On Saturday, the Palpa Hospital administration suspended all health care services, except emergency, after confirmation of coronavirus infections among doctors and staffers.

Of the swab samples from nine staffers at the hospital, collected for polymerase chain reaction tests, four tested positive.

On Thursday, three schools in Dang—Aishwarya Secondary School in Tulsipur Sub-metropolitan City-8 and Rapti Children’s Academy and Janata Sanskrit Secondary School both in Tulsipur Sub-metropolis-6—were shut down after confirmation of virus infections among students and teachers.

Officials say Covid-19 cases are rising, and the trend shows infections are being seen in clusters. Even health workers, who were vaccinated about a year ago, have been infected in Palpa Hospital, which is a cause for concern, according to them.

There are even children who were either recently given the first dose of vaccine or are unvaccinated and teachers who were vaccinated months ago testing positive.

The way coronavirus cases are rising should not be ignored, say public health experts, especially when neighbouring India is reporting an exponential rise in infections.

On Thursday, 540 people tested positive for Covid-19 in Nepal. On Wednesday, the number was 435. The previous day, the number stood at 393.

The daily test positivity rate (of polymerase chain reaction tests) for the last three days is—6.6 percent, 6.5 percent and around 4.5 percent, respectively.

Daily test positivity rate on December 29 was 3.2 percent.

Public health experts say most of the signs point to the third coronavirus wave.

“The rise in new cases is a clear indication that a new wave could hit anytime,” Dr Biraj Karmacharya, an epidemiologist, told the Post. “The new wave will start from clusters [schools, offices, unvaccinated areas and so on]—people who are unvaccinated will be much affected.”

While the Delta variant is not over yet, Omicron, the latest iteration of the coronavirus, is spreading around the world, including in India, with which Nepal shares a long porous border. Thousands of people cross into each country every day.

India on Thursday reported 90,928 cases of coronavirus infection, which is a sharp spike of over 56 percent in daily new infections. The country reported 325 deaths. So far, India’s Omicron tally stands at 2,630.

The Gujarat government even postponed an investment summit scheduled for January 10-12 in the wake of rising coronavirus cases. Prime Minister Sher Bahadur Deuba was set to attend the event—Vibrant Gujarat Global Summit. Deuba was scheduled to leave for New Delhi on Sunday. The visit has been called off.

Delhi itself is struggling to cope with rising Covid-19 cases and has declared weekend curfew—from Friday night to Monday morning.

Authorities have already said that there have been S-gene dropouts in a significant number of infections in Nepal.

The World Health Organisation says S-gene is not present in Omicron as a result of multiple mutations the variant has undergone and is considered a marker to identify the latest iteration of the coronavirus.

“One of the target genes is not detected [called S-gene dropout or S-gene target failure] and this test can therefore be used as a marker for this variant, pending sequencing confirmation,” states the UN health body.

“If we see the infection rate of India and other countries, new cases are doubling in every two to three days,” said Dr Prabhat Adhikari, an infectious disease and critical care expert. “The number of new cases could rise exponentially in the coming days.”

Doctors say if the S-gene is found missing in a significant number of new cases, it should be taken as Omicron and measures must be devised accordingly.

“The Alpha variant of the coronavirus has vanished and S-gene is not detected in those infected with the Omicron variant,'' said Adhikari. “Authorities should check S-gene dropouts to confirm Omicron cases.”

Scientists so far have said despite Omicron’s high transmissibility, its severity has been less, and it might not lead to deaths.

But the twin attack of Delta and Omicron could put pressure on health facilities.

The major concern is how many people have been vaccinated and whether there is time to administer booster doses.

Most of the experts the Post spoke to over the past week have stressed the need to ramp up the vaccination drive and start booster shots.

“Unvaccinated population, which is around 64 percent, is at high risk,” Dr Sher Bahadur Pun, chief of the Clinical Research Unit at the Sukraraj Tropical and Infectious Disease Hospital, told the Post. “Elderly people and those having comorbidities could be affected more.”

So far, 10,904,851 people, or 35.9 percent of the over 30 million population, have been fully vaccinated as of Thursday, according to the Ministry of Health and Population.

Since the country has enough vaccines and more doses are due to arrive, experts say extended doses and booster shots must be given at least to those with compromised immunity and to frontline workers including health professionals.

Nepal so far has received 39,203,927 doses of various Covid-19 vaccines—Vero Cell, AstraZeneca, Moderna, Janssen and Pfizer.

The Health Ministry had decided to administer extended shots to those having compromised immunity and those above 60 years of age who were jabbed with Vero Cell from Tuesday.

However, it reversed the decision within 24 hours. Officials said that the decision created confusion among people over the extended shots and that there was a backlash from various quarters, as a huge percentage of the population is still unvaccinated.

Doctors say that the decision to postpone extended doses to the elderly people is immature and could prove too costly in the coming days.

“Palpa Hospital stopped all services due to infection in health workers. Are we going to shut down Bir Hospital and [Tribhuvan University] Teaching Hospital if health workers there test positive in large numbers?” said Karmacharya, who heads the Community Programme at Dhulikhel Hospital.

Along with increasing vaccination pace, experts have called for starting preparations for case management, shutting down schools, prohibiting parties and huge gatherings and lessening crowds in public places to slow down the infection rate.

“Authorities should do what can be done immediately to slow down the infection rate,” said Pun. “Time is running out. The new wave is just about to strike.