Authorities continue to fumble around amid Covid-19 surgeWith pandemic showing signs of sliding into a devastating crisis, authorities mull a new law to streamline response, as they ignore the basics like tracing, testing and isolating.
It took Prime Minister KP Sharma Oli 11 months and close to 5,000 deaths to realise that Nepalis don’t have a strong immunity against Covid-19 and that he was under an impression that the virus would not hit the country as hard as it has.
On Saturday evening, speaking at a meeting with different sections of society, Oli said that he “thought” Nepalis’ immunity against diseases was strong, hence he did not expect the virus crisis to deepen to this extent. On June 10 last year, when Oli was mocking a lawmaker in Parliament for questioning his statement claiming Nepalis have strong immunity, the country had reported 15 deaths and the number of active cases stood at 3,675. On Saturday, when he appeared to be retracting his immunity claim, the total deaths had reached 4,856, with the number of active cases at 109,740.
What, however, does not seem to have changed is the response—like last year, there are hardly any sincere efforts from the Oli administration to deal with the virus situation.
Last week, on May 8, Oli told CNN that the virus “situation is under control”, only to plead before the world, just two days later, for help, saying his country is overwhelmed by Covid-19 through an opinion piece in The Guardian.
Unprepared still, the Oli administration is now groping in the dark. Instead of trying to step up some fundamental measures—contact tracing, testing and treating—and ensure enough beds and oxygen supply, it now thinks it’s the lack of laws that is hindering its Covid-19 fight.
“We have decided to bring an ‘integrated’ law for effective coordination among various agencies and tackling some problems in purchasing medical supplies immediately,” Minister for Foreign Affairs Pradeep Gyawali, who is also the government spokesperson, told reporters after Sunday's meeting of the Covid-19 Crisis Management Centre.
Gyawali is also a member of the Covid-19 Crisis Management Centre, known as CCMC, which is chaired by Deputy Prime Minister Ishwar Pokhrel.
Prime Minister Oli was also present at the meeting.
CCMC, the task force set up by the government to deal with Covid-19 on March 29 last year, however, is a mechanism which does not have a single expert or doctor as its member. Over the past year or so, it has served as a club of government ministers and officials, with no “empowered” role to take a decision on anything. All its decisions are subject to the prime minister’s nod.
A senior doctor at the Health Ministry, who did not wish to be named fearing retribution, said that there is a serious problem when it comes to taking decisions.
“Political leaders as well as the leadership and those who are at the policy-making level act as if they know everything,” the doctor told the Post. “They think they can deal with the current Covid-19 crisis without the need of experts’ advice.”
After logging steadily rising numbers of new cases and new deaths since the second wave hit the country in early April, the country, however, has not hit the 10,000 mark yet. After recording 5,743, the highest number of new cases on October 21 last year, there was a dramatic decline in the number of new infections. On May 11, the country saw its highest single-day spike with 9,317 new cases. But the country on Sunday reported 7,316 new cases. The Health Ministry said 145 had died of Covid-19 across the country based on the data provided by the Nepal Army which manages the bodies. The death toll stands at 5,001.
Experts say the threat is not over yet and what is concerning is the Oli government might get into a complacent mode, claiming that Covid-19 cases have plateaued.
Public health experts and doctors told the Post last week that even if the new infections hover around the 9,000 mark, the number of deaths could continue to rise if the authorities fail to ensure treatment, oxygen and beds.
On Friday, the World Health Organisation said that Nepal has emergency needs.
“India remains hugely concerning, with several states continuing to see a worrying number of cases, hospitalisations and deaths,” said Tedros Adhanom Ghebreyesus while addressing a regular media briefing on Covid-19 on Friday. “But it’s not only India that has emergency needs. Nepal, Sri Lanka, Vietnam, Cambodia, Thailand and Egypt are just some of the countries that are dealing with spikes in cases and hospitalizations.”
The United Nations in Nepal in its Friday situation report pointed to an urgent need for vaccines and essential life-saving commodities, including oxygen, critical care medicines and supplies, testing kits, personal protective equipment and temporary hospitals.
