Declare a health emergency

Two weeks to go to Dasain, a feckless government and reckless citizens are dragging Nepal headlong into a health emergency. 

Even as the total confirmed cases near the 100,000 milestone, and fatalities cross 600, sections of the public are ignoring the pandemic. It must be a combination of Nepal’s famous fatalism, bravado, and ignorance about the need for health precautions. 

The Dasain Bazar in Asan is sight to behold: huge crowds and even those with masks wear them around their chins. It is as if just dangling a mask is like a magic amulet. 

Nationwide, there are now about 10,000 PCRs being conducted daily, of which an average of 2,000 people test positive – more than half in Kathmandu Valley. Public health experts say an estimated 30% of the Valley’s population may have antibodies, which means some of them are asymptomatic carriers of the virus..

On Thursday, Nepal recorded its highest number of positive cases on a single day with 4,364, out of which 2,540 were in Kathmandu Valley alone. Twelve people died in the past 24 hours, bringing the total fatalities to 590. 

Nepal’s government showed remarkable alacrity by locking down the country in March after only the second person with travel history tested positive. Although the total infected in Nepal has exceeded the numbers in China, the  fatality tally in Nepal is ten times lower than China. While the global fatality rate is 3%, in Nepal it is still hovering at 0.6%

Local governments lack resources to tackle Covid-19, Nepali Times

However, it is also true that the government has squandered seven months in political one-upmanship, in kickback driven procurement of emergency equipment, and with incompetent flip-flopping on Covid-19 policy.

There was plenty of time to ramp up contact tracing, mass testing, expand ICU capacity where population density is highest. But the various agencies under the Ministry of Health did not coordinate implementation, and sat around passing blame when things got worse. The Health Ministry spokesperson is now telling citizens not to check in to hospitals unless they are about to faint.

Kathmandu Valley now has two-thirds of the total confirmed cases, making it not just the capital of Nepal, but also the capital of Covid-19 in Nepal. The government has not just refused to learn lessons from around the world, it has not even learnt from the experience of districts like Parsa which used to be a hotspot, but now has the disease under control. Parsa did not mix Covid and non-Covid patients in hospitals, and pursued aggressive testing and tracing.

As virus spreads, Kathmandu hospitals strain to cope, Sonia Awale

Kathmandu first banned private hospitals from taking Covid-19 patients, then it forced them to set aside 20% of their beds for coronavirus patients, and now it has allowed super-spreader crowds at government hospitals for Covid-19 testing. The result: the virus has spread so rapidly that Covid and non-Covid patients are now being turned away from hospitals.

It is not that Nepal does not have enough ICU beds, they are just not where they are needed the most. There are 233 patients in ICUs all over Nepal, but there are 2,600 ICU beds. Thirty-seven of the patients need ventilator support, but only 490 of the 900 ventilators are in working condition. 

Dr Govinda KC is on the 25th day of his hunger strike demanding reforms in Nepal’s health system. If those demands had been met, the country could have managed the Covid-19 crisis much better. Kathmandu Valley will soon need 1,000 ICU beds, and 100 with ventilator support. We need at least ten exclusively Covid-19 hospitals.

Just like the White House in Washington DC, Prime Minister K P Oli’s official residence in Baluwatar has also become a hotbed for the virus. Three of Oli’s advisers, his personal secretary and doctors, security guards have all tested positive. Obviously, protocols were not maintained

What kind of message is the prime minister sending to the public when he attends party secretariat and Cabinet meetings, does not self-isolate and there is no contact tracing, especially of those within Baluwatar. 

The Dasain-Tihar-Chhat festivals are around the corner with clan get togethers and travels that they entail. Right after that we go into the winter flu season with worsening air pollution. It is likely that we ain’t seen nothing yet. 

The government should declare a Health Emergency before Dasain to manage existing health facilities, equipment and personnel. Citizens must be made aware of the need to keep distance and not undertake unnecessary travel. Otherwise, Nepal is looking at an explosive situation this winter.

Shekhar Kharel is a regular columnist for Himal Khabarpatrika from where this op-ed was translated.

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