It was not long ago when families of hospitalised Covid-19 patients were frantically searching for a dose of remdesivir or hydroxychloroquine. These drugs were hard to come by, and their price surged. Convalescent Plasma Therapy which uses blood from those who have recovered from an infection to treat new cases was similarly thought to be another effective regime for Covid patients. Until that point during the Covid-19 pandemic, there were no working vaccines. Even when the first vaccines were produced, there were not enough doses for Nepal while the<a href="https://nepalitimes.com/here-now/delta-variant-s-wake-up-call-for-nepal"> delta variant </a>was sweeping India. Covid hospitalisation was at an all-time high, hospitals were running out of beds as even younger populations succumbed to the disease. Today, these drugs and treatment regimes have been found to be completely ineffective. A RECOVERY (Randomised Evaluation of Covid-19 Therapy) Trial started at Oxford University found that hydroxychloroquine was no good for hospitalised Covid patients. Surprisingly, the Recovery Trial also showed that it was a <a href="https://nepalitimes.com/opinion/dhanvantari/a-covid-19-exit-strategy-for-nepal">widely available cheap steroid called dexamethasone</a> that was the most effective in some groups. “Dexamethasone is the real winner by far, it is such an easy and cheap drug to use, followed by Tocilizumab and Baricitinib which are more expensive and difficult to access drugs but showed additional mortality benefits in severe patients,” said Peter Horby, infectious disease specialist and co-lead of the RECOVERY trial during a meeting in Kathmandu last month. He added: “Aspirin, azithromycin, hydroxychloroquine, plasma therapy, colchicine and lopinavir-ritonavir had absolutely no effect on survival rates. In fact, there are potential harms of using hydroxychloroquine.” Hydroxychloroquine gained much momentum after then-US President Donald Trump endorsed the antimalarial drug for use in Covid patients. The Oxford University RECOVERY trial with 49,051 patients enrolled and 189 sites with Nepal being the biggest only after the UK, is the largest randomised controlled clinical trial of Covid-19 treatments, more than twice as large as any other trial. It has so far produced clear answers on 13 different treatments, and no other trial has determined international treatment guidelines in the way RECOVERY has.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240524040532_29bd53f7eeda6d1b28894f37af7008bdf4792910aa3d5f6a893bf9381dce9164.jpg" data-media-id="editor_2" data-image-id="20240524040532_29bd53f7eeda6d1b28894f37af7008bdf4792910aa3d5f6a893bf9381dce9164" data-rendition-name="original" width="1750" height="1169" loading="lazy" alt="Still learning lessons from COVID Page 10-11 NT #1213"> <figcaption>Hospitals in Kathmandu ran out of beds during the Covid-19 pandemic in 2021 and patients had to be treated outside the wards on the floor. Photo: NEPALI TIMES ARCHIVE</figcaption> </figure>  The major finding of the RECOVERY trial that dexamethasone reduces mortality among patients admitted to hospitals with Covid-19 who need oxygen therapy saved over 1 million lives globally just in 2021. But before the trial, there was uncertainty whether or not this treatment would work. “Many well-known doctors actively discouraged the RECOVERY team against using a cheap steroid dexamethasone, but they had based their opinion on much smaller studies,” explains Buddha Basnyat, physician with the Patan Academy of Health Science and the Principal Investigator for the RECOVERY Trial for Nepal. He adds: “But Peter Horby decided we need to do a trial that was sufficiently large to be able to conclude if the drug works, he cut through the fog of confusion and the British review board went with it. It was science at its best.” The trial also demonstrated that powerful antiviral treatments such as <a href="https://archive.nepalitimes.com/news.php?id=19634">monoclonal antibodies </a>when directed against the virus could reduce mortality in patients who have not developed their own antibodies, which many doctors doubted would work. In Kathmandu, Horby recalled meeting a South American minister and found out that they still had aspirin in their Covid treatment guideline. He said: “There is still work to do to get this information through the policymakers about what works and what doesn’t.” The Covid-19 pandemic was an extraordinary global crisis, but in some ways it is similar to the tendency of governments to intentionally look for expensive and complex solutions to <a href="https://nepalitimes.com/here-now/nepal-s-frontline-workers-brave-it-out">medical emergencies </a>when proven cheaper solutions are available. For example, <a href="https://nepalitimes.com/news/remove-barriers-to-life-saving-drug-to-prevent-maternal-deaths">Misoprostol is a cheap drug that can prevent maternal deaths </a>from post-partum haemorrhage. It was a part of the program launched in the mid-2000s to protect women who give birth at home but now it faces opposition, neglect and shortages in Nepal because it is so cheap.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240524040532_e70428427a6f5a50955c544ff4f2e7f9c4c86a4065f4680a3d999dc3f667b957.jpg" data-media-id="editor_6" data-image-id="20240524040532_e70428427a6f5a50955c544ff4f2e7f9c4c86a4065f4680a3d999dc3f667b957" data-rendition-name="original" width="2000" height="1199" loading="lazy" alt="Still learning lessons from COVID Page 10-11 NT #1213"> <figcaption>Peter Horby speaking about the RECOVERY trial in Kathmandu last month.</figcaption> </figure>  “Tranexamic acid is another cheap drug for post-partum haemorrhage. The same steroid for Covid-19 called dexamethasone is the most effective drug for the treatment of severe altitude illness,” says Basnyat, who specialises in mountain medicine. “There is a tendency to underutilise some of these affordable, simple and easily available lifesaving drugs at our disposal.” The RECOVERY trial also turned out to help build medical research capacity in Nepal. The Infectious Diseases Hospital at Teku and the Armed Police Hospital were<a href="https://nepalitimes.com/here-now/nepal-s-doctors-are-like-soldiers-fighting-a-war"> at the forefront</a> while the Oxford University Clinical Research Unit Nepal spearheaded the campaign and convinced the Nepal Health Research Council to participate. “Nepal played a crucial role in the expansion of the trial from the UK to the rest of the world,” Horby told Nepali Times. “Nepal recruited more patients than any other country outside the UK.” &nbsp; Indeed, Nepal was the single biggest contributor to the trial and the research contributed to the global science, and it was a big boost for fledgling research culture in Nepal. Says Basnyat: “We stood to gain scientifically from this but also showed young doctors and nurses in Nepal were randomising patients in a very standardised way, learning new things despite the tragedy that was Covid-19.” The RECOVERY platform has now transitioned into finding treatments and better care for pneumonia and other influenzas which <a href="http://archive.nepalitimes.com/article/nation/Antibiotic-resistance,1974">still kill hundreds of thousands of people worldwide</a>. Added Horby: “RECOVERY has shown the benefit of large, streamlined trials and how they could be applied to any common health problem. Trials are essential if we are to know what is effective and what is not, so ensuring we can deliver more trials is important for public health.”

Sonia Awale

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Still learning lessons from COVID

