Last week, a man in his early 60s from Nuwakot died at home at around midnight. The deceased had flu-like symptoms—mild fever, headache and runny nose— and had continued his household chores until the day before.

“The deceased was healthy and had no major health complications,” said Narayan Adhikari, one of the neighbours of the deceased. “Most of the people in our village have flu-like symptoms, but only a few have undergone tests for Covid.”

This is a common refrain in many villages throughout the country.

Neither the health authorities nor the family members of the deceased are aware of the cause of death.

The Ministry of Health and Population compiles only the number of infected people and deaths reported by various hospitals and laboratories that run tests on those who come in voluntarily for testing.

On the contrary, thousands of people throughout the country have been opting for antigen testing with kits bought from pharmacies. The results of the Covid-19 tests conducted at home go unreported.

Moreover, not all people opt for tests despite having Covid-19 like symptoms.

“All of my 16 family members have Covid-19 like symptoms; some suffered from fever while some were down with headache, sore throat and runny nose. But none of us underwent testing,” said Arun Devkota from Naikap, Kathmandu.

The disconnect between the actual number of infections and deaths and the numbers shown in government data indicates the authorities’ negligent approach towards prevention, preparation and management of the Covid-19 pandemic, public health experts say.

“The number of Covid-infected people and related deaths could be 10 times what is being reported by the health authority on a daily basis,” surmised Dr Prabhat Adhikari, infectious disease and critical care expert. “Effective planning is not possible without accurate data. Authorities being unaware of the extent of the spread of infections means they do not know about the true Covid situation in the country.”

Doctors say that data collection of the infected people and deceased are necessary to plan vaccination, deliver booster shots and help hospitals prepare accordingly. But in the ongoing third wave of the pandemic, health authorities have pulled the plug on preventive and preparatory measures such as testing, contact tracing, isolation, quarantine and imposition of public health measures.

“The government’s apathy in times like these would have resulted in a large number of deaths if the dominant virus variant was fatal like Delta,” Dr Keshab Deuba, a public health epidemiologist, told the Post. “This variant also carries risks to one’s life but no one is taking it seriously.”

Doctors say that a multi-pronged approach is necessary to curb the virus spread.

Disease burden and excess mortality can be reliably estimated with the help of correct data and this also helps in data forecasting, which helps in overall management and prioritisation, Dr Nirmal Kandel, tweeted on Sunday. “Report the infection status as far as possible. This is necessary for disease management…”

Meanwhile, the Epidemiology and Disease Control Division on Sunday asked health institutions and laboratories to report the results of Covid-19 tests. The division has shared a hotline number and an email id where both health institutions who receive patients for testing and individuals using at-home test kits can SMS their test results.

“Authorities could have done this before the third wave hit,” said Dr Baburam Marasini, former director at the Epidemiology and Disease Control Division. “The consequences of mismanagement of data could have been severe if the dominant variant spreading in the country was more fatal.”

On Sunday, 3,540 people tested positive—3,049 in 9,910 polymerase chain reaction tests and 491 in 3,235 antigen tests. The Health Ministry added 32 previously unreported deaths to the tally on Sunday including 12 deaths in the Army Hospital.

Active cases stand at 83,999 throughout the country.

So far, 14,015,324 people have been fully vaccinated and 333,835 people have taken booster shots.