We are being tested

Nepal has been spared the worst of the COVID-19 pandemic so far, and Kathmandu Valley has been among the least affected areas of the country. But there has been a worrying increase in the capital since the lockdown was partially eased two weeks ago.

The detection of 23 new cases on Wednesday has brought the tally to 288, with 190 in Kathmandu, 53 in Bhaktapur and 45 in Lalitpur districts. From Thursday, three wards of Lalitpur’s Mahalaxmi Municipality have been put under strict lockdown after nine people were tested positive in those localities this week.

Public health officer Tek Raj Ojha said the nine were all returnees from abroad, patients at hospitals, and two were health workers themselves. They have been kept in isolation, and all are asymptomatic.

Open and shut case, Editorial

“Until we can conduct mass testing and find out where they were infected, we cannot say that there is community transmission,” Ojha says. Forty others who had been in contact have been traced and are being tested.

The three wards of the municipality are back in lockdown with all shops closed, although provision stores and pharmacies are allowed to open from 7-9AM.

The daily bombardment of total new cases does sound alarming. However, Nepal’s PCR test rate per capita is one of the highest in South Asia, the fatality rate of 0.2% is one of the lowest, hospitalisation and ICU admissions are normal. Nepal’s positivity rate is at 6% for PCRs, little lower than India at 7%.

The Ministry of Health and its agencies keep track of the trends, but make blunders. For example, on two days last week several labs showed 100% positive cases among those in PCR tests. The daily tallies are transmitted by labs at 1PM to the National Public Health Laboratory, then to the Epidemiology and Disease Control Department, which then passes them on to the Health Emergency Operation Centre at the Ministry of Health, which then announces them at a daily press briefing. None of the agencies detected the anomaly.

After it created a stir on social media, the government finally admitted that there had been an “error in the submission” of the figures by the labs which had bundled all positive cases without giving the total samples tested.

Teaching Hospital’s Niranjan Shah says he had tested 249 samples on 1 July of which 114 were positive. “But the Ministry published the table with only the positive figures without the total numbers tested,” he said.

Faced with the growing numbers in Kathmandu, the government is now increasing surveillance testing in crowded areas to confirm if there is community transmission. Although not all the results have come in, so far they show that the virus is not spreading in this way yet.

However, public health experts warn that Nepal should look at worrying trends in India. The country recorded its highest ever daily new cases with 26,000 positives on Wednesday – two weeks after the government loosened its lockdown. This brings India’s total caseload to 770,000 with 21,000 fatalities.

More worryingly, the daily cases are now rising in states bordering Nepal. West Bengal now has 807 deaths from COVID-19, and Uttar Pradesh also has 800 and counting.

And even though these numbers are small compared to India’s total population size, experts say it shows how quickly COVID-19 can spread in crowded cities where citizens do not comply with precautions.