On Wednesday, 50 people infected with Covid-19 were undergoing treatment at the Tribhuvan University Teaching Hospital. All of them were in serious condition. The hospital administration said all the intensive care unit beds were occupied by patients in critical conditions.

“We don’t have any intensive care unit beds for new patients,” Dr Santa Kumar Das, deputy director at the hospital, told the Post. “Although new cases have declined, patients with serious Covid-19 cases continue to occupy intensive care unit beds.”

From around 6 percent daily test positivity rate on October 10, the rate had increased to around 12 percent on Tuesday (October 19). And public health experts warned that the number of new cases and the positivity rate could increase in the coming days, as neither the authorities concerned nor the general public appear to be taking the risk of infection seriously.

The hospital has allocated 40 intensive care unit beds for Covid-19 patients.

Hundreds of thousands of people travelled during Dashain, met people and violated the Covid-19 safety protocol—wearing face masks, maintaining social distance and washing hands.

“People celebrated this Dashain forgetting Covid and its consequences,” said Dr Anup Bastola, director at Sukraraj Tropical and Infectious Disease Hospital. “Infection could make it difficult for the elderly people, and to those with compromised immunity. We have to wait one more week to find out to what extent the virus spread during the Dashain holidays.”

The Ministry of Health and Population claimed to have directed the authorities concerned to carry out antigen testing at all land crossings, set up sample collection centres in all local units and ramp up polymerase chain reaction tests during the Dashain.

However, the polymerase chain reaction test numbers had declined to 1,446 on October 16.

“New cases will increase in the coming days, as people from the cities have reached the villages and public health measures have been violated,” said Dr Anup Subedee, an infectious disease expert. “We can expect a small hump as new cases rise in coming days.”

Remote villages lack health facilities, laboratories for testing and trained health workers. Moreover, compared to major cities, Covid-19 vaccine coverage rate is too low in villages.

“People from far-flung villages neither undergo testing nor seek treatment unless they become seriously ill,” said Subedee. “Authorities should have increased testing and ramped up the vaccination drive to prevent the looming disaster.”

Even if the test positivity rate and the number of new patients declined of late, health experts fear the coronavirus has been spreading in communities.

They are of the view that only the people getting severe from infection and those needing polymerase test reports to go abroad are seeking tests.

Officials stopped contact tracing long ago and despite claims that antigen testing would be ramped up, the test numbers have not increased.

Doctors say increasing testing and contact tracing are the basic things that need to be done to know the infection status and contain the spread.

“People in remote villages, where both testing and treatment are absent, are at high risk, as their relatives visiting from cities may have passed the virus on to them,” said Dr Bikesh Tamrakar, an assistant professor at Kathmandu University who serves at Dhulikhel Hospital. “Authorities should carry out more testing and activate all mechanisms to monitor the situation in the villages.”

Dr Krishna Prasad Paudel, spokesperson for the Health Ministry, said it was still vital to take precautions and follow health protocols against Covid-19.

“Even if the infection rate has declined of late, it is not yet time to say that the risk has lessened,” he said.

So far, 6,489,828 people have been fully vaccinated. It is 21.4 percent of the country’s total population estimated at 30,378,055 by the Central Bureau of Statistics.

The Health Ministry said that 32.6 percent of the target population (21,756,763 aged 15 years and above) has been fully vaccinated.

Nepal needs to vaccinate around 78 percent of its 30 million population—or around 25 million people, as per the government’s new plan that includes those aged between 12 and 18 years. The government earlier had planned to vaccinate only those aged 15 years and above.

Since around 4-5 million people are said to be living abroad, the government needs to vaccinate around 19-20 million people. For this, the country needs a little over 40 million doses of double-shot vaccines.

Nepal so far has received 18,857,590 doses of Vero Cell, AstraZeneca and Johnson and Johnson vaccines in total.

The government has purchased 12 million doses—10 million doses of Vero Cell from China and 2 million doses of Covishield vaccine from India. The rest were provided under grant assistance by various countries and the COVAX facility.

COVAX, the UN-backed international vaccine sharing scheme, has committed to provide 13 million doses, sufficient to inoculate 20 percent of the total population.

So far, the facility has supplied 3,497,490 doses (1,534,850 doses of single-shot Janssen, 1,614,740 doses of AstraZeneca, and 348,000 doses of Covishield from AstraZeneca).

Officials at the Health Ministry said that they expect supply of the coronavirus vaccine from the facility at the earliest.

However, Reuters on Tuesday reported that India has delayed committing supplies of vaccine to the facility.

India, which is the world’s biggest vaccine maker, resumed exports of Covid-19 doses this month for the first time since April. It has sent about 4 million doses of vaccines to countries like Bangladesh, Nepal and Iran, but none to COVAX.

Delayed supplies to COVAX could disrupt inoculation drives in many countries including Nepal.

Nepal has also signed a deal with the facility to purchase 9.9 million doses—5.9 million doses of Vero Cell and 4 million doses of Moderna Covid-19 vaccine—through a cost-sharing mechanism.

Health Ministry officials also said they are close to a deal on purchasing an additional 6 million doses of Pfizer-BioNtech Covid-19 vaccine.