A 70-year-old man from Bara became the fourth Nepali to die of Covid-19. The man, admitted to the Birgunj-based National Medical College to receive treatment for tuberculosis and pneumonia, died on May 17.
The death was attributed to coronavirus only on Monday after his nasal swabs were re-tested in Kathmandu, said Dr Madan Upadhyay, medical superintendent at Narayani hospital in Birgunj.
The first two fatalities in the country (the 29-year-old new mother and the 41-year-0ld man) had one thing in common with the fourth case. All of them were patients admitted to a general hospital, and they did not have a history of travelling to disease-hit places outside or inside the country.
Several others, admitted to various non-Covid hospitals for treatment of other ailments have also tested positive for the contagious disease, leading experts to suspect that the country has entered into the phase of community transmission.
“The disease has spread rapidly in communities of the districts of Tarai region and sporadically in the hilly districts,” Dr Baburam Marasini, former director at the Epidemiology and Disease Control Division told the Post. “Due to the government’s failure to trace the contacts of infected people and stop people from illegally entering into the country we are in big trouble,” said Marasini.
Until now, only those with a history of travelling abroad were believed to be susceptible to the virus, but that has changed. "Now, people who haven’t been abroad are getting infected within the country," said Lila Bikram Thapa, senior public health administrator at the Epidemiology and Disease Control Division.
Officials at the Ministry of Health, however, say the country has technically not entered into the community transmission stage yet as the infection source in all cases has been confirmed. If the disease were being transmitted from the community, the source becomes untraceable, it is called the community transmission, they said.
Dr Roshan Pokhrel, chief specialist at the Ministry of Health concedes that the infection has been detected in people who don’t have a travel history to the disease-hit countries or districts. "Experts have various explanations, but detection of disease in patients admitted to general hospitals has made us worried," Pokhrel added. But technically, the country has not entered into a stage of community transmission, he said.
Meanwhile, the Epidemiology and Disease Control Division has started training over 2,000 health workers to conduct contact tracing as health ministry officials expect over 20,000 people to get infected with Covid-19.
"We are training provincial health officials, and they will train health workers serving at local levels," Dr Basudev Pandey, director at Epidemiology and Disease Control Division, said. "Hoping for a rise in the number of infected cases, we started the training."
A team of health workers from all 753 local levels will be trained to conduct contact tracing, according to him.
When asked why the division started training after so many people were already infected, Pandey said additional human resources were needed to trace contacts as the number of infected cases are going up every day.
“We need additional trained staffers for contact tracing in the coming days, as more people are expected to get infected,” he added.
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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