Covid-19 cases may have been declining in the past few days, but the number of daily deaths has remained somewhat the same—18 on an average, which experts say is quite concerning. Doctors say authorities must pay attention to testing, contact tracing and treatment, as well as the number of fatalities, before drawing a conclusion on the country’s Covid-19 status.

“The daily number of new cases may have declined because of fewer tests, but 18-20 deaths a day is something we must be concerned about,” said Dr Mingmar Gyelgen Sherpa, former director general of the Department of Health Services. “It’s not a small number.”

Amid the looming third Covid-19 wave, doctors say it would be too early for people to let their guard down, as around 20 deaths a day is still quite a big number.

In the past 24 hours, 21 people died from complications arising from coronavirus infections.

Since the number of deaths provided by the Health Ministry on a daily basis includes only those reported to the authorities, the daily fatalities could be even more, as some Covid-19 patients might be losing their lives without getting hospitalised.

After the second Covid-19 wave, which hit the country in April, slid into a devastating crisis, authorities had enforced strict lockdown measures. About two months later, the restrictions were relaxed gradually, and starting last week, almost everything has been allowed to reopen.

Schools, malls, cinemas, gymnasiums, temples, zoo, public transportation and other public places have reopened. People are behaving as though there is no virus.

The ongoing vaccination campaign and declining infection numbers could give a false sense of security, doctors warn.

The vaccination speed, however, has remained low.

“Only over 16 percent of the population has been fully vaccinated so far and we do not know how long the antibodies last in the body after vaccination,” said Dr Tulsi Ram Bhandari, a public health expert, who is also an assistant professor at Pokhara University. “There is no alternative to starting preparations for the possible new surge of cases.”

The presence of the super-contagious Delta variant makes things look even bleaker.

Nepal was hit by the second wave just after India was overwhelmed by the sudden surge in cases. At one point, Nepal mirrored India—hospitals were turning away patients for lack of oxygen, oxygen cylinders, ICU beds and ventilators.

With the festival season just around the corner, India is bracing for a third Covid-19 wave. Media reports said India has scaled up measures to “prepare for the worst”. Nepal and India share a long porous border through which thousands of people cross into each other’s territories and the two countries also observe some festivals during the same time.

As the festival season means celebrations and crowding, doctors say preparatory measures should be stepped up, just as people should be made aware of the fact that the coronavirus risk is not over yet.

Experts say what is more dangerous than the virus is complacency among authorities as well as the general public. There has been a massive decline in the number of people who are going for Covid-19 tests voluntarily, according to records from various hospitals and labs.

“Earlier, people used to go for tests voluntarily also because they needed a report to claim the insurance,” said a lab technician at the National Public Health Laboratory who did not wish to be named. “These days very few people seek Covid-19 tests, as the insurance scheme has been halted.”

Besides, the authorities are also not encouraging people to go for tests, and the government on its part has not been conducting enough number of tests. In May, the government had said it would conduct over 25,000 antigen tests a day, but this number has failed to cross the 5,000 mark.

The number of polymerase chain reaction tests too stands at around 10,000 on average.

Doctors say vaccines are the only way to fight the disease at present, apart from taking precautionary measures to keep the disease at bay.

But there is a caveat.

Infections have been seen in people who are fully vaccinated; the severity may be low though.

“Despite high vaccination rates in many countries including the United States of America, hundreds of thousands of people are getting infected every day and over 1,000 people are dying,” Dr Binjawala Shrestha, a public health expert, told the Post. “Since just around 16 percent of the population has been fully vaccinated in our country, we still have a long way to go. We should not let our guard down.”

As of now, 5,603,757 people (18.67 percent) have taken the first dose of the vaccine and 5,012,821 (16.7 percent) have been fully vaccinated.

As of Tuesday, the number of active cases in the country stands at 30,303. As many as 10,879 people have died of the coronavirus since the pandemic began.

As coronavirus infection and death rates have remained constant, many might understand that Nepal has entered an endemic stage, but the situation may change overnight if the new variants enter the country.

The United States’ Centers for Disease Control and Prevention defines endemic as “the constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area.”

Last week, the Ministry of Health and Population released a preliminary report of a nationwide seroprevalence study, saying 68.6 percent of the country’s population has already developed antibodies to Covid-19.

The full report has not been made public yet. The Health Ministry, however, said detection of antibodies in a large number of people, both vaccinated and unvaccinated, should be taken in a positive light.

Public health experts, however, have warned that the preliminary results of the seroprevalence study, which is confusing and misleading, could increase complacency in all sectors and lead to a spike in new infections.

The perception that Nepal could have entered some sort of the endemic stage, buttressed by the Health Ministry seroprevalence study claim, could be counterproductive, experts warn. Endemic means constant presence of a disease in communities and if misunderstood with regards to the coronavirus, it could make people careless.

According to Shrestha, ongoing complacency in all sectors might have been because of the misinterpretation of the seroprevalence study results.

“As the coronavirus continues to mutate, the arrival of any new variant could trigger a third wave,” said Shrestha. “The current decline in cases could be a calm before the storm, so preparatory measures must continue along with scaling up vaccination.”