Heat map of Nepal’s Covid-19 hotspots

Any other year, up to 1.5 million people leave Kathmandu Valley for their home districts during the Dasain festival. This year, according to police estimates, it was only 200,000. Constant warnings by the Health Ministry and the experts to celebrate this year’s Dasain-Tihar-Chhatin place seems to have worked.

However, those who went home left Kathmandu Valley where the pandemic has been raging for the past month, with more than 60% of new daily cases nationwide. The fear is that many took the virus with them and spread it across the country.

Now, a new study of the movement of people during Dasain by tracking mobile telephone geolocation gives precise information where most people from Kathmandu went for the festival, and where the risk of Covid-19 clusters are highest.

The Covid-19 Crisis Management Center (CCMC), in collaboration with telecommunication service providers Nepal Telecom and Ncell, have analysed the movement of at least 100,000 people who left for various districts two weeks before the start of Dasain by tracking their cellphone devices.

The data shows that the highest number of people left Kathmandu for Dhulikhel and Namobuddha of Kavre, Thaha and Manhari municipalities of Makwanpur, Melamchi and Sunkosi of Sindhupalchok, Parwanipur of Bara, Bharatpur of Chitwan and Lekhnath of Kaski districts.

The CCMC now has red flagged these municipalities, and advised local authorities to be vigilant. The committee has also classified parts of the country as 'moderate, low and extremely low risk' in terms of Covid-19 crisis based on human mobility.

Likhu in Nuwakot, Belkotgadi, Thakre of Dhading, Panchkhal of Kavre, Lisankhu of Sindhupalchok, Kamalamai of Sindhuli, Janakpur of Dhanusha, Triyuga of Udayapur and Barju in Sunsari are also at high risk of outbreaks because of the volume of people travelling there from Kathmandu in the past weeks.

Ncell had previously helped track the movement of Nepalis post-earthquake in 2015, when it found that more than 400,000 people left Kathmandu in the week following the disaster, while thousands of quake-displaced people temporarily settled in the capital.

At that time it was found that the maximum number went to earthquake-affected districts to check-up on families, with the eastern Tarai districts being the destination for others. The numbers going to western Nepal in 2015 was negligible.

To understand the movement pattern of people for effective aid distribution, Ncell collaborated at that time with Swedish organisation Flowminder to make use of the cellular network data for earthquake response.

In this crisis, areas identified as at ‘very high risk’ and ‘high risk’ of Covid-19 infection because of maximum human movement should be prioritised in terms of contact tracing and following stringent safety measures if we are to bring the infection under control, say experts. But the CCMC and Health Ministry seem to be working at cross-purposes and undermining each other.

The two agencies responsible for Covid-19 response are at loggerheads, consumed by turf battles, questions of responsibility, and of late have been blaming each other for the dramatic spread of Covid-19 across Nepal, especially in Kathmandu Valley.

In fact, in July-August when Birganj was reeling under a Covid-19 crisis, the CCMC had identified Kathmandu Valley at high risk of infection based on the number of people entering the capital from the Tarai. Just as projected, the capital is now the hotspot of Covid-19 infection in Nepal.

The total number of new Covid-19 cases which dropped this week during Dasain because testing centres were closed for the festival, is steadily picking up. Public health experts predict that the cases will rise as the backlog is tested, as well as because of the rise in infections due to family movement.

To prove this point, on Thursday the total numbers testing positive was back to the pre-Dasain 3,517 level, 1,888 of them in Kathmandu Valley. Some 4,096 patients were discharged in the last 24 hours. There were 16 more deaths, taking the total closer to 1,000. The recovery rate is 76.7%.

As of 30 October, Nepal has a total of 168,235 confirmed Covid-19 cases with 38,357 of them active infections, Kathmandu Valley accounts for most of them at 19,752. Total fatalities now stand at 920 with 333 of them in Kathmandu, Lalitpur and Bhaktapur districts.

There are about 300 people undergoing treatment in ICUs in various hospitals across the country with 71 of them on ventilator support. Bagmati province has the most seriously sick with 191 in ICU and 55 on ventilators.