Lockdown may be extended in Kathmandu

The District Covid Crisis Management Centre (DCCMC) has recommended extending the lockdown in Kathmandu Valley by two more weeks following a meeting of the mayors of Kathmandu, Lalitpur and Bhaktapur districts. 

The ongoing restrictions enforced from 29 April for 15 days ends on Wednesday. And as of Monday, 70 out of 77 of Nepal’s districts have been placed under some form of lockdown to contain the second wave of the pandemic that is sweeping across the country.

“We have suggested two more weeks of prohibitory orders given that the rate of infection has not gone down, but we have yet to finalise that decision,” said Kathmandu Chief District Officer Kali Prasad Prajuli, adding that the discussion on Sunday focused primarily on oxygen management and creating public awareness.

Nepal has been reporting an excess of 8,000 new cases a day for a week now with the number of recorded infections doubling every three days among a largely unvaccinated population. Kathmandu registers half of all new infections in Nepal. 

On Monday, there were additional 9,271 new infections and 139 fatalities. The number of active infections is closing on to 100,000, and the total confirmed cases exceeded 400,000 on Monday.

Nepal’s test positivity rate is exceptionally high at more than 40%, which is double India’s average. Even then, public health experts say it is a gross underestimation because of the limited number of tests. 

Human Rights Watch (HRW) on Monday urged the Nepal government to act urgently to manage the rapidly escalating Covid-19 emergency and pleaded with foreign donors to increase the availability of emergency medical supplies including bottled oxygen, ventilators, and therapeutic drugs to the country.

“Nepal’s under-resourced public health system is strained beyond capacity,” said Meenakshi Ganguly, South Asia director at Human Rights Watch. “Large volumes of oxygen equipment and other medical supplies are urgently needed to avert a Covid-19 catastrophe in the country.”

Nepal government’s Health Sector Emergency Response Plan for the Covid-19 Pandemic outlines that hospitalisation with oxygen support should be available for 15% of confirmed cases. But that is not the case and Nepal’s oxygen production capacity has been overstretched. 

Given the sheer number of patients requiring hospital admissions, ICU, ventilator and oxygen, the country’s modest healthcare system is at the breaking point. 

As of 10 May, there are 6,715 individuals undergoing treatment in hospitals. 910 of them are in ICU and 295 in ventilator support. 

Kathmandu’s main infectious diseases hospital in Teku is full, and pateints are being cared for in open verandahs and parking lots – a scene repeated in government hospitals across the country.

Family members thronged the main oxygen factory in Balaju over the weekend in a desperate attempt to obtain cylinders for patients. But on Sunday the government told factories not to sell cylinders directly to the public but to provide them to hospitals. 

The Ministry of Health announced on Monday that the allocation of oxygen cylinder supply would henceforth be coordinated by the inter-ministerial Covid-19 Control and Management Committee.

“We are in a very dire situation right now. We are running out of oxygen supplies. Our oxygen plants are not working properly. The number of cases is increasing rapidly, and the age group of patients is quite young,” said Roshan Pokharel of the Health Ministry, speaking to HRW.

In Birganj in Nepal’s southern plains, Covid-19 patients are sharing hospital beds and healthcare workers haven’t been able to distribute or manage oxygen fairly. Most can’t afford expensive private hospital care.

A Nepal Airlines plane is flying to Beijing on Monday night to bring China’s offer of 20,000 oxygen cylinders and other medical essentials. But even that is unlikely to fully meet the demand since Nepal needs to refill 72,000 cylinders a day but its 22 oxygen plants can only fill 18,000 a day. 

Less than three million of Nepal’s 28 million populations have been fully vaccinated against SARS-CoV-2. Another 1.3 million who received the first dose are unlikely to receive the booster shot anytime soon. 

The global short supply of shots has undermined Nepal’s vaccination drive, especially after the Indian government halted vaccine exports. “We are not getting vaccines from anywhere, although we do have the money,” Pokhrel said.