Respiratory wards at Kathmandu’s Bir Hospital and the TU Teaching Hospital are overwhelmed as cases of asthma, chronic obstructive pulmonary disease (COPD), pneumonia, and other respiratory infections have surged amid falling temperatures and rising air pollution.

At Bir, all 24 beds in the respiratory ward are full, and doctors have had to admit patients to other wards, as intensive care units are also operating at full capacity.

“Beds in the intensive care unit remain packed all the time and the number of patients with respiratory tract infections has risen significantly in recent weeks,” said Dr Aashes Dhungana, a pulmonologist and a critical care physician at Bir Hospital. “Some of the patients require intensive care, but we don’t have sufficient beds to accommodate all seriously ill patients.”

Although winter has yet to set in fully, minimum temperatures in the Kathmandu valley have dropped significantly, to around 7 degree Celsius. Rising air pollution is also being blamed for the surge in respiratory illnesses. Air pollution levels in the Valley reach hazardous levels in the mornings these days.

Dr Dhungana said over 300 patients with respiratory problems visit the hospital’s outpatient department daily. He said that the number of patients seeking emergency care for respiratory problems has also risen markedly.

The TU Teaching Hospital, Maharajgunj is seeing a similar surge.

“Over 300 patients visit the outpatient department for treatment of respiratory problems,” said Dr Niraj Bam, associate professor at the TU Institute of Medicine. “Emergency cases for respiratory problems have also risen sharply in recent days.”

Doctors at both hospitals, Nepal’s major tertiary care facilities, said the number of ICU beds is insufficient for the current demand. In many cases, patients’ relatives are forced to take their loved ones to private hospitals, which are several times more expensive than state-run health facilities.

Doctors warn that respiratory problems could worsen in the coming days as winter sets in, because multiple respiratory viruses and microbes become more active in colder conditions. Falling temperatures and deteriorating air quality could seriously impact public health, they say.

Viruses causing influenza are highly contagious, which spread quickly in communities and affect the lungs of infected patients. These diseases can cause fever, cough, body aches, and sometimes vomiting and diarrhoea, as well as pneumonia. If left untreated, they can lead to death.

According to doctors, poor air quality causes both short- and long-term effects on public health. Bad air quality can cause pneumonia, bronchitis, conjunctivitis, skin allergy, stroke and heart problems, among others, in the short term, ulcers and cancer of the lungs and intestine, kidney disease and heart problems in the long run.

Experts say early diagnosis is crucial to prevent infection. Patients recover early if treated on time. Experts also said that both the severity of the disease and deaths increase if seasonal influenza cases are not diagnosed in time.

Public health measures—mask-wearing, handwashing, avoiding crowds, and maintaining social distancing—can reduce infection, according to doctors.

They asked to get inoculated with influenza and pneumonia shots to the elderly people and those having underlying health conditions.

Meanwhile, the Meteorological Forecasting Division under the Department of Hydrology and Meteorology said there is no effect of Ethiopian volcanic ash in Nepal on Wednesday.

“Volcanic ash had entered Nepal on Tuesday, but it was high in the atmosphere and did not affect our country,” said Gobinda Jha, a meteorologist at the division. “The air has now carried it away. We don’t need to worry about that."

Ethiopia’s Hayli Gubbi volcano, which was dormant for thousands of years, erupted on Sunday morning and sent an ash column thousands of feet into the sky. The volcanic ash reached Nepal on Tuesday, but it remained high in the atmosphere and caused no impact on the country.