With an exponential rise in new cases of Covid-19, the Ministry of Health and Population has decided to launch vaccination drives, especially booster campaigns, aggressively.

The ministry said that all health facilities under Kathmandu’s local units started a vaccination programme on Tuesday, and local units and provinces concerned have been requested to launch similar drives at the earliest.

“People are not seeking vaccination, especially the third dose,” said Sagar Dahal, chief of the National Immunisation Programme. “Everyone should urge others to take booster shots if they have not already.”

The Health Office, Kathmandu said that all of the district’s local units started a booster campaign on Tuesday. The Kathmandu Metropolitan City has set up vaccination booths at vegetable markets in Kalimati and Jadibuti, Pashupatinath Temple premises, Swayambhunath Temple premises, Ason Chowk, Department of Passport at Tripureshwar, and in City Hall.

Gyan Bahadur Oli, an official at the Kathmandu Metropolitan City, said the vaccination drive will continue for the next four days. “People above 18 years old can receive the first, second and third doses of the vaccine from the immunisation centres convenient for them,” he said.

Despite having sufficient doses in stock, Nepal’s booster uptake has been very low. The Health Ministry said that it has over seven million doses of vaccine in stock.

Dr Prabhat Adhikari, an infectious disease and critical care expert, said authorities concerned should focus on administering the vaccine to a maximum number of people at the earliest. “The vaccines may not prevent infection but can save us from getting severe and reduce chances of death,” he said.

After the third wave driven by Omicron, a highly contagious variant of the SARS-CoV-2, gripped the country, the Ministry of Health and Population started administering booster shots on January 17.

Several studies, including one carried out in Nepal, show that the immunity level achieved from vaccination or natural infection wanes after six months of the vaccination or natural infection.

So far, 6,950,373 people or around 23.8 percent of the total population have received booster shots. The Health Ministry has opened the booster shots to all people who were administered with the second dose of vaccine at least three months ago.

Doctors say the number of new cases will go up significantly in the coming days as the virus has been spreading in the communities due to apathy of authorities concerned to take preventive measures.

The government has neither activated surveillance measures such as free testing and contact tracing nor has it enforced safety measures such as wearing face masks, hand washing and maintaining physical distance.

Meanwhile, multiple new sub-variants of Omicron have been detected in Nepal.

According to a doctor at Dhulikhel Hospital, which carried out whole-genome sequencing on various swab samples, BA.5, BA.5.2, BA.2.75. BA.2.73, BA.2.12.1, BA.2.38 and BF.1 sub variants have been detected in swab samples.

The hospital’s laboratory had carried out whole-genome sequencing on 22 swab samples of infected persons and obtained the results on Tuesday.

Whole-genome sequencing is a comprehensive method of analysing the entire DNA sequence of an organism’s genes. Researchers believe that whole-genome sequencing of the coronavirus could be instrumental in tracking the severity and properties of the virus.

Among the subvariant of the Omicron variant, Nepal recorded infection of BA.5 ten days ago, and BA. 2.12.1 during the third wave earlier this year.

The BA.5 subvariant currently dominates the global caseload.

Lately, BA.2.75, possibly a super contagious Omicron mutant that can evade immunity, has been spreading rapidly in India and in other countries, according to the Indian Express.

“Detection of several sub-variants of the Omicron variant at once is a matter of serious concern,” said Dr Rajiv Shrestha, head of genetic laboratory at Dhulikhel Hospital.

The BF.1 subvariant was first detected in June-end and has been spreading in the UK, Scotland, Denmark and Canada, among other countries.

Many things regarding BF.1 and BA.5.2 are not known but doctors say it could be more infectious than other variants and can evade immunity developed from all existing vaccines.

“Authorities concerned should enforce safety measures immediately and focus on vaccination,” Adhikari, the infectious disease expert, said. “Attention should be given to manage the surge by taking details of the number of hospital beds available and providing training to health workers, among others.”

The first wave of the pandemic in Nepal was driven by the virus variant first detected in Wuhan of China. The second wave was triggered by the Delta variant first reported in India. Over 8,000 people had died in the second wave. The Omicron variant, which infected almost all people of the country, was responsible for the third wave. It, however, did not inflict much damage compared to the Delta variant as many people were already vaccinated.

Nepal on Tuesday recorded 357 cases of the coronavirus—268 in 1,857 polymerase chain reaction tests and 89 in antigen tests.

Nepal has so far received 58,891,970 doses of Covid vaccines of various brands—AstraZeneca, Vero Cell, Moderna, Janssen, Sinovac-CoronaVac and Pfizer-BioNtech—including paediatric doses.

So far, 20,477,162 people have been fully vaccinated in the country.

Of the total infected people on Tuesday, 22 are under 20 years old. The Health Ministry said that 19 infected people have been receiving intensive care in various hospitals.

Experts say complacency, and lack of testing, contact tracing and enforcement of safety measures, could prove costly if a more lethal virus variant like the Delta spreads in the country.

As children under five years old are not vaccinated yet, they are vulnerable to infection.

Many people, including children, have been suffering from flu-like symptoms of late.

Doctors say that since this is neither a flu season, nor is the dust causing flu, anyone who is suffering from flu-like symptoms is most likely suffering from coronavirus.

They say that one should self-isolate immediately if they have flu-like symptoms such as runny nose, sore throat, body ache, and fever, among others, and inform people they have come in close contact with.

Dr Rajiv Shrestha, an infectious disease expert at Dhulikhel Hospital, warned that schools can again turn into hotspots.

“Authorities concerned should monitor if schools are following safety measures,” he said. “School administrations must prevent students from coming to schools if they have Covid-like symptoms.”

Meanwhile, the World Health Organisation on Tuesday said, the new wave of the Covid-19 pandemic has hit Europe, and health authorities must act now to mitigate its fallout.

“Waiting for the autumn to act will be too late,” reports quoting Dr Hans Kluge, WHO Regional Director for Europe, said.

“It’s now abundantly clear we’re in a similar situation to last summer–only this time the ongoing Covid-19 wave is being propelled by sub-lineages of the Omicron variant, notably BA.2 and BA.5, with each dominant sub-lineage of Omicron showing clear transmission advantages over the previously circulating viruses.”