Another Covid wave, but milder

Fever accompanied by chills, body aches, runny nose, sore throat or cough? You probably have Covid, and are likely over it.

After only recording a handful number of new Covid-19 cases for the last few months, Nepal registered nearly 400 in the last week. But these are only the official figures, doctors say there are flu-like cases recovering in almost every family.

The latest surge is once again in line with the rise of cases in India where the new sub-variant of Omicron has been found to be responsible. On 4 April, there were 3,637 new reported Covid-19 cases across India and seven deaths in the past 24 hours. Some 60% of the new cases have been attributed to the new variant circulating in the country, XXB.1.16, a subtype of the Omicron variant.

“This is proof that when it comes to Covid-19, we are not out of the woods yet, it is a reminder that we need to continue to be careful, especially with the elderly and populations with comorbidities,” says Buddha Basnyat, physician at Patan Academy of Health Sciences.

However, unlike in India, it is not yet known which strain is driving the new infections in Nepal. A genome sequencing in last 2022 found that there were 17 sub-variants of Omicron circulating in Nepal.

At Teku Hospital, virologist Sher Bahadur Pun has been observing a gradual increase in the number of Covid cases and old-age patients being admitted. Most symptoms are mild, but interestingly many are complaining of a lack of smell and taste, which was typical of pre-Omicron cases. Over time, Covid-19 symptoms have also gradually changed.

“What I’m seeing are breakthrough cases, these are people who have taken three shots, including a booster dose. This means we are likely to see a large number of such breakthrough cases in the near future,” explains Pun.

He adds: “This could very well be a new variant, a hybrid of these that were already circulating or XXB.1.16 like in India given there are no restrictions preventing the strain from travelling.”

But public health experts agree that while there has been a noticeable surge in the number of new cases being recorded, there has been no significant increase in hospitalisations and deaths.

In other words, while the newer variants are more infectious, they are less virulent and unlikely to cause complications, further helped by the fact the much of the population has gained some level of immunity due to natural infections as well as vaccinations.

Even so, it is important for vulnerable populations to be protected, and the best way to do that is by taking a booster. As of February 2023, 76.5% of Nepalis have taken two doses of the Covid-19 vaccine which is nearly 96% of the target population. But the booster intake is much lower at about 27%, as of December 2022.

“Given that it has been quite some time since the second dose or even a booster was administered, I urge the elderly, immuno-compromised individuals and frontline workers to take a booster shot or a second booster even,” says Pun. “If there is an option, take a bivalent booster, it will protect you against both the original coronavirus strain and the Omicron variant.”

Back in February, Nepal received 345,600 doses of Pfizer-BioNTech’s bivalent vaccine under the COVAX initiative, the first of the 1.5 million doses promised in four phases. But officials say the uptake has been discouraging, even in Kathmandu and other urban centres.

The new surge is likely to pass before long and without causing much impact on the overall population. But not taking preventive measures may endanger the elderly and people with comorbidities.

Warns Buddha Basnyat: “This surge is a reminder to continue to mask up and maintain hygiene not so much for Covid-19 at this point but to protect ourselves from a wide range of other equally prevalent infections in our part of the world like TB, typhoid and a host of diseases caused by air pollution.”