Four Covid-infected people in serious conditions were admitted to the intensive care units at several hospitals in Kathmandu Valley on Thursday. One of them is in a critical condition and has been placed on a ventilator, according to the Ministry of Health and Population.

As new cases of coronavirus infection rise, the number of serious and critical cases have also been rising.

“Rise in cases including serious ones could just be a start, as a new sub-variant of Omicron is spreading in communities,” said Dr Sher Bahadur Pun, chief of the Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital. “It takes some time for the infection to peak and the virus could cause complications in vulnerable populations—elderly people, those taking immunosuppressants and others having comorbidities."

Of late, Nepal has been witnessing a rise in new cases of coronavirus infection and XBB.1.16, a sub-variant of Omicron, is considered the main culprit. Doctors say XBB is a hybrid lineage of two Omicron sub-variants and has the capacity to evade immunity from prior infections and vaccinations.

What has alarmed infectious disease experts and virologists is that the cases of seasonal influenza are also rising simultaneously and symptoms of both diseases overlap.

According to the World Health Organisation’s Global Influenza Surveillance, at least 422 cases of influenza have been reported in Nepal since the start of 2023. Of the total influenza cases recorded by the UN health body, 316 were detected to be A (H30) also known as Hong Kong flu, 35 were A(H1N1) also known as swine flu, while cases of influenza B infections too had shot up (71 cases).

Experts say the simultaneous spread of both the influenza virus and Covid is concerning as it would increase the risk of misdiagnosis. Negligence too could be high and that may delay treatment.

“We had been talking about ‘twindemic’ several times since the start of the Covid pandemic, but that never happened,” said Pun, who is also a virologist. “But a real ‘twindemic’ could happen this time, as both viruses have been spreading in communities.”

Cough, fever, chills, nausea, vomiting, sore throat, runny nose, and continuous sneezing are among the symptoms of infection of the influenza virus and many of them are similar to the symptoms of the coronavirus.

Many people in Nepal do not take the influenza virus seriously, but doctors say the virus is also highly contagious. It could cause pneumonia and if left untreated, even death, according to doctors.

They also say that people can get infected with Covid and influenza at the same time.

Timely detection of the infection, be it from the coronavirus or the influenza virus, helps health workers start treatment on time, but many people in Nepal do not undergo testing.

The WHO says that mortality from Covid appears higher than from influenza, especially seasonal influenza.

“To lessen the severity of Covid infection, we should administer second booster shots to the eligible populations,” said Dr Prabhat Adhikari, an infectious disease and critical care expert. “The authorities should focus on bringing vaccine doses and increasing their uptake.”

Health authorities have been currently administering Covid jabs to people above 55 years old, pregnant women, those with comorbidities, those taking immunosuppressants, and health workers. However, the uptake of the vaccine in the said groups is very low.

Meanwhile, the ministry said that 85 new cases of Covid were reported on Thursday, while 99 more were reported on Friday.

Active cases reached 373 on Friday.