The rising number of coronavirus cases has thrown government authorities into a tizzy.

With 1,069 new cases in the last 24 hours, the national Covid-19 tally on Tuesday reached 40,529. Kathmandu Valley reported a record 481 new cases–393 in Kathmandu, 58 in Lalitpur and 30 in Bhaktapur, according to the Health Ministry.

Valley’s chief district officers, who have been granted powers by the federal government to take measures to contain the virus, now are confused about the next step, as the prohibitory orders that have been in place since August 19 midnight will end on Wednesday midnight.

“Actually, we are for continuing with the ongoing restrictions, at least for one more week, but with easing of some other services besides the essential ones,” said Humkala Pande, chief district officer of Bhaktapur. “It, however, is up to the Home Ministry.”

Chief district officers of Kathmandu, Lalitpur and Bhaktapur on Tuesday afternoon held discussions on the next move, according to Pande.

“We also discussed the ways to address difficulties faced by the public due to the prohibitory orders.”

The existing prohibitory orders entail a ban on public and vehicular movements and opening of shops and business, except those which provide essential services. However, after increased public activities–to buy vegetables and other stuff–during the first week of prohibitory orders, the district administrators clamped down on public movements and asked shops to open only until nine in the morning.

The virus has not slowed down though.

Data from the Health Ministry on Covid-19 cases and tests performed at various laboratories show that there has been a gradual rise in the percent-positive rate across the country since the lockdown was lifted on July 21.

The percent positive rate tells the current level of virus transmission and if enough testing is being done. This rate will be high on two conditions– if the number of positive tests is too high or if the number of total tests is too low.

A higher percent positive will mean higher transmission, indicating that there could be more people with the virus in the community needing to go for tests.

Public health experts say the percent positive rate can be a crucial measure, as it provides information on how widespread the infection is.

“We have not seen any decline in the number of cases even though we have been under strict prohibitory orders for the past two weeks,” said Dr Sher Bahadur Pun, chief of the Clinical Research Unit at Sukraraj Tropical and Infectious Disease Hospital. “This clearly shows there might be some fault in our approach. The authorities need to find the fault and fix it.”

Just while the district administrators are mulling extension of prohibitory orders, the Health Ministry too is considering continuing with restrictions in at least those districts which have reported more than 500 active cases.

“At this time, continuation of restrictions seems to be the only way to flatten the curve or slow the infection rate,” said Mahendra Prasad Shrestha, chief of Policy Planning and Monitoring Division at the Health Ministry. “Our recommendation is restrictions in Kathmandu Valley as well as some other districts which have over 500 active cases.”

According to the Health Ministry, currently 12 districts–Kathmandu, Lalitpur, Parsa, Bara, Morang, Rautahat, Chitwan, Dhanusha, Rupandehi, Sunsari, Sarlahi and Mahottari–have more than 500 active cases. Of the total active cases, 73 percent are in the said districts.

According to the Health Ministry data, the recovery rate has declined to 55 percent as of Tuesday from over 70 percent before the lifting of the lockdown on July 21. Of the 40,529 infected, 22,178 have recovered so far. The ministry says the death rate as of now is 0.5 percent.

Kathmandu Chief District Officer Janak Raj Dahal told the Post that there are suggestions from the local level authorities as well on what the next move could be.

“Breaking the chain of virus transmission is necessary at this time,” Dahal told the Post. “We will come up with a decision tomorrow.”

Chakra Bahadur Budha, spokesperson for the Home Ministry, said prohibitory orders are likely to continue in Kathmandu Valley, albeit with some ease, allowing other services apart from the essential ones to operate.

He, however, refused to elaborate.

“The Valley’s chief district officers will come up with the list of services that could be eased and a decision will be taken accordingly after holding discussions tomorrow,” Budha told the Post. “We have learnt from the past as to how it did not work when the lockdown was suddenly lifted. So we will take various aspects into account, as the virus, too, has continued to spread.”

Public health experts have for long argued that the government approach of resorting to restrictions is wrong and that without focusing on measures like ensuring effective contact tracing and increasing isolation beds, the virus will continue to spread and kill more people.

“Infection has already spread in the community due to the government’s apathy and the authorities still seem to be considering restrictions as the only way to contain the virus. That’s where they are making the mistake,” said Dr Baburam Marasini, former director of the Epidemiology and Disease Control Division. “When it comes to planning and preparations, the authorities have done zilch.”

Doctors told the Post on Monday that since the virus has already penetrated society, the authorities should start a seroprevalence survey, or antibody tests, in masses so as to understand the status of the virus spread in the community.

Meanwhile, testing, tracing and treating should continue without fail, according to them.

The government has failed to say what it did in the last two weeks to prevent the virus from spreading. Nor has it made any new plan to fight the pandemic.

“The authorities should have a well-thought-out plan as to why they are imposing restrictions and why they are going to lift them,” said Pun. “The restriction period by all the governments across the world is used to plan and prepare. We are not out of the threat yet and even a bigger threat is looming large.”