The Covid tsunami

On Wednesday, Nepal’s positivity rate was 24.5%. On 21 October 2020, when the country recorded its highest daily Covid-19 cases, the figure stood at 28.5%. At the pace the virus is spreading, it will not be long before one-third (or more) of daily tests turn positive.

Neighbouring India with 315,802 new cases and 2,102 deaths on Thursday is a shocking reminder of what is next door, across an open border. People are dying waiting for oxygen, hospitals are filled to the capacity, and drugs are in short supply.

It is too late for India to vaccinate its way out of this surge, and major cities have resorted to lockdowns and curfews again. This is not a second wave anymore, it is a tsunami. And, as we saw last year, the wave is lapping at our border.

Yet, here in Nepal, people are going about their lives as if there is no public health emergency. One might even say Nepalis are going out and about with vengeance, unmasked and crowding in markets.

The government has more or less surrendered to the virus, and is putting the onus on citizens to protect themselves. It has shut down schools for a month, but there are still political rallies and festival throngs. Even king Gyanendra coming back from the Kumbh Mela with the virus, and celebrities like Madan Krishna Shrestha testing positive, does not seem to deter the public.

Looking at the numbers, it might look like current active cases are far below the daily average back in October. But the rate of infection is much steeper in the second wave.

We have all but forgotten how during lockdowns, pregnant women couldn’t go to hospitals and how there was food insecurity and the crushing economic fallout.

Lack of preparedness at the border checkpoints, minimal contact tracing and chronic limitation of health institutions persist.

Health Minister Hridayesh Tripathi has reassured the public that there will not be another lockdown if people are more careful. Prime Minister K P Oli in his New Year message said if the public took precautions, a new lockdown could be avoided.

Nepal’s economy was just beginning to recover from the impact of the earthquake and blockade six years ago when the pandemic hit. The tourism sector will now need at least five years to recover, joblessness is at its peak, manufacturing is still seeing negative growth, and agriculture yield will likely decline after a prolonged winter drought.

Nepal will conclude its vaccination drive this week after administering the second dose for those inoculated in the first phase. There are no vaccines left for the rest.

Close to two million Nepalis have been vaccinated with either Covishield or China’s VeroCell shots. But the fate of the rest of the 19.6 million Nepalis that the government had targeted to inoculate remains uncertain. The Russian Sputnik V was recently granted conditional emergency use in Nepal, but through a private supplier.

The reasons for the new surge are the late arrival of vaccines in India and Nepal. But even the limited vaccination drive made both the government and the public complacent. Contact tracing has all but ceased, and many people stopped wearing masks. The other reason is that Covid-19 and its variants had a much higher infection rate.

There are now questions about whether the herd immunity building up that was probably keeping us safe so far, is not effective any more. What is new with the second wave is that it is affecting younger people and making them sicker. Unlike in the previous surge, patients in the 30-50 age group are arriving at hospitals with entire families infected.

Doctors are now faced with the unique challenge of treating children with Covid-19. This might mean a new set of health professionals, infrastructure and equipment as well as therapy and drugs.

Major hospitals in Kathmandu are already starting to feel the pressure with a steady inflow of patients requiring ICU and ventilator support. There is now a real danger that Nepal will face the same shortage of vaccines, oxygen and essential drugs that India is suffering.

This week marks the sixth anniversary of the devastating 2015 earthquake in which nearly 9,000 people were killed. The pandemic has so far killed 3,100 people. Most of those deaths in both disasters were preventable.

The Nepal government, meanwhile, is too busy with a power struggle in the ruling party, rendering the measures to control the new surge ad-hoc and haphazard.

The second wave is already here. Hospitals are soon going to be of no help. There are no more vaccines. The only way to deal with this is by adopting our own precautions: mask up, wash hands, and avoid crowds.

Sonia Awale

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