While women employees serving at government offices across the country celebrated the International Women's Day on Sunday, Smirti Shrestha and Suni Dongol, technicians at the National Public Health Laboratory, were examining specimens— nasal and throat swabs of suspected coronavirus patients.
As the laboratory, under the Department of Health Services, has faced a shortage of technical staff including lab technicians for a long time, Shrestha and Dongol were asked to come to office on Sunday as well.
"The previous day too they had stayed in office until 10 pm," Dr Runa Jha, director at the laboratory, told the Post. "Even on International Women's Day, we could not allow them to take leave."
Shrestha and Dongol were among the five lab technicians, trained to carry out a test of the specimens of suspected coronavirus patients, and they have been carrying out their duties around the clock.
According to Jha, the laboratory is not in a position to examine a large number of specimens all at once, given their limited human resource and the lab's grossly inadequate capacity in case there is an outbreak of the disease in the country.
"For that, we have to scale up our laboratory, train additional manpower and probably halt other services and focus on coronavirus tests," she added. "We have drawn the attention of the concerned officials at the Ministry of Health and Population."
Apart from human resource, the laboratory also lacked enough testing kits and viral transport medium (a box used to transport samples) to handle a possible outbreak of the new strain of coronavirus, dubbed Covid-19 and later SARS-CoV-2.
While China has managed to slow down its spread, the virus has spread to at least 103 countries across the globe including South Korea, Japan, and in the Middle East, where a large number of Nepalis have been serving. This has alarmed health experts.
Nepal so far has reported only one case, but health experts warn it is only a matter of time before the country sees an outbreak, as the government agencies have not taken the issue seriously.
"We are quite aware that the existing National Public Health Laboratory cannot carry out all the tests, in case of a large-scale outbreak in the country," Mahendra Prasad Shrestha, director general at the Department of Health Services, told the Post. "We have been working on expanding its capacity and weighing other options too."
Specimens of hundreds of people who come in close contact with the infected people need to be examined, which is impossible, given the existing capacity and staff strength of the laboratory. The laboratory has kits enough for only around 1,300 cases.
Shrestha said concerns were raised during a high-level meeting at the Ministry of Health and Population a few days ago, with the officials agreeing to expand the capacity of the laboratory and step up measures, and assuring budgetary support and other help, for the same.
Concerns were also raised about the existing surveillance and risk education, rapid response team, command and coordination, risk communication, point of entry, infection prevention and logistics management, at the meeting.
The Health Ministry also lacks sufficient surveillance and rapid response teams to respond to possible outbreaks.
"Health workers alone cannot carry out surveillance and respond to the outbreak immediately," Shrestha added. "For that, the help of the whole state machinery— army, police and others—is needed."
The government has made a command and coordination mechanism under the leadership of Deputy Prime Minister and Minister for Defence Ishwar Pokhrel. It comprises 10 ministers, including Minister for Health and Population Bhanu Bhakta Dhakal.
Frequently asked questions about the coronavirus outbreak
UPDATED as of September 22, 2020
What is Covid-19? Covid-19, short for coronavirus disease, is an illness caused by the coronavirus SARS-CoV-2, short for severe acute respiratory syndrome coronavirus 2. Common symptoms of the disease include fever, dry cough, fatigue, shortness of breath and breathing difficulties. In severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.
How contagious is Covid-19? Covid-19 can spread easily from person to person, especially in enclosed spaces. The virus can travel through the air in respiratory droplets produced when a sick person breathes, talks, coughs or sneezes. As the virus can also survive on plastic and steel surfaces for up to 72 hours and on cardboard for up to 24 hours, any contact with such surfaces can also spread the virus. Symptoms take between two to 14 days to appear, during which time the carrier is believed to be contagious.
Where did the virus come from? The virus was first identified in Wuhan, China in late December. The coronavirus is a large family of viruses that is responsible for everything from the common cold to Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). After an initial outbreak in Wuhan that spread across Hubei province, eventually infecting over 80,000 and killing more than 3,000, new infection rates in mainland China have dropped. However, the disease has since spread across the world at an alarming rate.
What is the current status of Covid-19?
The World Health Organisation has called the ongoing outbreak a “pandemic” and urged countries across the world to take precautionary measures. Covid-19 has spread to 213 countries and territoriesaround the world and infected more than 31,405,983 people with 967,505 deaths and 22,990,260 recoveries. In South Asia, India has reported the highest number of infections at 5,557,573 with 88,943 deaths. While Pakistan has reported 306,304 confirmed cases with 6,420 deaths. Nepal has so far reported 65,276 cases with 427 deaths.
How dangerous is the disease?
The mortality rate for Covid-19 is estimated to be 3.6 percent, but new studies have put the rate slightly higher at 5.7 percent. Although Covid-19 is not too dangerous to young healthy people, older individuals and those with immune-compromised systems are at greater risk of death. People with chronic medical conditions like heart disease, diabetes and lung disease, or those who’ve recently undergone serious medical procedures, are also at risk.
How do I keep myself safe? The WHO advises that the most important thing you can do is wash your hands frequently with soap and water for at least 20 seconds or use hand sanitizers with at least 60 percent alcohol content. Avoid touching your eyes, nose and mouth with unclean hands. Clean and disinfect frequently used surfaces like your computers and phones. Avoid large crowds of people. Seek medical attention if symptoms persist for longer than a few days.
Is it time to panic?
No. The government has imposed a lockdown to limit the spread of the virus. There is no need to begin stockpiling food, cooking gas or hand sanitizers. However, it is always prudent to take sensible precautions like the ones identified above.
Arjun Poudel is a health reporter for The Kathmandu Post. Before joining the Post, he worked for Sagarmatha Television, Naya Patrika, Republica and The Himalayan Times.
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