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.