On Monday, a police personnel guarding an isolation centre at Aniruddha Secondary in Yashodhara Rural Municipality reached the local unit’s health bureau with the news that two individuals at the centre were taken ill with diarrhoea—one of the less common symptoms of Covid-19. The policeman asked the bureau’s health workers to attend to the patients. But the health personnel declined to visit the centre, which currently has 88 Covid-infected individuals. The officials at the bureau returned the policeman with antidiarrheal drugs.

Kapilvastu has so far reported 337 cases of Covid-19 spread across all its 10 local units. While the district administration is scrambling to locate the infected and suspects at quarantine facilities and isolation centres, it is also grappling with a shortage of medical staff. Even those that are available refuse to visit isolation centres, as in Monday’s case.

“We don’t have enough personal protective equipment or the skills to handle highly infectious diseases,” said Jyoti Prakash Dubey, chief of the Yashodhara health bureau. “To directly attend to the patients without proper knowledge is to risk one’s life and theirs. So we inspect the isolation centres without actually engaging with the patients.”

The isolation centre lacks physicians who are trained to treat Covid-19 patients, Dubey added.

Aniruddha isolation centre represents the state of the district’s Covid-19 response. The protocol demands that the isolation centres have doctors, staff nurses, paramedic staff and an ambulance on standby. But most of the isolation centres in the district are led by senior auxiliary health workers, except the one in Mayadevi Rural Municipality which has doctors and staff nurses.

The district has reported the highest Covid-19 cases in the country. As many as 4,500 people are quarantined, most of whom are returnees from India. Cross-border movements are on the rise and the number of returnees is increasing by the day. But the quarantine and isolation centres in the district are struggling with the management.

Chief District Officer Dirgha Narayan Poudel said that a May 22 meeting of the district-level Crisis Management Committee had decided to ask the provincial government for 30 skilled health workers, including ten physicians and 20 staff nurses. Eleven days since the demand, the provincial government has yet to respond.

Province 5 has been struggling to contact trace Covid-19 suspects and manage quarantine centres, most of which are crowded and mismanaged. Yashodhara, for instance, has reported 100 cases but there has been no contact tracing of the infected. This is due to a lack of manpower and Viral Transport Medium (VTM) kits, according to Dubey.

“There’s been no contact tracing since the first 12 cases,” he said. “We are in no situation to start it now.”