<a href="https://www.nepalitimes.com/banner/dengue-days-are-here-to-stay">Dengue ravaged Nepal last monsoon</a>, with over 55,000 hospitalisations and 88 fatalities. But that is just the official count, and many who died from the mosquito borne virus that caused haemmorhagic fever were healthy adults. Public health experts had warned last year that the virus would strike again in the 2023 rainy season because the virus hibernated with the larvae of infected mosquitos. They say the larvae are just waiting for the puddles to hatch, and with it the virus can again spread exponentially. Waiting until the monsoon to target mosquito breeding areas will be too late. “Local government must start the search-and-destroy larvae campaign now, we cannot wait for the rains,” warns virologist Sher Bahadur Pun at Teku Hospital. “Dengue is a real public health crisis and we cannot prevent it without the government and the communities working together, individual precaution can only go so far.” The key is to raise awareness, preferably through school children so that we can reach their families and subsequently the community at large, about the nature of aedes mosquito that carries the dengue virus and the protective measures. Last year, almost every family in Kathmandu had multiple members suffering from <a href="https://www.nepalitimes.com/news/state-of-malaise">dengue</a>. Although 90% of patients were asymptomatic, they helped spread the virus.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230408040436_c88bd2e1183ab33f7763f64b18be6b6945cfae7fa1a6c1b793c9ffdeb3cf739f.jpg" data-media-id="editor_2" data-image-id="20230408040436_c88bd2e1183ab33f7763f64b18be6b6945cfae7fa1a6c1b793c9ffdeb3cf739f" data-rendition-name="original" width="5827" height="3885" loading="lazy" alt="dengue"> <figcaption>Photos: SUMAN NEPALI</figcaption> </figure>  Dengue patients generally have two weeks of high-grade fever accompanied by extreme muscle and joint aches, loss of appetite, nausea, and pain in the eye sockets. Many who had both dengue and Covid said dengue was much worse. <a href="https://nepalitimes.com/news/another-covid-wave-but-milder">Covid-19 is also back again</a>, possibly with a circulation of a new variant in the region. So all three levels of government must prepare for both outbreaks simultaneously. “Dengue is among the biggest public health challenges of the 21st century, given the disease burden and its socioeconomic impact in these parts of the world,” says Buddha Basnyat, physician at Patan Academy of Health Sciences. “And there is every potential of another outbreak given that we have not learned our lesson from previous outbreaks or taken any measures to prevent another one this year.” Indeed, Kathmandu had a major dengue outbreak in 2019, just before Covid-19 spread out of China in December of that year. There were over 17,000 official cases that monsoon but they were largely adult patients, most of which had milder symptoms and the fatality was very low. But <a href="https://www.nepalitimes.com/banner/as-covid-abates-nepal-sees-dengue-outbreak">last year’s outbreak</a> was much more widespread and serious. Although debilitating, fatality from dengue is rare but there were more complications and deaths. The mosquito eradication campaign came too late, and by that point dengue was out of control. We did not learn the lessons of 2019, and we haven’t learned the lessons of 2022. “How not to get dengue? It is simple, do not get bitten by a mosquito,” says Pun. “But preventing a mosquito bite is anything but simple because we do not do anything until it is too late.” Unlike the anopheles mosquito which carries the malaria parasite, aedes is active during the daytime, particularly in the early hours of the morning and evenings. This means avoiding the outdoors during these hours, if possible. So, mosquito net or coils at night do not help. Insect repellents should not be toxic, and contain the active ingredient that the aedes mosquito avoids. Full-sleeve clothes are always a better alternative.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20230408040436_960e7fc347fa61878bfa623db07296c1e068a4c932f1257bbc43b70a56e7421b.jpg" data-media-id="editor_5" data-image-id="20230408040436_960e7fc347fa61878bfa623db07296c1e068a4c932f1257bbc43b70a56e7421b" data-rendition-name="original" width="1000" height="699" loading="lazy" alt="dengue"> </figure>  Also important is the knowledge of the breeding habits of aedes mosquito. Any pool of water is a fertile breeding ground, even egg shells and water bottle caps in garbage piles. &nbsp;Fumigation, as some Kathmandu wards did two months into the outbreak last year, was ineffective because the virus was already spreading from already-infected people. In short, destroying the larvae by removing possible breeding sites is the best preventive measures. “Every step that the government took last year after the onset of the pandemic, take them now. In fact, the people should pressure their local governments to do so right away,” adds Basnyat. Unlike Covid and most other infectious diseases, a dengue reinfection is even more dangerous and can be fatal. <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30007-3/fulltext">Writing in the journal The Lancet</a> in 2020, authors Sudeep Adhikari, Buddha Basnyat and Kripa Maharjan explain: ‘Primary infection with any serotype in a non-immune population generally causes mild disease. When secondary infection with another serotype occurs in the same population, there is antibody-dependent enhancement, which usually causes severe dengue. Over time, this secondary infection might lead to a so-called explosion of the disease.’ Such an explosion occurred in 2022 in Nepal’s urban areas, affecting mostly children and young adults. Misdiagnosis also caused complications in patients. Hospitals were overwhelmed and many patients had to be turned away. There was rampant overtreatment, often with antibiotics which are ineffective against viruses. With global warming, disease vectors like mosquitos and the virus are also <a href="https://www.nepalitimes.com/news/nepal-s-dengue-outbreak-exposes-climate-risk">moving to higher altitudes</a> spreading not just dengue but malaria, kalazar and chikungunya. &nbsp; Additional reporting by Ritika Tewari.

New dengue outbreak likely this monsoon

Fever accompanied by chills, body aches, runny nose, sore throat or cough? You probably have Covid, and are likely over it.
After only recording a handful number of new Covid-19 cases for the last few months, Nepal registered nearly 400 in the last week. But these are only the official figures, doctors say there are flu-like cases recovering in almost every family.
The latest surge is once again in line with the rise of cases in India where the new sub-variant of <a href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care">Omicron</a> has been found to be responsible. On 4 April, there were 3,637 new reported Covid-19 cases across India and seven deaths in the past 24 hours. Some 60% of the new cases have been attributed to the new variant circulating in the country, XXB.1.16, a subtype of the Omicron variant.
“This is proof that when it comes to Covid-19, we are not out of the woods yet, it is a reminder that we need to continue to be careful, especially with the elderly and populations with comorbidities,” says Buddha Basnyat, physician at Patan Academy of Health Sciences.
However, unlike in India, it is not yet known which strain is driving the new infections in Nepal. A genome sequencing in last 2022 found that there were 17 sub-variants of <a href="https://www.nepalitimes.com/here-now/boosting-booster-jabs-against-omicron">Omicron</a> circulating in Nepal.
At Teku Hospital, virologist Sher Bahadur Pun has been observing a gradual increase in the number of Covid cases and old-age patients being admitted. Most symptoms are mild, but interestingly many are complaining of a lack of smell and taste, which was typical of pre-Omicron cases. Over time, Covid-19 symptoms have also gradually changed.
“What I’m seeing are breakthrough cases, these are people who have taken three shots, including a booster dose. This means we are likely to see a large number of such breakthrough cases in the near future,” explains Pun.
He adds: “This could very well be a new variant, a hybrid of these that were already circulating or XXB.1.16 like in India given there are no restrictions preventing the strain from travelling.”
But public health experts agree that while there has been a noticeable surge in the number of new cases being recorded, there has been no significant increase in hospitalisations and deaths.
In other words, while the newer variants are more infectious, they are less virulent and unlikely to cause complications, further helped by the fact the much of the population has gained some level of immunity due to natural infections as well as vaccinations.
Even so, it is important for <a href="https://www.nepalitimes.com/here-now/protecting-nepal-s-elderly-from-covid-19-c6e60vp6">vulnerable populations</a> to be protected, and the best way to do that is by taking a booster. As of February 2023, 76.5% of Nepalis have taken two doses of the Covid-19 vaccine which is nearly 96% of the target population. But the booster intake is much lower at about 27%, as of December 2022.
“Given that it has been quite some time since the second dose or even a booster was administered, I urge the elderly, immuno-compromised individuals and frontline workers to take a booster shot or a second booster even,” says Pun. “If there is an option, take a bivalent booster, it will protect you against both the original coronavirus strain and the Omicron variant.”
Back in February, Nepal received 345,600 doses of Pfizer-BioNTech’s bivalent vaccine under the <a href="https://www.nepalitimes.com/opinion/hope-hyperbole-and-hypocrisy-of-covax">COVAX initiative</a>, the first of the 1.5 million doses promised in four phases. But officials say the uptake has been discouraging, even in Kathmandu and other urban centres.
The new surge is likely to pass before long and without causing much impact on the overall population. But not taking preventive measures may endanger the elderly and people with comorbidities.
Warns Buddha Basnyat: “This surge is a reminder to continue to mask up and maintain hygiene not so much for Covid-19 at this point but to protect ourselves from a wide range of other equally prevalent infections in our part of the world like <a href="https://www.nepalitimes.com/opinion/comment/pandemic-eclipses-nepals-tb-epidemic">TB</a>, typhoid and a host of diseases caused by <a href="https://www.nepalitimes.com/here-now/warning-breathing-is-hazardous-to-health">air pollution</a>.”

