Window on the future

The coronavirus is here to stay. Vaccines will not be available for Nepalis till late next year. There are no proven therapies yet. The only way to stay safe is through prevention, since hospitals will be full.

That is the prognosis from health experts for the coming winter and into next year. Even before SARS-CoV-2, Nepal used to see a winter spike in deaths of the elderly from pneumonia. But with the added threat of the new virus, this winter is going to be even more dangerous than previous ones.

“This thing will keep going for another year at least, the only way to deal with it is prevention – that means masks, separation and handwashing,” says Buddha Basnyat at the Patan Academy of Health Sciences.

People above 65 and those with pre-existing conditions need to be especially careful –their family members have to take strict precautions not to bring the virus into the household.

Protecting Nepal's elderly from Covid-19, Alisha Sijapati

Doctors advise taking flu shots where available so that the high risk groups do not end up having to fight on two fronts in the coming months.

“In Nepal, data shows that winter is a killer of older people, so in the coming months  they need to minimise interaction with immediate family members who move about in public,” says Sameer Mani Dixit of the Centre for Molecular Dynamics. He advises that seniors isolate in their rooms, and meet relatives in open spaces wearing masks.

What makes high risk groups even more vulnerable is that in winter windows are closed, and they tend to mingle with the extended family with whom they share the home. They should also get as much exercise as possible, and expose themselves to direct sunlight to boost immunity. Similar precautions need to be taken by those with hypertension, diabetes, obesity and other conditions.

Says Dixit; “High risk individuals like the elderly and those with pre-existing conditions have to treat all members of the household and visitors as if they are Covid positive. That means wearing masks, keeping separation and meeting them only in open areas.”

Home healthcare during lockdown, Alisha Sijapati

The government, which seems to have more or less given up trying to control the virus by leaving it to the public to take precautions, needs to prepare for the winter surge. There has to be adequate oxygen supply to hospitals, more ICU capacity, separate corona wards in hospitals, and the new Nepal Army hospital could be turned into a Covid-dedicated facility.

The silver lining is that mask-wearing and handwashing have reduced other chronic infections in Nepal. Hospitals report a marked decrease in water-borne diseases like typhoid and dysentery, and airborne infections like COPD (chronic obstructive pulmonary disease). Mask-wearing slowed the spread of seasonal flu in this year’s southern hemisphere winter.

Some in Nepal are promoting ‘herd immunity’ as an antidote to the expected winter surge. Scientists caution against this notion because there is still so much uncertainty about the virus. 

Says Buddha Basnyat: “Herd immunity is herd mentality, it is dangerous.”

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What is novel about the novel coronavirus, Buddha Basnyat