Contact tracing, a key measure in fight against virus, poor amid Omicron risksOfficials and experts say failure to follow basics could spell disaster, as cases have been rising.
When Omicron was travelling across the world after its first detection in South Africa in late November last year, public health experts in Nepal followed the global update on the virus as they kept a close eye on the southern neighbour India.
If the trend in the past is anything to go by, the virus has struck Nepal after making inroads into India. And it was a matter of time, after about a month and a half, Omicron, the latest iteration of the coronavirus that has kept the world on tenterhooks, arrived in India.
The Health Ministry said that around 22 percent of the samples out of 1,146 showed S-gene target failure report and that 24 out of 24 samples on which geneone-sequencing was performed returned Omicron results.
But where are these people?
Neither the Health Ministry nor any other government agency has conducted contact tracing, one of the immediate measures to be followed to curb the spread.
“We could not trace contacts of some of the people infected with the Omicron variant,” said an official at the Epidemiology and Disease Control Division (EDCD), the agency responsible for dealing with the pandemic. “And anyway it won’t help now, as it’s already been more than two weeks since they were infected.”
The Health Ministry said on Friday that it had conducted tests on random samples from across the country in the month of Poush (starting December 16).
Officials said that like in the case of any other variant, the EDCD had asked respective provincial health authorities and the latter had directed health agencies of the respective local units to carry out contact tracing.
“Everyone knows how effective our contact tracing has been,” said an official at the Department of Health Services, seeking anonymity. “Despite calls, contact tracing has remained poor.”
With the government stopping free testing in October 2020, contact tracing has by and large been halted and even in the devastating second wave last year it was not resumed.
Like in any other variant, respective local federal units are responsible for carrying out contact tracing in the cases of Omicron also, but most of the local governments are unaware of the infections by the new variant.
The Health Office Kathmandu said that it has not been informed about any particular Omicron cases as of now—neither by the Epidemiology and Disease Control Division nor by any laboratory or any other agency.
“We inform the infected people about their infection status only,” Sambhu Kafle, chief of Health Office Kathmandu, told the Post. “We do not tell people about the virus variant, as we ourselves do not know. We are not informed about any Omicron case in Kathmandu district as of now.”
The Health Ministry has not unveiled the details of the infected people. Nor has it informed the concerned agencies for contact tracing.
“I am not informed about the Omicron infections,” said Gyan Bahadur Oli, the Covid-19 focal person at Kathmandu Metropolitan City.
Dr Krishna Prasad Paudel, director at the Epidemiology and Disease Control Division, said that since all the samples on which whole-genome sequencing returned Omicron results, it’s obvious that the infections by the new variant have been rising.
Concerns are growing also because India, with which Nepal shares a long porous border, is reporting a surge in cases for the past few days.
India reported 141,986 Covid-19 cases and 285 deaths on Saturday.
According to data released by the Union Ministry of Health and Family Welfare of India, 3,071 cases of Omicron were reported across 27 states and union territories so far.
Officials at the Health Ministry said that the coming days will not be easy and infections by the new variant could peak within the next few weeks.
Though not as exponential as in India, Nepal too has been reporting a steady surge in cases. The Health Ministry said on Saturday 696 people tested positive from 9,762 polymerase chain reaction tests in the last 24 hours—up from 572 the previous day. An additional 248 people tested positive from 3,502 antigen examinations.
Daily positivity rate of polymerase chain reaction tests has jumped to 7.1 percent.
As of Saturday, the number of active cases stands at 6,140.
Experts say authorities’ failure to make contact tracing effective amid S-gene target failure on most of the samples and then genome-sequencing returning Omicron cases could spell disaster.
“Most people know what to do after the infection and we have informed the respective provinces about the infection and the latter informed the health agencies of local units,”said Paudel. “The same measures that are followed for other variants need to be followed by everyone.”
Paudel agrees that there could be more Omicron cases, as the swab samples randomly collected from across the country have shown Omicron infections. He admitted authorties’s failure to effectively carry out contact tracing of some of the infected.
Of the people infected with Omicron, some are Army personnel who returned from a peacekeeping mission in Africa. Others include foreign returnees and the members of the public, according to Paudel.
Public health experts warn that the country is again on the brink of a catastrophe and negligence from the authorities and the general public could prove costly.
“We all have known all along about the risk. We also know the measures to be taken to prevent a disaster,” Dr Bhagwan Koirala, chairman of Nepal Medical Council, the national regulatory body of medical doctors, told the Post. “But we seem to have been lackadaisical in our approach. We cannot afford to commit the same mistake again and again. All agencies concerned must act responsibly.”
That the percent positivity rate has risen, from 2.61 percent on Tuesday to 7.10 percent on Saturday, is a cause for concern. In contrast, the vaccination rate has failed to pick up.
As of Saturday, 11,111,468 people, or 36.6 percent of the total population, have been fully vaccinated.
“The rise in infections when Delta cases were declining and the vaccination rate was increasing is an indication of the arrival of Omicron,” said Dr Anup Bastola, an infectious disease expert, who is also a former director of the Sukraraj Tropical and Infectious Disease Hospital. “There could be breakthrough infections.”
As cases are rising, officials are considering some restrictive measures with a decision likely on Sunday. A member from the prime minister’s private secretariat said some steps could be announced on Sunday.
Experts say contact tracing is key and officials should consider other steps to control the virus spread rather than resorting to another lockdown.
“The new variant may not make people seriously ill, but it spreads fast in communities, which ultimately increases pressure on hospitals,” said Dr GD Thakur, former director at the Epidemiology and Disease Control Division. “We all have experienced the lockdown and we know what impact it causes. We should focus on measures to control the contagion.”