Calls to allow returnees to self-quarantine grow as officials fail to manageAs authorities step-up testing, resource-strapped labs are under pressure to process samples quickly. With long queues for tests, returnees from India are forced to stay in quarantine for more than the mandatory period.
On Sunday night, 42 individuals, who recently returned from India and were awaiting their coronavirus test results, ran away from their quarantine centre in Malpara, Kapilvastu Municipality.
Police, however, tracked all of them down and returned them to the centre on Monday morning, said Chief District Officer Dirgha Narayan Poudel.
This was not an isolated incident. Eleven individuals ran away from their quarantine centre in Rangapur, Yashodhara Municipality, on May 19. An additional 44 had fled in mid-May from two facilities in the municipality. A similar incident took place in Narainapur, Banke, last week.
Following the incidents, calls to allow returnees from abroad, especially India, to self-quarantine in their respective homes are growing across the country as officials fear mismanaged and overcrowded quarantine centres across the country, including the Tarai, could help spread Covid-19 rapidly.
According to reports prepared by Ministry of Health officials mobilised in the provinces, there is a lack of coordination between agencies under the three tiers of governments. Similarly, various agencies are doing the same work, and contact tracing has been taken lightly.
The health workers serving at local levels take orders from the Ministry of Federal Affairs and General Administration, and this has become a major headache for the health ministry. As a result, most quarantine facilities are overcrowded and mismanaged.
After the government imposed the nationwide lockdown to contain the spread of Covid-19 on March 24, local governments prepared an estimate of people who might return from India, and made provisions for quarantine based on the estimate. But more people returned home than expected, and overwhelmed the provisions, said an official at the health ministry, who was deployed in Province-2.
The official said that charities that used to provide food to people in quarantines, stopped providing food after infection cases surfaced. This made it more difficult for local governments with limited resources to provide for people in quarantine, the official said.
"Agencies under the Ministry of Health prepared guidelines and published it on their website," said Dr Prakash Budhathoky, chief of ENT and Oral Health Unit at Curative Service Division under the Department of Health Service, deployed in Province-5.
"But when we came to the field, we found that health workers working at local levels were unaware of the protocol and guidelines."
The other problem quarantine centres are facing is that people are not getting test results on time. As authorities step up sample collection, resource-strapped labs across the country haven’t been able to keep pace, and people have been forced to stay in quarantine awaiting for more than 20 days.
“Many people don’t know whether they have the virus or not for at least a week,” said Kapilvastu Chief District officer Poudel. “The corona-testing lab in Bhairahawa is under a lot of pressure as more samples are being collected every day.”
Following similar reports from all over the country, officials from the Ministry of Health, deployed to the provinces to deal with the epidemic, have told authorities in Kathmandu that unmanaged makeshift quarantine centres, especially in the Tarai, have been turned into coronavirus “breeding centers”.
They have suggested that instead of sending people returning home from abroad to such centres, it is better that they go home, and self-quarantine.
"We have told elected representatives of local levels of the bordering districts—Banke and Kapilvastu Rupandehi and others that staying home is a far better safer option than staying in the quarantine centres,” said Budhathoky.
Budharam Raidas, a local of Mayadevi Rural Municipality also agrees. He said, "Infected people transmit the disease to his/her family members if they are sent home, but if they live with hundreds of others, everyone in the quarantine will get infected."
The official said that the quarantine centres, which are intended to separate people exposed to infection, don’t work if the infection rates are high. "Even infected people British Prime Minister Boris Johnson stayed in home quarantine," said the official, "Our country cannot keep people in quarantine, when thousands of people get infected," the officials added.
Mahendra Prasad Shrestha, director general at the Department of Health Services, concedes that home is a safer place for returnees if quarantines cannot be managed properly, and safety of the people living in them cannot be ensured.
"No, doubt, home is safer than unmanaged quarantines," said Shrestha. "It is true that quarantines are not being managed properly and a lot of people are getting infected there."
Frequently asked questions about the coronavirus outbreak
UPDATED as of July 11, 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 213 countries and infected more than 12,625,155 people with 562,769 deaths. In South Asia, India has reported the highest number of infections at 822,603 with 22,144 deaths. While Pakistan has reported 243,599 confirmed cases with 5,058 deaths. Nepal has so far reported 16,719 cases with 38 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.