Another Covid wave, but milder

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20230112100136/63bfd50f9c7e80680e0d30d0jpeg.jpg" alt="" width="1024" height="576"/><figcaption>Health workers transporting Covid-19 vaccines in rural Nepal. Photo: NARENDRA SHRESTHA/ADB NEPAL</figcaption></figure>It was exactly three years ago that the novel coronavirus first emerged from Wuhan. SARS-COV-2 has now come full circle as cases soar and hospitals are overwhelmed across China.Beijing abandoned its zero-Covid policy, and has stopped registering fatalities from Covid-19. Official case load and death figures are said to be underreported. International health experts believe more than 1 million people may die from the disease this winter.Several countries now require mandatory Covid tests from passengers arriving from China, after Beijing eased travel restrictions in the new year. Countries in the region including Nepal are on high alert.The Health Ministry last week made masks once again mandatory in public places while appealing to people to resume hand washing and social distancing. On 28 December Nepal reported only 8 cases and zero Covid deaths.The Ministry has also urged the public <a href="https://www.nepalitimes.com/banner/why-is-there-vaccine-hesitancy-in-nepal/">to take booster shots, and second boosters</a> for people above 55 and the immunocompromised. The Drug Advisory Committee on 27 December granted emergency use approval for the Pfizer-BioNtech bivalent vaccine of which Nepal is set to receive 1.5 million doses from the COVAX global initiative by mid-January.Read also: <a href="https://www.nepalitimes.com/here-now/three-years-of-living-dangerously/">Three Years of living dangerously,</a> Sonia Awale“What is of utmost priority now is to protect our elderly and vulnerable populations. We need to fully vaccinate them if they have not or give them a booster, bivalent would be even more effective as it can fight both the original and Omicron strains,” explains Sher Bahadur Pun at the Teku Hospital.Pun likens what is happening in China now to the Omicron surge in Hong Kong earlier this year which also saw a significant rise in hospitalisations and deaths. Nepal also suffered a spike in fatalities among the elderly towards the end of the <a href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care/">Omicron third surge in 2022</a>. In both cases, the unvaccinated were victims.“Omicron might be less severe but in vulnerable groups who have not been vaccinated, even this strain can cause complications,” he warns.More than 80% of Nepal's eligible population (above 5) have been fully vaccinated against Covid-19. But the booster uptake is much lower at only 27%. There is also concern that it has been more than a year since most Nepalis got their last shots, and their immunity might be waning. Officials recommend a booster even though memory cells could provide some residual protection.The WHO has asked China to reveal its true Covid figures, and the nature of the prevalent strain. Experts attribute its surge to vaccination hesitancy among the elderly, stringent zero-Covid strategy which suppressed natural immunity, and Chinese vaccines like Sinovac being less effective than mRNA jabs.Read also: <a href="https://www.nepalitimes.com/banner/why-is-there-vaccine-hesitancy-in-nepal/">Why is there vaccine hesitancy in Nepal?</a> Sonia Awale“China did great with lockdowns and restrictions but took it to unnecessary levels, which means the population is Covid naïve compared to other countries. When they reopened, the variants already present multiplied rapidly,” explains Buddha Basnyat, physician at Patan Academy of Health Sciences. “It also seems they did not learn from the rest of the world, did not vaccinate their elderly sufficiently and relied only on their own vaccines.”The efficacy of Chinese-made vaccines has long been debated, but there are no studies to prove their efficacy, or lack thereof. However, experts agree that all the available vaccines recommended by WHO considerably reduce the severity of the disease.Media amplification of the China surge has caused some panic in the neighbourhood. Japan, Malaysia, Taiwan and India are the latest countries to require Chinese passengers to have Covid tests. India has also introduced nasal vaccine this week, those who had taken Covishield and Covaxin can take it as a heterologous booster dose.Read also: <a href="https://www.nepalitimes.com/banner/nepals-uneven-covid-19-deaths/">Nepal’s uneven Covid-19 deaths</a>, Ramesh KumarHowever, the BF7 Omicron strain has already spread around the world and it is not virulent, and does not seem to adversely affect vaccinated individuals. Experts also caution that although 1 million deaths sounds like a lot, it is a tiny fraction of China’s population. The Chinese government has accused the West of ‘hypocrisy and hyping the threat’.“The BF7 is not a new variant, it has been around for a while. It has been circulating in Europe, America and parts of Asia. It has been reported in India and chances are high it is in Nepal too, we probably just haven’t detected it yet,” says Sameer Mani Dixit of the Centre for Molecular Dynamics Nepal.He adds: “Nepalis have developed enough resistance through reinfections and vaccinations, especially as subsequent strains have been more contagious but less virulent.”The WHO says it is concerned about further mutations and the emergence of new variants, but mutations do not necessarily mean increased severity. Just like Omicron is more contagious but less severe than Delta.Says Pun: “There are at least 17 sub-variants of Omicron in Nepal. This means we have had enough immunity gained via reinfections. We also have protection from vaccination and the proof of this is how we marked our festivals, and elections without following safety measures and without any resulting surge.”Read also: <a href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care/">Omicron may not be risky, but take care,</a> Sonia AwaleHaving said that, the <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/">pandemic is not yet over.</a> Parts of China including Hong Kong, South Korea, Hong Kong and Japan which have high mobility of Nepalis are also seeing a Covid-19 surge this winter.The health desk at Kathmandu airport is not strictly checking vaccination or PCR tests anymore, and some experts say it should increase surveillance — especially when flights from Chinese cities resume on 8 January. After being locked down for so long, many Chinese are already booking holiday travel to Asian destinations.The Rasuwa border post also reopened this week to resume the cargo transport at Kerung and the trade between the two countries. The checkpoint which has been shut due to the pandemic since early 2020.Says Buddha Basnyat: “There is no harm in continuing to follow safety measures, it is now proven that masks and hand washing saves lives. It also protects us from a host of infections including typhoid and TB and more importantly from air pollution, all non-Covid silent killers.”

China’s surge: should Nepal be worried?

