Nepal braces for its 2nd Covid wave

India reported over 100,000 new cases on a single day for the first time on Monday, putting neighbouring Nepal on high alert. A repeat of what happened exactly a year ago seems likely, as imported cases from the southern neighbour led to rapid community spread.

Nepal shares a 1,770km long porous border with India and migrant workers are returning home in large numbers, as some of the most affected Maharastra, Karnataka and New Delhi announce lockdowns and curfews. 

Experts say just like April 2020, it may not be long before Nepal will also see its second wave since what happens in India directly impacts Nepal. Health Minister Hridayesh Tripathi told Parliament on Monday that Nepal could see a surge of new cases by May.

The India connection in Nepal’s COVID-19 status, Nepali Times

While Nepal is experiencing a déjà vu with a repeat of the situation, the major difference from last year is that there is no lockdown at the moment. People are out and about in the markets and holding political rallies, while many have stopped wearing masks, or even keeping safe distance. This time, it does not seem to be the state that is uncaring, but the people. 

“Nepalis have a short-term memory and have already forgotten what we went through a year ago,” says epidemiologist Lhamo Yangchen Sherpa. “By this point, we should have learned our lessons, but unfortunately, people are back to crowding and are not even wearing masks.”

Last week, Kathmandu’s youth were out in thousands at Basantapur Square to collectively celebrate Phagu Purnima as if there was no health crisis at all, even though India was already seeing a worrying rise. 

Adding to Nepal’s woes is a shroud of smoke from wildfires that have covered the country with hazardous levels of air pollution for the past two weeks. With no sign of rain in the forecast, there does not seem to be an end in sight to the bad air.

For the past 48 hours Kathmandu has recorded Air Quality Index (AQI) measurements above 300, aggravating the health of those with respiratory problems, including Covid-19 patients.

Locals in Bhaktapur on Monday took to the streets to protest the cancellation of the Biska Jatra in Bhaktapur, saying they should be allowed to go ahead since political rallies and international football matches have been allowed to go ahead.

To make matters worse, there are only about 3,000 PCR tests being done, and contact tracing has been all but abandoned. Nepal was pinning its hopes on its early vaccination drive but after 1.6 million people had been inoculated, there is uncertainty even for second doses because of the Indian ban on export of Covishield.

Nepal has 500,000 doses of Covidshield in the stock, just sufficient to provide a second dose for individuals who inoculated in the first phase. Nepal Army has additional 100,000 doses gifted by the Indian Army.  There is another 800,000 doses of Sinopharm from the Chinese government.

Says Sherpa: “We sound like a broken record now, but we have to keep reminding people to wear a mask, wash hands and maintain physical distance. Vaccinate if possible, continue contact tracing and testing, particularly at the border.”

Public health experts agree that there have to be tests at the Indian border, and those testing positive or with symptoms should be quarantined. However, they also admit that the border is open and returnees could easily bypass the official border checkpoints, as was the case last year.

“We saw how Nepalis desperate to get home swam across the border river to cross over from India, that is why local governments must monitor those who have returned from India and strictly enforce a 10-day quarantine on them, and allow them out only after PCR tests,” says epidemiologist Sher Bahadur Pun. “If local governments act now, we can control the second wave.”

Sameer Mani Dixit of the Centre for Molecular Dynamics agrees, but says everyone coming form India should be tested and be under mandatory five-day monitored quarantine. 

“Since cases are rising rapidly in India, I see the possibility of a surge in the Tarai first, but as it is not possible to test everyone at the border, it should be the responsibility of local governments to keep returnees under observation for five days,” he says. 

Read also: Nepal relaxes entry for tourists, Nepali Times