Not over till it's over

BRIDGING THE HEALTH GAP: Community health worker Birma Devi Kunwar, 32, crosses a bridge in Darchula with a Covid-19 vaccine box on her back. Nepal’s success with previous vaccination drives is the main reason the country has now fully-inoculated 81% of its eligible population against Covid-19. But booster doses are trailing.

On 23 March, Nepal recorded 38 new Covid-19 cases, one of the lowest figures since early 2020. The pandemic does not make it to the headlines anymore, and Nepalis are going about as if the crisis is a thing of the past. 

But it is not over until it is over. Given the latest outbreaks in Hong Kong and China, the WHO has warned that we may only be ‘halfway’ through the pandemic. That surge is just across Nepal’s northern border. 

Parts of China are back under lockdown. Hong Kong with its world class health care system, is seeing high fatality rates from the Omicron and BA.2 sub-lineage.

Omicron and its stealth variant may have run their course in the Subcontinent, but the Deltacron hybrid has been detected in several countries, including India. 

While there is no evidence yet to suggest that the recombinant virus is more contagious or virulent than previous strains, it is too early to make any assumptions. 

“If the new surges around the world are due to the BA.2 variant, we might not have to be as concerned,  but the same can’t be said for Deltacron since we have not yet established its transmissibility and virulence,” says virologist Sher Bahadur Pun at Teku Hospital.

Physician at Patan Academy of Health Sciences Buddha Basnyat agrees: “It is an unfolding story, but it will be prudent to assume that the pandemic is not yet over. And if there is anything we should learn from the past two years, it is that this is a very wily virus.”

In January, the WHO projected that the acute stage of the pandemic would end in 2022 provided that there was necessary treatment and equitable distribution of vaccines worldwide. 

But citing the latest rise in case numbers, it has changed its forecast saying the world is only in the middle of the pandemic. 

Universal vaccine coverage is the only way to prevent another surge, and newer variants from coming up. In the last two years, SARS-CoV-2 has proven to be very adaptable, naturally mutating and attacking the unvaccinated. 

In Hong Kong, the majority of those hospitalised had not been vaccinated, or had received the less effective Sinovac jabs. 

Nepal’s inoculation status is now relatively high: over 93% of the adult target population is partially vaccinated while 81% have got both doses. Much of the credit goes to grassroots health workers mobilised across the country who built on Nepal’s past success with vaccination drives for other diseases (pictured above).  

However, the figure for booster doses is at only 9.8% even though Pfizer vaccines are now easily available, and the government may soon start offering it to children up to five years. 

Nepalis do not show vaccine denial so much, but there is some Covid complacency. 

“We have to keep up with the pace of vaccination, but we must continue prioritising vulnerable populations and children," adds Pun. "And it might help to provide the rationale and evidence to back the need for a booster because for most people, complete vaccination means only two doses.” 

Nepalis are slowly becoming careless about masking up and avoiding crowds but, experts say, this must continue to be a part of prevention measures. Testing needs to continue, especially as countries around the world open up for businesses and tourism. 

Nepal has also now removed mandatory PCR test and quarantine for fully vaccinated visitors, but the country cannot let its guard down.

Says Buddha Basnyat: “Masks are protecting us, there is no harm in continuing to wear them. They in fact defend Nepalis from a myriad of other infections, as well as air pollution.”