages. The government had to plead with the international community for support to get medical supplies including oxygen cylinders and oxygen plants.

According to Thakur, former director at the Epidemiology and Disease Control Division, the suggestions were made after estimating the number of infections during a potential third wave of the pandemic. He said up to 10,000 people could get infected in a day in the worst-case scenario and up to 9,000 people may need intensive care at a time and the pandemic may last up to four months.

“It has been estimated that a significant number of children could also get infected in the third wave and we had advised the government to make preparations accordingly,” said Thakur.

The government had to bring antiviral drug Remdesivir from Bangladesh after India restricted export of medicines used in the treatment of Covid-19 amid record spikes in cases there during the second wave of the pandemic in March.

Nepal still lacks the key antibiotic drug, Tocilizumab, required for the treatment of critically ailing Covid-19 patients. For the drug, people are being forced to pay up to 17 times the price set by the Department of the Drug Administration, the national medicine regulatory body.

Officials at the Health Ministry said that they have also asked the department about the stock of the general and critical care medicines in the country.

“We have asked the suppliers and manufacturers about the size of their stocks of all kinds of medicines including the medicines used in critical care and in Covid-19 treatment,” said Santosh KC, spokesperson for the department. “We have also assured that the department is ready to facilitate importing some medicines if they are facing difficulties.”

It has been reported that the central government in India has started preparations to create a stockpile of critical medicines for Covid-19 to prepare for a possible third wave.

Experts in India estimated that the third wave of the pandemic will hit the country in October.

Doctors in Nepal said if the third wave hits India it will take up to five weeks for it to enter Nepal.

“At present there is no shortage of medicines except for Tocilizumab administered to treat critical Covid-19 patients,” said Mrigendra Meher Shrestha, the president of Nepal Chemists and Druggists Association. “There will be no shortage of medicines if things go normal and if the government of a particular country, especially India, halts the supply, then the government has to deal with the Indian government.”

Shrestha informed that his association has held a discussion with the Department of Drug Administration about the stock of medicines.

Public health experts said that preparations should not be limited to only hoarding medicines and equipment. Aid agencies have provided hundreds of ventilators and other equipment after the government pleaded for help during the peak of the second wave but many such equipment are gathering dust in many places.

“It is important for us to start preparations to deal with the worst-case scenario,” Dr Mingmar Gyelgen Sherpa, a former director general at the Department of Health Services, told the Post. “It has already been late to start preparations and we have no other way than to face whatever happens if the third wave hits.”