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111413114/63722f979c7e80680e0c2523jpeg.jpg" alt="" width="4096" height="2731"/><figcaption>Photo: AMIT MACHAMASI/NEPALI TIMES ARCHIVE</figcaption></figure>A new surge in Covid cases in Nepal has served as a reminder that <a href="https://www.nepalitimes.com/latest/not-over-till-its-over/" target="_blank" rel="noopener noreferrer">the pandemic is not over yet</a>, and on the need to keep masks one, avoid crowds, and get booster shots.Hospitals have not reported an increase in admissions, and no fatalities from Covid have been reported since March. But <a href="https://www.nepalitimes.com/opinion/omicron-is-coming-to-nepal-be-prepared/" target="_blank" rel="noopener noreferrer">highly transmissible</a> new sub-strains like BA.4 and BA.5 have also been detected in Nepal, as they have elsewhere in the world.“For the most part, people who have been fully vaccinated are unlikely to get very sick from the new strains, there has been no real increase in hospitalisation,” confirms Sher Bahadur Pun, virologist at Teku Hospital in Kathmandu.The fact that the new sub-strains are all Omicron variants means that, unlike the <a href="https://www.nepalitimes.com/here-now/delta-variants-wake-up-call-for-nepal/" target="_blank" rel="noopener noreferrer">deadly Delta variant</a>, they mostly infect the upper respiratory tract and not the lungs. Delta was responsible for millions of deaths in India in 2021, and killed at least 8,000 people in Nepal as hospitals ran out of oxygen and vaccines were delayed.But with 82% of the eligible population now<a href="https://www.nepalitimes.com/editorial/deubas-mixed-report-card/" target="_blank" rel="noopener noreferrer"> fully vaccinated</a>, Nepalis are now more protected from severe illness. But the virus is still mutating, and scientists are engaged in a cat-and-mouse to stay one step ahead of new strains.“Covid-19 has proven itself to be even more cunning than we thought. It is clearly still prevalent, and can be life-threatening for some,” warns Buddha Basnyat, physician at the Patan Academy of Health Sciences. “This is not the end of the Covid story.”That is not to say that the present surge is a <a href="https://www.nepalitimes.com/latest/from-pandemic-to-epidemic-to-endemic/" target="_blank" rel="noopener noreferrer">new wave</a>. While each new sub-lineage of Omicron is more contagious, they are also milder. That is good news, but asymptomatic infected people are also spreading the virus wider.While active cases are on the rise in Nepal, hospitalisations are not, and infected individuals could be putting the elderly and <a href="https://www.nepalitimes.com/latest/nepal-needs-to-prepare-for-new-covid-wave/" target="_blank" rel="noopener noreferrer">those with co-morbidities</a> at risk at home, or at work.Studies overseas have shown that up to half of those infected with the new sub-strains are asymptomatic. As people travel more this summer and shed masks, the BA.5 and other variants are<a href="https://www.nepalitimes.com/latest/nepal-has-all-the-conditions-for-an-omicron-surge/" target="_blank" rel="noopener noreferrer"> infecting and re-infecting</a> even those who are vaccinated.“We must continue to vaccinate and take a booster, especially those who haven’t even had their first shot. It might also be the time to start thinking about a fourth dose for vulnerable populations,” says Buddha Basnyat.Because ‘immune escape’ is putting more people who have had Covid-19 still at risk of reinfection, scientists are trying to improve the <a href="https://www.nepalitimes.com/banner/vaccines-variants-and-a-third-wave/" target="_blank" rel="noopener noreferrer">efficacy of vaccines</a> as they try to keep up with mutations of the coronavirus.“Eventually, Covid-19 will be like seasonal flu, and perhaps we will have vaccines for different strains,” says Sher Bahadur Pun at Teku.BA.4 and BA.5 were first seen in South Africa, and are currently the dominant strains in Nepal. This is surprising because it is BA.2.75 that was spreading in India last month, and the surge is now peaking there. Whatever happens in India <a href="https://www.nepalitimes.com/banner/vaccines-or-no-vaccines-mask-and-distance/" target="_blank" rel="noopener noreferrer">comes to Nepal with a two-week lag</a>,  experts say, and predict the same scenario could play out again here with the present surge.“Newer strains, and mutations are nothing abnormal but we have to continue to mask up and vaccinate. As for the new surge, it is peaking at the moment and it will have subsided by end-July,” predicts Sameer Dixit at the Centre for Molecular Dynamics.The Centre is leading Covid-19 gene sequencing in Nepal, and it worked with the Nepal Health Research Council, Birat Nepal Medical Trust, Liverpool School of Tropical Medicine and Oxford to study 1,800 Covid-19 samples collected from all over Nepal in the past year. The findings will be released soon, and could reinforce the importance of genetic sequencing in Nepal so scientists can predict the behaviour of the next variant.Nepal is also a part of the largest Covid-19 recovery study, currently being undertaken in the UK which has come up with significant findings, including the use of some steroids in the treatment of coronavirus diseases.But the fact that the new strains are milder does not discount the inherent correlation between health and the economy. Even the best health care systems can collapse as seen in Sri Lanka. Moreover, <a href="https://www.nepalitimes.com/banner/state-sponsored-economic-crisis-2/" target="_blank" rel="noopener noreferrer">we now have record inflation</a> brought on by the Russian invasion of Ukraine, which has made healthcare even more unaffordable for most Nepalis.“Nepal with its limited resources and government indifference needs to be even more prepared for a health crisis, which often spells disaster for those unable to afford treatment,” cautions epidemiologist Lhamo Yangchen Sherpa.She adds: “The new surge may look mild, but it is always better to be over-prepared than under-prepared.”

1. Mask Up. 2. Avoid Crowds. 3. Get Boosters

<figure><img width="960" height="640" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101148/63720ee29c7e80680e0b7942jpeg.jpg" alt=""/><figcaption>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.</figcaption></figure>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 <a href="https://www.nepalitimes.com/here-now/omnipresent-omicron-starts-to-lose-its-edge/" target="_blank" rel="noopener noreferrer">may have run their course in the Subcontinent</a>, 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 <a href="https://www.nepalitimes.com/latest/from-pandemic-to-epidemic-to-endemic/" target="_blank" rel="noopener noreferrer">acute stage of the pandemic would end in 2022</a> 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 <a href="https://www.nepalitimes.com/latest/enlisting-female-health-volunteers-to-fight-covid-19/" target="_blank" rel="noopener noreferrer">grassroots health workers mobilised across the country</a> 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 <a href="https://www.nepalitimes.com/banner/vaccines-or-no-vaccines-mask-and-distance/" target="_blank" rel="noopener noreferrer">masking up</a> 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 <a href="https://www.nepalitimes.com/latest/no-more-pcr-for-nepal-passengers/" target="_blank" rel="noopener noreferrer">removed mandatory PCR test</a> 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.”

Not over till it's over

<img width="1808" height="1251" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101144/63720e8e9c7e80680e0b7926jpeg.jpg" alt=""/>One month after <a href="https://www.nepalitimes.com/opinion/comment/ukraines-lessons-for-sandwiched-nations-like-nepal/" target="_blank" rel="noopener noreferrer">Russia’s invasion of Ukraine</a>, the fallout of the war on global fuel prices threatens to derail Nepal’s aviation and tourism sector which was finally reviving after two years of the Covid pandemic.
Nepal Oil Corporation (NOC) has raised prices for petrol and diesel at filling stations several times, but it is aviation turbine fuel (ATF) that has seen the steepest hike.
International airlines serving Kathmandu which had already seen some booking cancellations due to the Ukraine war are now paying double the rate for refuelling their planes at Kathmandu airport.
ATF cost in Kathmandu has risen steeply from $715 per kilolitre in June last year to nearly $1,500 after the latest NOC price hike on 17 March (see graph). 
But the NOC appears to be passing on the rising import bill for petroleum products to its customers, while keeping its profit margins intact. The <a href="http://noc.org.np/" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=http://noc.org.np&amp;source=gmail&amp;ust=1648181914714000&amp;usg=AOvVaw2vxZrc3-FmibmlA9NtNpz7">state-owned monopoly’s own website</a> shows that the profit it makes from <a href="http://noc.org.np/fortnightly" target="_blank" rel="noopener noreferrer" data-saferedirecturl="https://www.google.com/url?q=http://noc.org.np/fortnightly&amp;source=gmail&amp;ust=1648181914714000&amp;usg=AOvVaw30xV_D5k1K3ycFpKU14IgA">ATF sold to airlines has risen</a> from Rs23.92 per litre inJanuary to Rs67.93 this week.
The NOC’s overall fortnightly losses have also soared from Rs1.83 billion to Rs4.66 in that same period. It is clear that NOC is compensating for its losses from petrol, diesel and LPG sales at fuel stations by doubling the price it charges airlines in order to subsidise Nepali customers.
NOC officials have justified the <a href="https://www.nepalitimes.com/business/petroleum-price-hike-3/" target="_blank" rel="noopener noreferrer">price hike</a> saying that the fuel needs to be transported in tankers from the Indian border, and the hike in diesel prices has added to the cost of ATF in the international market.
However, the price of aviation fuel at Indian airports was only $900 per kilolitre — which is $600 less than in Kathmandu. 
Nepal’s domestic airlines, which were <a href="https://www.nepalitimes.com/here-now/pokhara-will-be-a-game-changer/" target="_blank" rel="noopener noreferrer">seeing a boom</a> since the Omicron wave started to subside earlier this year, have passed on the added cost to passengers with a hefty fuel surcharge. 
However, it is medium and long haul operators to Kathmandu like Singapore Airlines, Korean Air, Turkish Airlines, Qatar Airways, Himalaya Airlines and Nepal Airlines which have been hit hardest. Airlines have started flying in on full tanks only topping up in Kathmandu to save on fuel costs. 
Read also: <a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/ukraine-climate-and-nepal/" target="_blank" rel="noopener noreferrer">Ukraine, Climate, and Nepal</a>, Sonia Awale
A Boeing 777 or Airbus 330 on a 7-hour flight from Kathmandu to Incheon or Istanbul, for instance, burn 40 tons of fuel at a cost of $75,000. That cost will now soar, but airlines cannot raise prices on pre-booked tickets.
“Because of the rise in passenger demand we were thinking of increasing our frequency to daily flights, but with this kind of fuel cost it is just not feasible,” says one Kathmandu-based international airline executive. “Aviation fuel prices have gone up everywhere, but in Kathmandu it is 50-90% higher than any other Asian airport.”
NOC first raised its price of aviation fuel steeply to $1,095 on 2 March after the Russian invasion sent international oil prices sky high. It then raised it to $1,295 on 4 March, and again hiked it to $1,495 on 17 March. 
Brent crude prices had dropped somewhat last week, but with Russian counter sanctions against oil and gas supplies to European countries and the spectre of a long-drawn war of attrition in Ukraine, it again climbed above the $120 per barrel mark.
Some US states have legislated to temporarily waive taxes on fuel to stabilise gas prices at filling stations and reduce burden on consumers. Nepal also has heavy taxes on all petroleum products, but it cannot afford to reduce the levee at a time when it faces budgetary pressures, a spiralling trade deficit, and plummeting foreign exchange reserves. 
To be sure, Nepal is not alone in being hit by volatile oil prices because of Russia’s invasion of Ukraine, and <a href="https://www.nepalitimes.com/here-now/ukraine-crisis-hits-nepal-economy-hard/" target="_blank" rel="noopener noreferrer">the entire economy is affected</a> — not just the aviation sector. However it could not have come at a worse time, just as the country’s tourism was starting to show signs of revival after two years of Covid closure.
Several European tour operators have cancelled bookings to Nepal at the last moment. The crisis has coincided with the start of the peak trekking and mountaineering season, and a large Ukrainian expedition to Mt Everest has been cancelled. The number of climbers who had booked Himalayan peaks is expected to go down by half.
More than 1 million people depend directly on <a href="https://www.nepalitimes.com/latest/nepal-reopening-for-tourists/" target="_blank" rel="noopener noreferrer">Nepal’s tourism industry</a> and they have been without income for more than two years because of the pandemic. There was considerable optimism that Spring 2022 would see a revival, but those hopes have been dashed. 
There have been other indirect impacts from rising energy prices in Nepal, with electricity rationing this week along industrial corridors in the Tarai. As the dry season flow of Himalayan rivers reduces generation capacity, demand this week outstripped supply by 600MW. 
The Nepal Electricity Authority (NEA) was meeting this shortfall with imports from the Indian grid, but on Tuesday and Wednesday it was outbid by other purchasers. Most of India’s electricity is generated from coal and diesel powered plants, and this has nearly doubled the price of peak power imports from India to INR13 per unit on Wednesday.
Read also: <a href="https://www.nepalitimes.com/latest/what-does-defending-europe-mean/">What does ‘Defending Europe’ mean?</a>, Slavoj Žižek

