Second wave caught Nepal unawares. No lessons learned a year laterNo strategies made to fight new surge when there was lull despite warnings of an explosion of infections, experts say.
On Friday, hours after the Health Ministry confirmed 24 new Omicron cases, Prime Minister Sher Bahadur Deuba hurriedly called a meeting of the country’s Covid-19 response agency. He took stock of the situation and passed instructions, which included monitoring the situation on a daily basis and ensuring that hospitals were equipped with oxygen, medicines, beds and ventilators.
As many as 572 people had tested positive from 8,272 polymerase chain reaction tests while 396 from 6,699 antigen tests that day.
Two days later, the Health Ministry on Sunday said 1,167 people tested positive for coronavirus—841 in 8,848 polymerase chain reaction tests and 326 in 3,784 antigen tests.
The daily positivity rate jumped to 9.5 percent.
The Covid-19 Crisis Management Coordination Centre (CCMCC) held a meeting and made a slew of recommendations. Accordingly, the Home Ministry on Monday issued a circular to limit the use of public amenities and access to government offices to the vaccinated, effective from January 21, and ban gatherings of more than 25 people.
The government also imposed restrictions on entry from nine countries. The Education Ministry decided to shut schools until January 29.
On Monday, Nepal posted a sharp rise in coronavirus cases—1,357 people tested positive from 8,965 PCR tests. An additional 89 people tested positive from 2,464 antigen tests.
Public health experts say no strategic decisions have been taken, as the agencies formed to deal with the pandemic waited until the virus to strike.
“Since the start of the pandemic, we have been asking authorities to be on alert and keep preparing strategies as per the evolving situation,” said Dr Krishna Man Shakya, a public health expert. “But authorities here wake up only at the last hour.”
Government officials admit that there were no plans in place, especially to fight the Omicron-driven third wave, even though an explosion in infections was looming.
“We are still working to prepare a rapid action plan,” said Dr Hemanta Chandra Ojha, an official at the Epidemiology and Disease Control Division. “The rapid action plan is in its final stage; we will unveil and implement it soon.”
Even some holding centers, that were to be set up at border points before the second wave of the pandemic, have not been completed yet.
Doctors say no extraordinary measures have been taken by the government, as discussions were never held with public health experts who had been warning of the third wave.
Restriction on entry for passengers arriving or transiting from nine countries—South Africa, Botswana, Zimbabwe, Namibia, Lesotho, Eswatini, Mozambique, Malawi and Hong Kong—is a continuation of an earlier decision.
Even though there were concerns about Omicron’s fast spread in the southern African nations since its emergence in South Africa in late November, cases in the region declined as soon as they spiked. The new iteration of the virus instead is wreaking havoc in Europe, the United States and India.
There has been no decision on surveilling arrivals from these countries.
This clearly shows authorities did not make any strategic plans to fight the new surge of the virus driven by Omicron, according to experts.
Yet another decision which has prompted mixed reactions is making the vaccination cards mandatory in public places.
“It seems Nepali authorities are trying to imitate decisions of some foreign governments, including the United States,” Dr Sarad Onta, a public health expert, told the Post. “Though the decision is not incorrect in itself, it would not help contain the spread of the virus in the country.”
Nepal’s vaccination drive has remained woefully slow despite the government having enough doses in its stock.
As of Monday, 11,232,683 people, or 37 percent of the over 30 million population, have been fully vaccinated.
Of the 39,203,927 doses of vaccines secured so far, around 12 million doses are in stock.
Officials at the Health Ministry said in December last week that booster shots will be started once 40 percent of the total population is jabbed. The Health Ministry on December 29 also announced that it would launch a campaign to vaccinate 500,000 people a day. Both plans have failed.
Experts say that instead of encouraging people to get vaccinated, the decision to allow only the vaccinated to access public amenities and government offices, if implemented, could mean injustice to the unvaccinated.
“There could be multiple reasons for people not taking vaccines, including a lack of easy access,” said Onta. “And this decision on the vaccine cards may do injustice to such people who have not been able to get the jab because of lack of access.”
Officials, however, say despite their utmost efforts people have not been showing up at vaccination centres.
“We have been repeatedly requesting people to visit vaccination centres. But people are not seeking vaccines these days,” said Dr Samir Kumar Adhikari, joint spokesperson for the Health Ministry. “We are working to increase the vaccination pace by forming several high-level committees up to the local level to increase vaccine coverage.”
Officials said making vaccination cards mandatory at public places could lessen the crowds, which in turn could help lessen the virus spread.
“We hope that this decision will encourage people to go for vaccination,” Sunita Nepal, spokesperson for the CCMCC, told the Post. “The recommendation was made in good faith; the only aim is to increase the vaccination rate.”
Dr Prabhat Adhikari, an infectious disease expert, said that such a decision should have been taken much earlier, if the goal is to encourage people to visit vaccination centres.
“I hope the decision to allow only vaccinated people to enter public facilities and avail government services will prompt more people to rush to vaccine centres,” Adhikari told the Post.
Government officials, however, maintained silence on why there were no strategic preparations when the caseload was not too high.
“We were vaccinating people. What was there to do?” said an official at the Health Ministry. “We have constantly urged people to follow health safety protocols. Anyway there is no guarantee if our recommendations will be indeed implemented.”
Officials at the CCMCC said their job is limited to “making recommendations” and that they cannot take decisions.
“We can only recommend; we cannot take any decision,” said Nepal, the spokesperson for the CCMCC. “There are separate agencies which can implement our recommendations.”
Nepal’s political leadership and bureaucrats have invariably failed to pay heed to the threat posed by the virus since the very beginning. Experts say there is a tendency among leaders and bureaucrats to take decisions on their own even on matters that need to be dealt with by people with specialized knowledge. Even during the first and second waves, suggestions offered by public health experts—even though they were invited once in a while to discuss the pandemic–were never accorded priority.
“They do invite experts for meetings and seek suggestions, which are rarely implemented,” said Dr Mingmar Gyelgen Sherpa, former director general at the Department of Health Services. “Things are not being done not because experts have not provided their suggestions. The problem is the government’s implementation mechanism is poor.”