Patients seeking treatment in non-Covid hospitals are testing positive for coronavirusHealth Ministry officials, who have so far claimed that the infection does not spread from asymptomatic patients, are now saying there is a high risk of community transmission.
Shahid Gangalal National Heart Center in Bansbari, Kathmandu, has halted all services except emergency for an indefinite period from Tuesday following the detection of coronavirus infection in some patients.
Specimens—nasal and throat swabs—of 20 patients seeking surgery at the hospital were sent for polymerase chain reaction tests and seven of the test results had come positive for the coronavirus which causes Covid-19.
The patients whose tests came positive were asymptomatic, meaning they had not exhibited any symptoms associated with the coronavirus infection.
"A lot of hospital staff including doctors and nurses were exposed to these infected patients," an official at the Health Ministry told the Post on condition of anonymity. "The health workers will be tested first and the in-door patients will be managed before the hospital is allowed to resume its services."
The hospital’s officials declined to comment, saying that the Health Ministry officials had warned them against talking with the media.
Along with Shahid Gangalal Hospital, several other hospitals, including Tribhuvan University Teaching Hospital, Kathmandu Medical College, Nepal Medical College, Bir Hospital, Patan Hospital, Alka Hospital, Vayodha Hospital, Star Hospital, Grande International Hospital and Hams Hospitals, have also reported coronavirus infection among their patients.
The detection of coronavirus infection in these hospitals had prompted partial or complete shutdown of the health care services.
According to the Health Ministry, scores of patients in over 40 hospitals, both state-run and private across the country, have tested positive for coronavirus infection as of Tuesday.
Over 112 health workers including doctors and nurses working in the front line have also contracted the virus.
The Health Ministry officials so far have been maintaining that the country does not have community transmission of the coronavirus. However, there have been several cases of infection in people who did not have any history of travelling to the infection zones or coming in contact with infected individuals.
The ministry officials have even gone so far to claim that the coronavirus does not spread from asymptomatic patients and directed health facilities not to perform the coronavirus tests on asymptomatic patients before surgery.
"Gangalal sent samples of about 20 asymptomatic patients ignoring the government's direction for not to perform tests of asymptomatic patients. But seven of them tested positive. This is an example of what the government has been doing and how much the disease has spread in the community," Dr Ramesh Koirala of the Shahid Gangalal Hospital tweeted.
Public health experts have long been asking the government for active surveillance, community testing and regulation of public movement to prevent mass outbreaks.
Despite their warnings, the government authorities released thousands of people from makeshift quarantines set up throughout the country without testing them, saying that they had no symptoms and asymptomatic patients do not spread the virus.
"If the disease has reached the community, it is an alarming situation," Anup Bastola, spokesperson for Sukraraj Tropical and Infectious Disease Hospital in Teku, Kathmandu, told the Post. "People from the community, who do not have a travel history or have not come in close contact with the positive cases, means asymptomatic cases are rising more than expected."
Dr Bikash Devkota, chief of Quality Standard and Regulation Division at the Health Ministry admitted that the infection risk has increased to the point of community transmission.
"We are planning to test all asymptomatic patients, patients admitted in intensive care units and those awaiting surgeries," said Devkota. "We will also collect random samples from communities and focus on health facilities to prevent the outbreak."
Devkota also conceded that the ministry committed a blunder by claiming that asymptomatic patients do not spread the coronavirus and by sending quarantined people home untested.
Meanwhile, the Epidemiology and Disease Control Division under the Health Ministry, has said that it has started collecting samples from health facilities— both state-run and private— to study if the disease has spread in the community.
"As more people admitted in non-Covid hospitals have started to test positive, we have decided to perform tests on the samples of those hospital staff, " Dr Basudev Pandey, director at division, said. "We have also deployed officials for collecting samples from several communities, where cases have been seen."
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 territories around 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.