Sky high fuel price hits Nepal’s tourism, airlines

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101144/63720e899c7e80680e0b7923jpeg.jpg" alt="" width="1400" height="933"/><figcaption>Photo: ANTONIO BELTRÁN RODRÍGUEZ</figcaption></figure>Daily wage labourers Dharma and Gita lost their jobs during the pandemic. The young couple exhausted their meagre savings in less than a month, after which they started to buy food on credit. Still unable to repay loans, they limited their diet to one small meal a day.Soon, Gita started feeling weak. She often had a fever and cough. As the lockdown extended, her health deteriorated and the medicines were of little help. The couple even took a PCR test which came out negative. They visited five different health centers and bought bags full of medicines. The treatment was so expensive they had to sell their two cows. A month later, and heavily in debt, she was diagnosed with tuberculosis.Tuberculosis mainly afflicts the poorest. The numbers are staggering: one in every three people globally is infected by Mycobacterium tuberculosis, and even if they carry the bacteria most people do not get sick unless their immune system is weakened due to disease or malnutrition.And yet, this easily preventable and curable biblical disease thrives in Nepal and the Subcontinent due to inadequate measures taken to prevent, diagnose and treat the infection.A 2020 National TB Program report revealed that over 100,000 people are living with tuberculosis in Nepal. This figure is much higher than previously estimated but has most likely increased since as many patients have been unable to access treatment during the pandemic.Of these cases, 40,000 patients were not diagnosed or treated at government centres, which means nearly one in every two people were not diagnosed. Oftentimes, people reach standard TB treatment and care after months or even years. Their pathway to cure is complex, long and include misdiagnosis leading to unnecessary prescriptions. This in turn could lead to unnecessary death and suffering. Patients are also ostracised by friends and families, resulting in self-isolation from communities.These challenges are exacerbated by Nepal’s limited health infrastructure. Health care centres are understaffed and poorly managed, maintenance of laboratory equipment, as well as supply of quality chemicals for tests, are erratic.Across Nepal’s Tarai, settlements are overcrowded, people live in extreme poverty, hygiene and sanitation are at a bare minimum. In the hills and the mountains, difficult geographical terrain and poor road networks pose obstacles for people seeking health care.These deeply-rooted structural inequities collectively resulted in magnified impact on TB service delivery during the pandemic. As a result, we observed increased deaths from the disease.In 2018, global leaders committed to reducing TB by 2022. To meet this goal, we need comprehensive intervention programs with sufficient investment for prevention, early diagnosis and treatment. There are four key areas that require increased funding to decrease TB fatalities:1 PreventionWe saw how the world community got together to rapidly develop vaccines for Covid-19 with unprecedented funding and resources. TB on the other hand has only one vaccine and a very weak one at that. Developed over a century ago, BCG does not prevent adults from developing TB disease.UnderNepal's national TB program, young children living with adults who have TB are provided medicines to kill any TB bacteria they have inhaled and prevent the development of the disease. The Birat Nepal Medical Trust for the first time in Nepal is providing a shorter 12-dose course of TB preventative medicine to adults infected with the bacteria to stop them from getting sick and spreading the disease.In 2020, only $684 million of the estimated $2.16 billion needed globally for TB research and development was available from donors. Covid-19 on the other hand received over $100 billion in just two years to develop vaccines. The pandemic exposed this global inequity, and is proof of what sufficient funding and political commitment can achieve.If funding for the global TB prevention program is increased by 3-4 fold, we could design better community-based services, develop a more effective vaccine and promote shorter treatment regimens, all of which will achieve a TB-free Nepal sooner.TB awareness and health promotion messages also do not get as much coverage in the media as they used to. World TB Day, observed every year on 24 March, should serve as a reminder that TB is an epidemic and needs accelerated efforts for elimination.2 Diagnosis and InnovationGovernment health centres provide TB diagnosis and treatment free of cost. Yet, people spend a lot of money and time before they are correctly diagnosed and enrolled in treatment. This is because symptoms of the disease are common to many infections. People develop cough and fever and immediately resort to taking paracetamol and general antibiotics before realising that they have TB.Moreover, Nepal needs to quickly adopt GeneXpert machines which use PCR testing, and chest X-ray that diagnoses early-stage TB effectively and efficiently. Investment should be concentrated to expand, strengthen and maintain these diagnostic tools at health centers all over the country. Health care providers should be similarly trained to operate these machines.GeneXpert technology should be deployed with active case finding where community health workers make home visits to screen and identify TB patients. This method also commonly known as contact tracing was applied in containing the spread of the Covid-19 virus, and has been used in TB programs for decades.Although proven to be effective, new diagnostic technologies are expensive and active case-finding strategies require large and sustained financial commitments. One might question if a country like Nepal can afford such investments. But the question we should be asking is, can we afford not to?The costs of the continued TB epidemic are far greater than the investments required to reduce it. Investing in better  tools including tax waivers on the import of TB diagnostic machines and test kits, and increased global funding for implementation of active case finding strategies for low and middle-income countries like Nepal are urgently needed.3 Community-based Treatment and Care Incomplete or delayed treatment can cause drug resistant TB and even death. Therefore, the treatment of tuberculosis should be patient-centred.TB programs have been implemented in Nepal for over half a century, we now have plenty of experience to employ the best strategies and  to eliminate the scourge.One of the challenges to eradicating TB is the long duration of treatment. Under the DOTS program, tuberculosis patients have to visit health centres daily for medication to be taken in the presence of care providers. But this could expose them to other TB patients, and resulting stigma. It is also time-consuming and comes with additional transport expenses.Investment in research and development of shorter course treatment regimens, and scaling up telemedicine is a priority area.4 Social Protection TB and poverty form a vicious cycle, each fuelling the other. It is mainly the neediest in society who are most affected. Having TB increases financial strain in their families with far-reaching socio-economic consequences. Children may have to forgo education and seek employment to compensate for the loss of income in families with an infected adult. Providing cash to families after the diagnosis will alleviate the financial burden.TB also causes malnutrition making people more vulnerable. Providing diversified food packages with appropriate nutritional value will be a big support, it will also help reduce the mental stress of fulfilling family needs.But these are just a few recommendations, a study to identify feasible and acceptable support for people with TB will enable us to design an improved tuberculosis support program. These should incorporate health education to people with TB and their families to better understand the disease, cope with its treatment and overcome stigma.Ultimately, it is the government’s responsibility to protect the lives of its people. Therefore, investing in and incorporating locally appropriate social protection schemes within the TB program should be the key agenda and priority of policymakers.The slogan this World TB Day today on 24 March is ‘Invest to End TB. Save Lives’, which reiterates the need to increase funding to prevent, diagnose and treat TB. Without substantial investments that will accelerate collective efforts of the community, country and the world, it is unlikely we will win the fight against TB, reverse the huge setback caused by the pandemic or save lives.Kritika Dixit is the Research Manager at Birat Nepal Medical Trust (BNMT) and a doctoral student at Karolinska Institutet, Sweden. Rajan Paudel is the Research Associate at BNMT.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101144/63720e8c9c7e80680e0b7924jpeg.jpg" alt="" width="80" height="109"><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101144/63720e8d9c7e80680e0b7925jpeg.jpg" alt="" width="82" height="109">Read also: <a href="https://www.nepalitimes.com/banner/for-nepal-a-game-changer-in-tb-control/">For Nepal, a game-changer in TB control</a>, Buddha Basnyat and Maxine Caws

