Seriously ill patients seeking inpatient care for respiratory illness at Bir Hospital have to wait for hours at the hospital’s emergency department to get shifted into wards, as all designated beds are full in recent days.

Since the air quality of the Kathmandu Valley started deteriorating in the second week of January, cases of pneumonia, influenza, asthma, and chronic obstructive pulmonary disease have surged, doctors at the hospital said.

What concerns them most is that, for months, the number of seriously ill patients seeking care for respiratory problems at the hospital has remained consistently high for several weeks now, which they attribute to worsening air quality.

“Even very young people are suffering from bronchitis, asthma and pneumonia and other respiratory problems,” said Dr Ashes Dhungana, a pulmonologist and a critical care physician at Bir Hospital. “Some patients require intensive care, but we don’t have enough beds to accommodate all seriously ill patients.”

Air pollution levels in most parts of the Valley have been steadily declining since the start of winter, and it reaches hazardous levels most mornings. Vehicle emission testing by the Kathmandu Metropolitan City, halted since June last year, and this has worsened the situation.

Officials at the Kathmandu Metropolitan City said that a mechanical engineer hired to conduct emission testing on a contract basis accepted a better job elsewhere, which has prevented the resumption of testing.

“We have not been able to resume emission testing in the ongoing fiscal year, due to various reasons,” said Sarita Rai, chief of the Environment Department under the city office. “And the testing will not resume before the March 5 elections.”

Officials said that random on-the-spot emission testing of vehicles has long figured in the metropolis’ roster of plans to tackle growing air pollution in the Kathmandu Valley.

Tests carried out last year showed that around 80 percent of diesel-fueled vehicles—buses, micro-buses and tata pick-up trucks—on Kathmandu’s roads emit black smoke beyond permissible levels. Likewise, around 30 percent of petrol vehicles—cars and motorcycles—also failed the tests.

Emission testing was suspended at the end of last fiscal year after the previous mechanical engineer’s contract expired. The prolonged halt of pollution control measures has raised serious concerns, as the Kathmandu Valley is witnessing a spike in air pollution with the air quality index reaching very unhealthy and hazardous levels.

Meanwhile, the International Centre for Integrated Mountain Development’s (ICIMOD) air quality monitoring station in Khumaltar recorded an average level of 45 micrograms (µg) of 2.5-micrometre-particulate matter (PM2.5) per cubic meter of Kathmandu’s air in December 2025.

Between December 2025 and February 2026, the mean PM2.5 level was around 50 µg/m³. Doctors say PM2.5 is the key pollutant of concern because it penetrates deeply into the lungs and other vital organs. Poor air quality can have short- and long-term effects on public health.

In the short term, it can lead to pneumonia, bronchitis, conjunctivitis, skin allergy, stroke, and heart problems. In the long run, it can contribute to severe conditions like ulcers, cancer of the lungs and intestines, kidney disease, and heart complications.

ICIMOD, in its report, stated that Kathmandu's winter air quality remains hazardous to human health, still exceeding the World Health Organisation’s “unhealthy” air quality threshold.

Dr Dhungana of Bir Hospital said that more than 150 patients with respiratory problems visit the hospital’s outpatient department daily. He said that the number seeking emergency care for respiratory problems has also risen markedly.

Doctors at Patan Hospital said that cases of viral influenza have risen in recent days, including in children. The exact cause of the spike in respiratory illness is not known, but they say air pollution can worsen such cases.

“Viral influenza cases have arisen in recent days at our hospital,” said Dr Srijana Shrestha. “Declining air quality could be responsible for rising respiratory illness.”

Doctors say 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, and ulcers and cancer of the lungs and intestine, kidney disease and heart problems in the long run.

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