How Covid-19 saves lives in Nepal

The Covid-19 crisis has dominated news bulletins in Nepal for the last six months, and in the past week the headlines are about rising cases and fatalities. But what is missing from the news is that the pandemic has also helped save lives.

Police statistics show that about 1,400 people were killed in Nepal in road traffic accidents between March-August 2019. This year, the figure dropped to 707 in the same period. Meanwhile, 390 people have died with Covid-19 across the country since the lockdowns began. 

In those six months last year, more than 5,000 people were seriously injured in highway accidents. This year, the number of wounded was down to 1,978 between March-August. Because of the pandemic, there are therefore far fewer trauma patients in hospitals, and many of them have been saved from lifelong physical disabilities.

Besides lives saved in road traffic accidents studies have shown that improved air quality in the cities of north India during the lockdown has saved many thousands of lives.

The Centre for Research on Energy and Clean Air (CREA) estimates that improved air quality since Covid-19 has saved 15,000 lives in 12 of India’s big cities. In New Delhi alone, 4,600 people who may have died of acute respiratory distress have lived because of the cleaner air. 

A similar study in Nepal is not available, but since Kathmandu Valley’s air quality at certain times of day is as bad as New Delhi, and much of the suspended particulates from north India is carried by prevailing winds into Nepal in winter, there could also be a correlation here between improved health and better air quality during the lockdown.

To be sure, the pandemic has led to other hardships, often adding to unnecessary fatalities. Many more women have died this year than in 2019 during the lockdown because they have not been able to get to hospital for delivery. Child mortality is similarly up 30% compared to pre-lockdown months because of delayed vaccinations, and parents unable to get sick children to hospital in time. Patients with chronic ailments have also been deprived of treatment. Jobs losses have increased hunger and susceptibility to disease.

The dramatic drop in highway fatalities, however, reveals just how dangerous Nepal’s roads are, and has provided the government an opportunity to take concrete steps to improve road safety even as the government decided to allow long-distance buses to resume their services this week.

The fact that 707 people were killed on Nepal’s roads even despite an almost complete ban on vehicular traffic in cities as well as on inter-district highways between March till August this year shows just goes on to show how deadly Nepal’s highways are. 

A paper in the British Medical Journal shows that even before the pandemic in 2017, transport injuries killed more young people in Nepal than from tuberculosis, malaria and HIV combined. 

Seven Nepalis died every day in road and highway accidents in Nepal before the lockdowns, and on average, 40 people were injured. Last year, there were nearly 13,000 road accidents in which 2,736 people lost their lives and 10,731 were seriously injured.

But at the same time, Covid-19 has seen rapid spread in the past weeks. Nepal registered the highest number of confirmed coronavirus cases on Friday with 2,020 new cases out of 11,158 PCR tests conducted across the country, Kathmandu Valley alone accounted for 859 positive SARS-CoV-2 cases, also the highest so far. 

But the last 24 hours also saw 871 people returning home after a successful treatment, bringing the total recoveries to 43,820 and the recovery rate to 71%, up from 55% in August. Nepal now has 17,383 active cases.

While the government has decided to further relax the lockdown by allowing domestic airlines to operate, hotels and restaurants to reopen and intercity bus services to resume, the odd-even rule for vehicles is still in force.

This could help contain the spread of Covid-19 somewhat, but it will keep traffic accidents and fatalities low -- especially during the monsoon when roads are even more treacherous in the mountains with additional risk of landslides and flash floods.  

Highway accidents are now among the biggest killer in Nepal, right after heart diseases, diabetes, tuberculosis and renal ailments. Age-adjusted death rate at 21% is among some of the highest in the world.

The cause of accidents in Nepal is usually carelessness and speeding, and poorly-maintained roads and vehicles. The number of accidents is rising faster than the increase in the number of vehicles.

Those who survive often have traumatic brain and spinal cord injuries, requiring long-term or life-long expensive rehabilitative care, available in only few institutions in Nepal and in limited capacity.