Pandemic eclipses Nepal's TB epidemic

<img width="2048" height="1282" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101144/63720e1d9c7e80680e0b78fcjpeg.jpg" alt=""/>While many countries <a href="https://www.nepalitimes.com/latest/nepal-reopening-for-tourists/">lift mask mandates and coronavirus restrictions</a>, Hong Kong and China are reeling from an Omicrons surge. Britain, the US and some parts of Europe are seeing a new spike in cases. In Nepal, the <a href="https://www.nepalitimes.com/here-now/omnipresent-omicron-starts-to-lose-its-edge/">public is determined to believe</a> that the worst is over. But there is a danger that China's Omicron surge will bring out a new variant. Hong Kong's Centre for Health Protection, Department of Health has urged all residents to avoid non-essential travel. The territory may soon impose a lockdown, just as China has isolated entire provinces. The surge in China and Hong Kong has been attributed to low natural immunity because of the zero-Covid strategy, the relative inefficacy of Chinese vaccines to Omicron, and the emergence of the Omicron BA.2 sub-variant.Meanwhile cases of a new hybrid strain that is as transmissible as Omicron and as serious as Delta, dubbed the 'Deltacron', has broken out in the United States and Europe.The WHO warned this week that the world is “only half-way” through the pandemic, and although news of <a href="https://www.nepalitimes.com/here-now/ukraine-crisis-hits-nepal-economy-hard/">Russia’s invasion of Ukraine</a> has overshadowed Covid-19, the virus is still spreading in unpredictable ways.Given all this, it may be prudent for Nepal not to lift all vaccine restrictions just yet. Masks and avoiding crowds must still be enforced to spread a future surge. Even though, as we have seen in the last two years, new variants can easily come in <a href="https://www.nepalitimes.com/latest/nepal-on-high-alert-for-omicron/">from travelers and spread in the community</a>.Read also: <a href="https://www.nepalitimes.com/latest/the-story-of-nepals-first-covid-19-fatality/">The story of Nepal’s first COVID-19 fatality</a>, Laxmi BasnetA number of European countries have relaxed restrictions and several states of the US have moved to eliminate mask mandates after a new guideline by the Centers for Disease Control and Prevention (CDC). The hope is that the pandemic is giving way to an endemic. An endemic has been described by the CDC as a ‘constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area’. "We're almost there, it is now the beginning of the end, at least in the UK," Prof Julian Hiscox at the University of Liverpool told the BBC recently. "I think life in 2022 will be almost back to before the pandemic.” CDC director Rochelle Walensky echoed this, saying earlier this year that the pandemic is likely to become endemic in the US and around the world. Virologist Ian Jones of the University of Reading in the UK also said recently: “There is now no doubt that Omicron is attenuated and taking as a step toward endemicity”. Medical historians argue that most pandemics last between two and a half to three and a half years. Without a clear explanation and vaccination, the <a href="https://www.nepalitimes.com/opinion/remembering-a-pandemic-100-years-ago/">1918 Spanish pandemic</a> that infected one-third of the world’s population and claimed over 50 million lives fizzled out in 1919. An analysis suggests that the Omicron variant has now changed the shape of the global pandemic and this is likely to lead to the 'endemic world'. Chris Murray of the University of Washington takes the fact that despite the surge in infections, hospitalisation and fatality rates are still low as indication that we are now entering an endemic phase.Stephen Kissler at the Harvard T H Chan School of Public Health has been quoted as predicting: “Omicron will soon become endemic much like flu." Read also: <a href="https://www.nepalitimes.com/editorial/survive-revive-thrive/">Survive, revive, thrive</a>, EditorialWhat is puzzling scientists is why Hong Kong’s fatality rate is so high, while Omicron has not killed people at the same rate elsewhere. The risk of reinfection from Omicron is estimated to be 5–fold higher and this poses a danger to the high risk groups, elderly and to those not yet infected.Epidemiologists warn that the worst may yet to come of new variants emerge from the spread in China. Spreading to other parts of the world not yet infected to Omicron, this could have a devastating effect. Nevertheless, turning back the pages of the history of pandemics, we have seen that viruses naturally mutate and slowly evolve into an endemic phase that circulates at more manageable levels. The 1918 <a href="https://www.nepalitimes.com/editorial/preparing-for-a-no-normal/">influenza strain may never have disappeared, and continued to mutate and circulate</a> to this day. What we need to develop and adopt is <a href="https://www.nepalitimes.com/banner/why-is-there-vaccine-hesitancy-in-nepal/">sustainable coping strategies, including vaccinations</a>. What are critically missing and paying least attention to is social interventions such as behavioural change, communication for mask wearing and avoiding crowds for the near future.Medical historians also agree that the pandemic ends socially before it ends medically. And proof of that is Nepal, where mot people seem to think that they no long have to worry about the pandemic. What if the virus has decided not to enter an endemic phase just yet?Mohita Upreti is Journalism student at St. Xavier's College, she regularly contributes to the College’s monthly newsletter - The Xavierian Chronicles.Read more: <a href="https://www.nepalitimes.com/banner/why-is-there-vaccine-hesitancy-in-nepal/">Why is there vaccine hesitancy in Nepal?</a> Sonia Awale

