On September 20, a 70-year-old man of Sukhkhanagar Ward 8 in Butwal visited a local clinic with complaints of fever and cough. Although he showed symptoms of Covid-19, the physician at the clinic advised him to take medicines for viral fever since the patient had no travel history and there were no reported Covid-19 cases in his locality.

Five days later, the patient exhibited respiratory problems and was taken to Lumbini Provincial Hospital for a swab test. He tested positive for the coronavirus and was shifted to the provincial Corona Special Hospital.

A week since the patient’s diagnosis, tracing of those who came in contact with him is yet to be done. The Butwal Sub-metropolis has stated that contact tracing will only be done if the suspects show symptoms of the virus.

In another instance, a 50-year-old man of Manigram in Tilottama Municipality Ward 8 tested positive for the coronavirus in the first week of September. The patient had stayed in home isolation for nine days before being moved to the ICU of the provincial Coronavirus Hospital on September 19. He died two days later while undergoing treatment.

His family members tested positive for the virus three days after his death and his neighbours a week later. Had the family members’ tests been conducted while the patient was in home isolation, the virus would have been contained within the family, local residents say.

“If the family members had known that they were also infected, they wouldn’t have moved about. The virus would not have spread in the community,” said Laxman Khatri, a local entrepreneur. “The government’s decision to lower the scope of contact tracing and the rate of testing is putting the public at health risk.”

Between April and August, Kapilvastu, Banke, Dang and Rupandehi districts reported hundreds of Covid-19 cases per day. The authorities used to collect swab samples from the affected areas and test them on a daily basis. But now only around 650 PCR tests are being conducted on a daily basis, according to the data of the Ministry of Social Development.

According to health workers in Kapilvastu Municipality, the isolation facility in Taulihawa, the district headquarters of Kapilvastu, has been vacant since Saturday. Umesh Gupta, coordinator at the health section of Kapilvastu Municipality, says that the municipality does not have any critical Covid-19 patients, but the number of active cases in the local unit is 79.

“At the beginning of last month, the government stopped conducting contact tracing and the local units have also slowed down PCR testing,” said Gupta. “Although the number of active cases seems low, there is no telling how many people are infected since not enough tests are being conducted”

Until September 8, the provincial government conducted tests from six different places in the province. Around 800 swab samples used to be collected on a daily basis. Since mid-September, the province has been collecting swab samples from nine different places but the number of samples being collected has decreased. On Wednesday, only 609 swab samples were collected from various locations.

Govinda Khanal, senior central vice chairman of the Human Rights and Peace Society, says the government is making a mistake by slowing down tests in the province.

“Currently there is no contact tracing of suspects and the rate of PCR tests has gone down. It looks like the government has surrendered to the virus,” he said. “Hospitals, clinics and doctors have also started to treat patients for seasonal flu without checking for coronavirus infection.”

Dr Bishnu Gautam, information officer at the Covid-19 centre in Lumbini Provincial Hospital, says the number of critical patients has started to increase in the hospital after the government stopped contact tracing.

“Since there is no tracing and testing, Covid-19 patients reach the hospital only when their health deteriorates,” he said. “The government should not stop contact tracing and testing. Treatment of the infected is only possible when the patients know that they are infected.”

According to him, there are 57 critical Covid-19 patients in the hospital at present.

“Three patients are on ventilator support while 29 others are receiving oxygen. Twenty-five patients are in the ICU facility,” said Gautam.

Dr Pushparaj Paudel, spokesperson for the Ministry of Social Development, however, claims that the province has not lowered the rate of PCR tests but that it is adhering to the standard issued by the provincial government in the first week of September. According to the standard, only patients with symptoms will be tested by the local units.

“The government is currently focused on treating symptomatic and critical patients,” he said. The government is preparing to add ICU beds and ventilators in various hospitals in the province. “We are conducting contact tracing and PCR tests of those who fall within the government guidelines.”

“If one member of a family tests positive for the virus, we test other members only if the patient shows symptoms within seven days of home isolation,” said Paudel. “We follow the same procedure for contact tracing.”

The total number of Covid-19 cases stands at 10,720 in the province with 2,144 active cases. The death toll in the province has reached 83 as of Thursday.

Manoj Paudel in Kapilvastu contributed reporting.