Three Indian nationals in Birgunj test positive for Covid-19Despite the lockdown, the emergence of new cases shows that the government needs to enforce stronger supplementary measures, public health experts say.
Three Indian nationals residing in the city of Birgunj in Parsa district have tested positive for Covid-19, the Health Ministry confirmed on Sunday.
According to the ministry, throat and nasal swabs from 21 men residing in a mosque at Chhapkaiya in Birgunj Metropolitan City Ward No. 2 were tested for the coronavirus at the laboratory of the Vector Borne Disease Research and Training Center in Hetauda on Friday.
“Three of them aged 37, 44 and 55 were taken to an isolation ward of the Narayani Hospital after they were suspected to have contracted the virus,” the ministry said in a statement.
After the samples tested positive for Covid-19, they were dispatched to the National Public Health Laboratory in Kathmandu for confirmation.
“The laboratory on Saturday evening confirmed Covid-19 in all three samples,” said Dr Bikash Devkota, spokesperson for the Health Ministry, at a regular press briefing on Sunday. “All three have been sent to the isolation facility set up at the Narayani Provincial Hospital in Birgunj.
Devkota said that the health condition of all three patients is normal and that contact tracing of all who came in close contact with them has begun.
According to health officials in Parsa, 26 people who had come in contact with the three persons have been sent to a quarantine facility set up at the Siddhartha High School in Birgunj.
Saturday’s confirmation brings the total number of Covid-19 cases detected in Nepal to 12. Besides the three identified in Birgunj, all other patients are Nepali citizens from Kailali, Kanchanpur, Baglung and Kathmandu.
The last time Nepal reported new cases was on April 11, when three Covid-19 patients were identified in Kailali and Kanchanpur, including one case of local transmission. The government had subsequently extended the lockdown until April 15.
The confirmation of three more cases has now raised alarm and authorities have placed Birgunj on high alert.
Dr Madan Kumar Upadhyay, medical superintendent at Narayani Hospital, said that all out-patient department services have been halted until further notice.
Police meanwhile are attempting to ascertain when the three Indian nationals entered Nepal. According to police, the three men told health officials that they have been in Nepal for the last four months.
“How did they get infected if they have been in Nepal for the last four months?” an official at the Narayani Hospital told the Post.
A police official said that they are attempting to track the men’s travel history.
“We have yet to ascertain whether they entered Nepal before or after the lockdown,” he said.
Nepal enforced a nationwide lockdown starting March 24 and a day later, India announced a 21-day lockdown.
Nepal’s contact tracing has so far been poorly handled, even when there were nine cases. Now, given the confusion surrounding the new patients’ travel history, public health experts are wondering if the lockdown is the best way to contain the spread. There should be no new cases if the lockdown was effective, they say.
“A lockdown lessens the risk of community transmission,” said Dr Baburam Marasini, former director of the Epidemiology and Disease Control Division. “But what matters is how we utilise this lockdown period and what preparations and measures we are taking to fight the disease.”
Nepal is currently mulling extending the lockdown, as India continues to report a surge in Covid-19 cases despite being under lockdown. India has extended its lockdown until April 30 and Nepal is likely to follow suit.
Marasini, however, cautioned that continuing the lockdown could be akin to damming a swelling river.
“When the dam is opened, it creates devastation,” said Marasini. “What we need to understand is we need to utilise the lockdown to step up our efforts and introduce stronger measures.”
The World Health Organisation too has said that while lockdowns can contain community spread of the virus, governments must take other important measures.
Confirmation of the first local transmission last Saturday took Nepal into stage 2 of the pandemic, which means that the government needs to use the window provided by the lockdown to put in place a system to test and identify cases and expand capacity to treat and isolate, according to public health experts.
“Our state machinery is not in a position to handle the flow of patients if the lockdown is removed at once,” Dr Sharad Onta, professor at the Department of Community Medicine and Family Health at the Institute of Medicine, told the Post. “Risk of transmission remains as long as there are active cases in any part of the globe. But we cannot enforce the lockdown indefinitely.”
In Birgunj, fear has gripped locals. Entire neighbourhoods have closed themselves off.
“It is time for the concerned government agencies to start thinking about the next step once the lockdown is lifted,” said Onta.
Bhushan Yadav contributed reporting from Birgunj.
Frequently asked questions about the coronavirus outbreak
UPDATED as of May 25, 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 had spread to 210 countries and infected more than 5,498,580 people with 346,688 deaths. In South Asia, India has reported the highest number of infections at 138,536 with 4,024 deaths. While Pakistan has reported 54,601 confirmed cases with 1,133 deaths. Nepal has so far reported 603 cases with three 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.