From pandemic to epidemic to endemic

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101140/63720d5e9c7e80680e0b78bdjpeg.jpg" alt="" width="1226" height="773"/><figcaption>Photo: NEPALI TIMES ARCHIVE</figcaption></figure>Travellers to Nepal now do not need to present previously mandatory PCR-RT test results to be granted entry into the country. The latest regulations released by the Department of Immigration and confirmed by international airlines say arriving passengers only need proof of vaccination.The provision of hotel quarantine has also been scrapped. Only those unable to present vaccination proof will need a PCR negative result, but the regulations say visitors must abide by health protocols including wearing masks in public and maintaining physical distance irrespective of vaccination status.Passengers will still need to fill out their <a href="https://www.nepalitimes.com/latest/ccmcs-serious-infringement-of-citizen-privacy/" target="_blank" rel="noopener noreferrer">CCMC forms</a> and get a digital QR code and show it at the health desk on arrival at Kathmandu airport.Outgoing passengers, however, need to abide by the regulations in the destination country as well as the rules set by airlines, which vary widely.The decision comes a week after Kathmandu Valley removed all Covid-19 restrictions due to a sharp decline in the number of daily new cases, and the positivity rate. <a href="https://www.nepalitimes.com/here-now/omnipresent-omicron-starts-to-lose-its-edge/" target="_blank" rel="noopener noreferrer">The Omicron variant</a> which is thought to be the dominant strain circulating in the region is also largely mild, keeping hospitalisation figures low in Nepal.On Friday, there were 77 new Covid-19 cases against 7,981 PCR and RDT tests. There was only one fatality nationwide. The figure for active cases across the country is also down to 5,212 whereas a total of 189 individuals recovered in the last 24 hours. Nepal recorded 10,052 new cases on 20 January, it’s highest, during <a href="https://www.nepalitimes.com/here-now/3rd-wave-in-2-years/" target="_blank" rel="noopener noreferrer">the third wave</a>.The easing of the restriction has come as a respite for tourism entrepreneurs and operators who have suffered heavily in the past two years due to the pandemic. Nepal's spring trekking and mountaineering season has already started and there were 16,000 tourists entering the country in February, about one-tenth of pre-pandemic figures for that mounth, but still higher than in February 2021.At least 1 million Nepalis depend on <a href="https://www.nepalitimes.com/editorial/survive-revive-thrive/" target="_blank" rel="noopener noreferrer">the tourism sector</a> which makes up nearly 8% of the GDP. Before the outbreak of the coronavirus crisis, the government had declared 2020 Visit Nepal Year with a target of bringing in 2 million tourists.However, the figures dropped to 230,085 in 2020 and further down to 150,962 in 2021 due to travel restrictions, lockdowns and <a href="https://www.nepalitimes.com/banner/call-to-ease-entry-of-tourists-to-nepal/" target="_blank" rel="noopener noreferrer">complicated entry provisions</a> when the country was periodically open for travellers.Heavy losses incurred during the pandemic forced many star hotels and restaurants to shut down. But perhaps the hardest hit are trekking porters and guides who depend on seasonal income during spring and autumn.Initial projections estimated that it will take <a href="https://www.nepalitimes.com/latest/nepal-tourism-may-take-5-years-to-recover/" target="_blank" rel="noopener noreferrer">five years for the industry to pick up</a> and tourists to return to pre-pandemic levels, but tour operators are optimistic with more businesses opening up and expanding with services geared towards adventure and nature tourism, which is expected to take off in the post-Covid world.Health experts have also predicted the pandemic to end in 2022 with equitable distribution of vaccines and access to treatment, further normalising the situation. But perhaps the biggest reassurance for the industry is the <a href="https://www.nepalitimes.com/latest/all-vaccines-prevent-severe-covid/" target="_blank" rel="noopener noreferrer">increasing rate of vaccination</a> in and outside the country.A total of 62.5% of Nepal’s population has been fully inoculated while 74.5% have taken at least one dose. The figure for a booster dose is however low at 5.2%. Even so, Nepal is still on the travel red list of many European countries, the US, and Australia.

