As the number of people infected with coronavirus grows steadily in Karnali, the provincial government is grappling with resource constraints.

The province, which has reported 198 infected as of Monday, has 550 isolation beds, according to data from the provincial Ministry of Social Development. But the beds are not evenly distributed among the districts.

“The number of infected continues to rise. We are discussing how to manage the situation,” said Dailekh Chief District Officer Yubaraj Kattel. Of the 93 people diagnosed with Covid-19 in the district, the highest in Karnali Province, only 34 are placed in isolation as of Monday. The district has 40 isolation beds.

But in Salyan, the bed capacity is 15 while the number of infected has reached 35. According to Arjun Budhamagar, chief of the District Health Office, 13 among the infected have been put up at the Surkhet-based Provincial Hospital and 12 at the district hospital. Ten others, however, are still in quarantine. “We plan to add at least 100 more isolation beds in a few days,” Budhamagar said. “The situation is dire and we can’t handle it with existing resources.”

On Sunday, a meeting of the provincial government decided to treat the infected in three phases, accounting for asymptomatic and symptomatic people and those at high risk.

It has designated three hospitals as corona-specific hospitals: the provincial hospital in Surkhet with 70 isolation beds, the 120-bed Jumla-based Karnali Academy of Health and Science, and the Chaurajahari-based community hospital in Rukum (West) with 15 beds.

But the hospitals have asymptomatic patients who pose a challenge in the treatment of those at high risk, a physician at the provincial hospital said.

Meanwhile, Govinda Bahadur Pun Magar, mayor of Chaurajahari, said that the corona-specific hospital in his town refused to admit patients and they were sent to Surkhet. “The infected spent a whole night at a campus because they were denied admission at the hospital,” Magar said.

According to physicians involved in the treatment, almost all of the infected in Karnali are in normal health, and haven’t shown any symptoms of Covid-19. But cases are rising at an alarming rate since the province registered the first case two weeks ago.

The number of people returning from India is rising too, with 19,616 people returning in the second half of May. As many as 22,482 are quarantined across the province.

According to the Office of Chief Minister, quarantine facilities in Karnali have a cumulative capacity of 29,137. The province has 52 ventilators in total.

Dal Rawal, provincial Minister of Social Development, reckons that if the cases continue to surge at the current rate, the government may have to set up isolation wards in quarantine facilities. “The government is currently focused on preventing community spread of the infection,” he said. “We have planned to set up isolation wards in quarantine facilities.”

If the numbers continue to go up, all hospitals in the local units may have to be used for treatment of Covid-19 patients, said Dambar Khadka, director of Provincial Hospital, where 51 infected are currently undergoing treatment. Of the 198 infected in the province, 65, are still in quarantine.

But most of the local units across the province are unable to set up quarantine facilities. Of late, returnees from various parts of the country and India are being sent home directly due to lack of space in quarantine facilities. As many as 35 people, who arrived in Jumla from India on Sunday, were sent home as the integrated quarantine facility set up in Khalanga, the district headquarters of the district, was full to its capacity.

The Dailekh District Police Office said around 40 people arrived in Khalanga on Sunday afternoon. Acting Chief District Officer Om Prakash Devkota said 23 people from Tatopani Rural Municipality and 12 from Chandannath Municipality went home as the integrated quarantine facilities set up in four different places in the district headquarters were full.

Five returnees from Guthichaur Rural Municipality were sent to the quarantine in their own local unit, he added.

Quarantine facilities have been set up at Karnali Academy of Health Science in Chandannath, Durga Secondary School in Lama, Saraswoti Secondary School in Kudari and Sita Secondary School in Raralihi. These quarantine facilities are currently packed with 501 people, most of them returnees from India.

Devkota admitted the lack of enough quarantine facilities in the district to accommodate a Nepali workers returning from India. “Efforts are on to find suitable locations to set up quarantine facilities, but the responsibility of establishing quarantine facilities is that of the local units,” said Devkota.

Chandannath Municipality said it had planned to set up additional quarantine facilities, but could not find a suitable location. “All the quarantine facilities in the municipality are crowded with returnees. We are struggling to establish new ones,” said Mayor Kantika Sejuwal.

In Mugu, returnees from India have pitched tents in the open for lack of space. A total of 167 people who returned from India have set up tents in Halekhada and Chhote of Khatyad Rural Municipality. “How can we stay here for 14 days? There’s no toilet or drinking water,” said Rabin Baniya, who returned from Nainital in India five days ago.

“It’s the women and children who are suffering the most because the nights are cold under the tents,” said Kamal Baniya, another returnee from India.

“We are compelled to keep the people returning from India in Patan (meadows in high altitude) as the villagers protested when we tried to set up quarantine facilities at a community school close to the village,” said Jayananda Rawal, the vice-chairperson of the local body.

Karnali Province, which reported its first Covid-19 case on May 18, is now at high risk of the virus spreading quickly. On Monday, the Health Ministry confirmed 75 new cases in the province (41 in Dailekh, 19 in Jumla, 10 in Salyan and five in Surkhet) taking the tally to 198.

(Raj Bahadur Shahi and LP Devkota reported from Mugu and Jumla)