“Current messaging around self-care and caring for loved ones is generic and ineffective,” said the UN. “Contextualized, locally relevant messages are critically needed.”
Analysts and experts say that an integrated law is fine, but without stepping up basic requirements, laws only won’t be of help in the fight against the virus.
Experts had suggested last year that Nepal could have done better had it brought an integrated law and not relied totally on the decades-old Infectious Disease Act.
At that time, government authorities were indifferent to such calls, saying existing laws were sufficient.
Since the government paid little attention to contact tracing and testing and did nothing to increase hospital beds, ventilators and oxygen production capacity, authorities found themselves on the backfoot in the last week of April, as the country posted new records for virus cases.
The government once again resorted to “prohibitory orders” in Kathmandu Valley on April 29. The orders are still in place, and all but three of the 77 districts are under prohibitory orders.
According to Gyawali, the government is mulling over an “integrated law” so that concerted efforts could be made to fight the pandemic.
“We have also faced some problems when it comes to coordination between hospitals, as they are under different ministries–some are under the Health Ministry while others under the Education Ministry as academies,” Gyawali told reporters after the meeting. “Besides, some are run by provincial and local governments. An integrated law would be useful in running them in an effective manner.”
Officials could not provide details as to what all such an integrated law entails.
An official at the CCMC told the Post that such a law could be in place within “a few days”.
“Such laws are called sunset laws, and they are automatically terminated after their purpose is over,” said Khagaraj Baral, member secretary of the CCMC. “We are expecting the law within a few days given the pressure, and it will be introduced even through an ordinance.”
With no details available, there are, however, concerns about what the government actually is aiming at. Since there is no Parliament session, the law would come into effect as soon as the President promulgates the ordinance, as suggested by Baral.
Tika Ram Bhattarai, an advocate, said that such integrated laws can be brought in the times of crises to achieve certain objectives like acquiring public properties providing compensation to the owners, purchasing medical supplies immediately and coordinating with all three tiers of the government.
“We had suggested that the government introduce an integrated law last year but it did not pay heed to our advice,” Bhattarai told the Post. “If the law had been in place, maybe the country’s fight against the pandemic would have been more effective and many lives could have been saved.”
The government is also discussing if a health emergency should be declared. Officials, however, said Sunday’s CCMC meeting did not take any decision in that regard.
“This has been an agenda for quite a while,” said Gyawali, the government spokesperson. “[We believe] if a health emergency is declared, it needs to be done in such a way that it indeed yields results.”
The Health Ministry in September last year had suggested a health emergency should be declared if the number of active cases cross the 25,000 mark.
A month later, Nepal’s active cases crossed 25,000 on October 7, but the government did not make any move to declare a health emergency.
As of Sunday, the number of active cases stood at 110,263.
Doctors say if a law is indeed needed to smoothen procurement processes to make the battle against the pandemic stronger and more effective, authorities should have done so long ago.
“Now trying to bring laws in the name of making procurements easier does raise suspicion, given the corruption controversies that were reported last year,” said a doctor who has worked in the public health sector for decades and led various government hospitals successfully. “After failing to deal with the crisis, authorities are coming up with more excuses and half-hearted plans.”
Public health experts and doctors say the Oli administration must set its priorities right if it is really serious about saving the lives of the people rather than wasting time on multiple things.
Now that the virus seems to have reached villages–unlike in the first wave when cases started to decline after heating the peak in urban centres–there are concerns about more deaths due to lack of health facilities, beds, ventilators and oxygen.
Experts say the only way to reduce the number of patients needing hospitalisations–beds, oxygen and ventilators–is increasing testing and tracing.
On Sunday morning, Dr Anup Subedee, an infectious disease expert, described the situation succinctly in a Twitter thread.
“There's too little happening in terms of public health response to the pandemic surge– test/trace/isolate & quarantine/vaccinate–the only interventions that can reduce the number of new cases in the community and the number of those needing hospital beds, oxygen or ICU care,” Subedee wrote. “There’s just too much reluctance, incomprehension, sheer lack of interest on the government's side to work in mitigating the community spread.”