Western Nepal potential COVID-19 outbreak

Nepalis returninghome from India. Photo: DINESH KHABAR

The detection of three new cases of coronavirus in Dhangadi on Sunday has led public health experts to urge more widespread testing and stricter quarantine for people returning from India to their homes in western Nepal.

Nepal closed its border with India nearly two weeks ago leaving thousands of Nepali workers stranded on the Indian side, as both countries went into lockdown. However, many thousands of others returned to their villages through the porous border.

The three new patients bring the total of infected people in Nepal to 9, although an earlier patient recovered. Two of the new detections were men aged 21 and 41 who had recently returned from India.

The third person is a 34-year-old female relative of a man who had flown in from Dubai two weeks ago, and travelled from Kathmandu to Kailali in western Nepal. She is the first community transmission case detected in Nepal, all other eight patients had come to Nepal from Europe, China or India. 

A Cabinet meeting on Saturday decided to conduct rapid diagnostic testing in the three districts where new cases have been found: Kailali, Kanchanpur and Baglung. “We are going in for mass-testing in the three districts through contact tracing and of all individuals suspected of being infected,” government spokesman and Finance and Information Minister Yubaraj Khatiwada told a press briefing.

The Cabinet also decided to ban with immediate effect all inter-provincial travel, and people going from one district and local government unit to another. It also decided to enforce more strictly the lockdown.

Public health experts had said in-country infections were inevitable, and they are actually surprised that it has taken so long for it to appear. One reason could be that Nepal has only now expanded its testing to places beyond Kathmandu. This would mean that the country’s case load which had so far been relatively low compared to neighbouring South Asian countries, will go up in the coming week.

They expect western Nepal to be a hot spot for a possible future spread of the virus because of the large number of Nepali workers returning home without screening from India after the lockdown there. 

India reported 355 new COVID-19 cases on Saturday, pushing the total to 2,902, and there have been 68 fatalities so far with 184 patients have been discharged after treatment. 

Of the four Indian states bordering Nepal, the most populous Uttar Pradesh has 174 official infections and has recorded two deaths, while Bihar has 29 cases and one death. Uttarakhand, from where one of the cases detected in Nepal on Sunday came from, has 16 cases.

Police records in Darchula show that 128,022 people entered Nepal before the border was sealed. Many of those trapped on the Indian side have been swimming across the Mahakali river, or using tyre tubes to float over to the Nepali side. 

The India-Nepal border is mostly open and porous, and even at official checkpoints health desks are only equipped with thermometers. The mountainous districts of western Nepal are considered to be the most vulnerable because every family has at least one worker in India who has now returned.

“If anyone is infected here, it is going to be a disaster. All we have are thermometers,” says Padam Giri, mayor of the Budhinanda municipality in Bajura, one of the remotest districts in northwestern Nepal. 

Bikash Gauchan at the Bayalpata Hospital in Accham district says many thousands of Nepalis have returned to western Nepal from Maharastra, Delhi and Bihar, which are the hardest-hit COVID-19 states in India. He adds: “We have a few ventilators in the entire western Nepal, and a limited stock of oxygen. We will not be able to do anything if the situation is to turn for worse.”