Three people who had visited the emergency unit of the Surkhet-based Karnali Provincial Hospital a week ago have tested positive for Covid-19. They are neither returnees from India nor have they stayed in any quarantine facility. Following the report of the positive cases, the hospital had sealed its emergency unit for some time. The three infected are now in isolation while the health workers who were involved in their treatment have been quarantined.

Covid-19 infections, which were limited to quarantine facilities until a few weeks ago, have now entered the community transmission stage in Karnali Province. The authorities concerned have been unable to focus on contact tracing and collection of swabs for laboratory tests to control the virus. To make the matter worse, many people staying in quarantine facilities were sent home without conducting PCR tests on them.

“The risk of community transmission is increasing due to the lack of contact tracing and delay in PCR tests. We have to be cautious while treating patients at the emergency unit of the hospital,” said a doctor at the provincial hospital, preferring anonymity.

It is suspected that the virus has been spreading in the community through health workers, security personnel, people’s representatives and workers who are involved in the treatment of quarantined individuals and management of isolation and quarantine facilities.

Dailekh until Saturday had reported 12 Covid-19 cases from outside quarantine and isolation facilities.

“The number will certainly rise if mass testing is conducted in the community. However, mass testing is not possible due to limited resources” said Regmi.

As many as 87 people of Narayan Municipality in Dailekh, who were sent home in the last week of May before their PCR test results came out, have now tested positive for the virus. The infected people had stayed with their families for three to five days before they were brought back to the isolation ward. After a three-week stay at the isolation ward, the infected were sent home on Thursday before their second PCR tests results came out.

“We collected the swabs of the infected people for the second time but their PCR test reports are yet to come. They were allowed to return home as they did not show any symptoms of coronavirus during their three-week stay in the isolation centre,” said Regmi.

Karnali Province has reported 1,278 Covid-19 cases as of Sunday. Among them, three died of the virus and 125 returned home after recovery.

But most Covid-19 patients in the province have been discharged from isolation wards before the release of their second PCR test results. On June 3, the federal government had implemented a directive to send infected individuals home if they don’t show any symptoms of the disease after spending two weeks in isolation.

“Even if the patients do not show any symptom, it cannot be said that they are free from the virus. Hospitals and isolation centres have started discharging asymptomatic patients without confirming if they have recovered from the virus,” said a doctor at the provincial hospital.

According to the Ministry of Social Development in Karnali Province, 22 cases of community transmission have been reported in the province as of Saturday. To curb the virus’s spread, the ministry has formed a contract-tracing team led by Birkha Bahadur Shahi, a public health officer, to trace those who might be infected with the disease.

“We plan to coordinate with the local units to collect swab samples from all communities. But the collection process has yet to gain pace,” Shahi said.

Cases of community transmission have concerned not just the locals but health workers too. A health worker in Chaukune Rural Municipality, Surkhet, recently tested positive for coronavirus, while the emergency unit of the provincial hospital has already been sealed twice due to reports of Covid-19 cases. In the second week of June, the emergency department was sealed after a snake bite victim tested positive for coronavirus.

Dr Dambar Khadka, director at the hospital, said, “The exposure of coronavirus at the emergency ward has made things very challenging for us.”