No more PCR for Nepal passengers

One smoggy winter morning in February 2019, Ekta regretted coming to her sculpture class. It was the first day of her period, and the 19-year-old wished she was home, curled up in bed with a hot water bag to soothe her cramps.
Her class was at Kalapremi Ceramic Studio, a dark room on the ground floor of a house in Maharajganj, and Ekta’s teacher was the artist Gopal Das Shrestha ‘Kalapremi’, a noted sculptor.
Two other students were already there, using all their muscle strength to knead the sculpting clay. Ekta, now 24, recalls how Kalapremi asked her if she was feeling all right. She avoided him, as she did not want everyone to know she was menstruating.
Kalapremi repeatedly asked Ekta what was wrong. She finally muttered that she was having her period, after which he grabbed her hand and led her to a partitioned corner of the studio and sat her on a chair. Before she could stop him, he slid his hand under her dress, and started massaging her abdomen.
“I was horrified,” Ekta recalls. “I told him to stop, but he didn’t listen, asking me not to be shy, saying he knew how to relieve my pain. He stopped only after I protested furiously.”&nbsp;
The art tutor then said, “You’re like my daughter. I’m doing it out of love to make you feel better, but you’re so stubborn.”&nbsp;
“Instead of saying sorry he acted like I was the one having crazy thoughts,” remembers Ekta, adding that from April 2016 to August 2020 beginning the time she was 16, the artist sexually abused and harassed her on several occasions. &nbsp;
Now, Ekta and the artist’s other former students are finally sharing their experiences and some are pressing legal charges against him, hoping that others do not have to endure what they did.&nbsp;
Award-winning artist and teacher Gopal Das Shrestha ‘Kalapremi’ (the name means ‘Art Lover’) is known for his ceramic art, sculpture, and contemporary pottery. He was <a href="https://nepalitimes.com/review/the-house-of-kalapremi">profiled in Nepali Times after a collaborative exhibition</a>, ‘Where the Wild Things Are’ at the Siddhartha Art Gallery three years ago.&nbsp;
His pieces, titled Gaalis, featured sculpted female figures with the heads of dogs, sheep, and donkeys (pictured) to depict derogatory terms for women. Some critics said the collection was a satire on feminists.
Kalapremi started his artistic and teaching career in 1983 and over the years taught at Bhanubhakta School, Kathmandu University School of Arts, Lalitkala Campus and at his private Kalapremi Ceramic Studio. He has also lectured at Jeonju University in South Korea and recently at Tabor Academy in the United States.
Seven of Kalapremi’s former students were interviewed for this story. Five female students said he touched them inappropriately in his studio or at Kathmandu University. Two male students said they witnessed him abuse and harass the women. In all cases, the students struggled to recognise the abuse when it occurred, and the lack of reporting systems left them to cope on their own for years.&nbsp;
Earlier this year, students shared a social media post hinting at Kalapremi’s history of abusive behaviour following which more students of the artist reached out sharing similar experiences. Some students spoke of abuse that happened as long as 20 years ago.
Kalapremi, 60, has denied the allegations. He told Nepali Times: “Some years ago, there was a movement encouraging people to hug and kiss. I used to do it purely out of friendship and love. But after seeing posts on social media last year calling out my behaviour, I realised my actions may have hurt some people. I understand now that I should have been more mindful.”
He added: “I am also an auxiliary health worker, so I know the exact points to massage to relieve menstrual pain. It’s not just menstruation, I take anyone who is ill to the hospital.”
Sexual abuse is much more rampant than reported given how difficult it is to prove it in court. The law defines sexual abuse as occuring when someone touches another’s private parts, coerces them into touching theirs, uses vulgar language, shows degrading images, or behaves indecently towards them without consent.&nbsp;
Ekta and her fellow students are consulting lawyer Suneeta Regmi Pokhrel, who says they know that even if the court decides in their favour, it is difficult to survive after speaking up, and influential men defend themselves saying they are being framed.&nbsp;
“They are in a lot of pain and weep when recalling how he abused them,” Regmi Pokhrel told us. “They are angry and have filed a case against him, but they are also terrified. They know he is a powerful man and they have seen how our society treats women who speak up against abusers. Unless people speak up, perpetrators will be emboldened.”
Art and academia in Nepal simply reflect the power imbalances in society where people with intersecting identities experience worse forms of abuse. Theatre actors Raj Kumar Pudasaini, Rajan Khatiwada, and Sunil Pokhrel were called out during the #MeToo movement in the Nepali theatre scene in 2019. Even after the allegations Pokhrel went on to receive national awards, while others continued to work without repercussions.
“If you speak up against abusers, you gradually get sidelined from projects,” explained a theatre artist who wished anonymity fearing professional setbacks. “The theatre scene in Nepal is quite small, you just have to make peace with the perpetrators and work with them if you want to sustain yourself.”&nbsp;
In academia there is a history of faculty members sexually harassing students and getting away with it. After Tribhuvan University (TU) lecturer Krishna Bhattachan was accused of harassing women students, the university said it would follow Nepal’s sexual harassment law and set up a reporting mechanism. But nothing happened to the professor, who had already retired. Instead, he counter-accused the students of 'attacking the indigenous people’s movement with baseless allegations' as <a href="https://kathmandupost.com/letters/2019/01/29/bhattachan-responds">he told the Kathmandu Post in 2019</a>. He continues to be featured as a prominent speaker including at TU.
Other faculty members previously accused of sexual harassment include Jagadish Murti Koirala from TU, Bishnu Prasad Acharya from Ratna Rajya Campus, and Bodha Raj Tripathee from Lalitpur Madhyamik Vidhyalaya. A woman staff member from TU also filed a sexual abuse complaint against Dambar Chemjong from TU.
Prominent figures like <a href="https://nepalitimes.com/news/the-rise-and-fall-of-nims-purja">mountaineer Nims Purja</a> have been <a href="https://www.nytimes.com/2024/05/31/sports/mountaineering-sexual-harassment-abuse-nims-purja.html">accused of sexual assault</a>, and cricketer Sandeep Lamichhane, actor <a href="https://nepalitimes.com/news/celebrity-rape-case-spotlights-nepal-laws">Paul Shah</a>, and former speaker of Parliament <a href="https://nepalitimes.com/news/mahara-arrested">Krishna Bahadur Mahara</a> have been accused of rape, but society-at-large has let off the alleged perpetrators amdist a larger debate about justice for survivors and punishment of perpetrators.&nbsp;
‘Gaushala-26’ is the court name given to the 18-year-old who accused Sandeep Lamichhane, former captain of Nepal’s national cricket team and skipper of Biratnagar Kings in the <a href="https://nepalitimes.com/here-now/here-comes-the-nepal-premier-league">ongoing Nepal Premier League</a>, of rape. She left the country citing society questioning her character affecting her mental health while Lamichhane got an outpouring of support. In May, the Patan High Court overturned a prior verdict that found Lamichhane guilty of rape and had sentenced him to eight years in prison. During the 23-month legal battle to pursue justice, Gaushala-26 faced threats of gang rape and acid attacks.&nbsp;
Exhausted by the struggle, Gaushala-26 sought to “move to a new world” where she could live free without hiding her identity.
Actress Samragyee Rajya Laxmi Shah in an Instagram video now deleted detailed the harassment she faced from a filmmaker during a movie shoot. She did not name any name but veteran actor Bhuwan KC filed a defamation case against Rana, but the court ruled that the charge lacked sufficient evidence.&nbsp;
Former Kathmandu mayor <a href="https://nepalitimes.com/opinion/theytoo">Keshav Sthapit also mocked the #MeToo movement</a>, calling accusations against him by journalists Rashmila Prajapati and Ujjwala Maharjan “a rape of men’s rights”.
Serial Abuse
Back at the Kalapremi Ceramics studio, another former student, 24-year-old Rajiv, says he felt the need to speak out after seeing his female classmates being abused.&nbsp;
“He frequently kissed them on their cheeks,” he told Nepali Times. “Whenever they walked into the studio he flailed his arms like a child asking for a hug. They awkwardly hugged him from the side, but he pulled them closer, held their chin, and kissed their cheeks.”&nbsp;
Rajiv says he also saw Kalapremi pull the women’s bra straps, touch their breasts, and slap their buttocks. The young students would freeze, not knowing how to react, and if they protested, he would say it was “normal in art”. Rajiv, 19 at the time like his classmates, remembers thinking perhaps the well-respected artist was right after all.
Another student, Luna, who took lessons at Kalapremi’s studio from 2020 to 2022 did try to confront the tutor after he made an obscene proposal to her. She recalls: “One day when the other students had left the studio and it was just the two of us, he told me that God had given him special artistic talent and he could transfer those powers to me. But to do that both of us will have to be naked, inside a dark room, and have sex.”
Luna, who was 18 then, was livid and told him she did not want any of his powers, but she says he laughed at her as if he was joking. She did not tell her family about the incident because she thought no one would believe her.&nbsp;
“They were all in awe of this famous artist and felt I should be grateful that to be learning sculpting from him,” she says. “I was scared to be alone with him in case he talked about sex again. My coping mechanism was to be rude so he wouldn’t try to come close to me.”
Seeing how some classmates were standing up to Kalapremi, Ekta too tried to push back against his advances, but she said he found ways to coerce her. Since Ekta, Rajiv, and Luna could not afford Kalapremi’s Rs30,000 monthly fee for lessons, he had offered them all a stipend to assist him in the studio.
“He had spondylosis and took me to his therapy sessions to learn massage techniques, then he often made me and other students massage him,” says Ekta. Whenever she refused, he would feign pain to make her feel sorry for him. “He would insist that I put my hands under his shirt so that I could massage him better,” she adds.
The art tutor often tried to “seduce sympathy” from Ekta by sharing how he had never been loved as a child and was “sexually frustrated” as an adult.&nbsp;
“At 7PM, he would pour himself Signature whiskey and immediately go off again about how he was sex-starved. I didn’t know how to respond. It took me time to realise alcohol was just an excuse to talk about sex,” Ekta says.
If convicted, Kalapremi could face financial penalty and/or a prison sentence of up to three years according to Section 224 of National Penal (Code) Act 2017.&nbsp;
Data suggests that victims of child sexual abuse on average take nearly 24 years to tell someone about their trauma, and some may never disclose it at all.&nbsp;
“In our culture, children are rarely taught about boundaries. They often react, show anger when adults pinch their cheeks. But adults insist they did it out of love, and force the children to accept it,” says Sita Lama, a psychotherapist at Manka Kura. “And even when someone touches them inappropriately they struggle to identify and verbalise it.”
When perpetrators claim to be “acting out of love”, Lama says survivors are likely to perceive it as something safe, rather than recognising it as abuse.&nbsp;
“It may take years for them to realise they were abused,” she explains. "And even when they become aware, the power imbalance with the abuser and the associated shame often prevents survivors from speaking up."
Other former students from the School of Art at Kathmandu University have also come forward years later, saying Kalapremi sexually abused them. As young adults, they felt his behaviour was off but were uncertain if it was inappropriate, illegal, or they did not know how to respond. After having understood that it was indeed abuse, they say they are speaking out now to protect others.&nbsp;
Amina Singh, a visiting faculty member at Kathmandu University, says there is no clause against sexual abuse in contracts of teachers, and there is no formal grievance handling mechanism for the students.&nbsp;
“So the only way students can to deal with sexual abuse is approach someone they trust,” she says.
Eight other former art students of Lalit Kala Campus and Srijana College of Fine Arts of Tribhuvan University and other private art studios in Kathmandu say they were also sexually abused by their art teachers. Three faculty members interviewed from these institutions said they saw the abuse, but felt it was futile to report it given how powerful the teachers were.
In the absence of a formal system, some longtime women artists warned each other about “problematic” artists. They shared &nbsp;a “heads-up” to be more cautious when collaborating with them, and avoided responding to their calls and texts after work hours.
To ensure art institutions are safe for all, galleries, museums, artist studios, and smaller art spaces need to develop policies on sexual harassment. This would include a code of conduct or studio policies that hold the leadership accountable and outline the principles of professional ethics.&nbsp;
Students and employees should inquire about accountability mechanisms for raising concerns, both formally and informally, advocates say.
Three years after Ekta left the ceramics studio, she learnt that Kalapremi had harassed many other women. Still trying to get a footing in the art industry, she attended a workshop in Kathmandu where women artists discussed ways to stay safe in the art sector.&nbsp;
Since it was a close-knit group Ekta opened up about how she felt violated and realised she was not alone, he had been abusing underprivileged students for years, and this was common knowledge among artists in Nepal.
Ekta says that even after she quit, Kalapremi continued sending her text messages like ‘I am thinking of you’, ‘Why have you stopped speaking with me’, or ‘I am waiting for your call’.&nbsp;
But what really forced her to act was when Ekta found out that he was sending similar texts to her younger sister.&nbsp;
“I’ve had enough,” she told us. “He abused me all these years but I won’t let him abuse my sister.” &nbsp;
Ekta, Rajiv and Luna are not the real names of the students.&nbsp;

‘Art Lover’ accused of sexual abuse

It was 8:15 in the evening of 25 March 1968 when everyone in the village of Batulechaur near Pokhara heard a deafening sound like thunder as a bright flashing object hurtled down to land in a field.&nbsp; That field belonged to Kul Timilsina, and the next morning he retrieved a sheet of metal about 2m by 1m and carried it home with the help of a few others, thinking it would be useful for his buffalo shed.&nbsp; Before he died at age 83 three years ago, Timilsina had told photo archivist Sunil Ulak that the black metal sheet was not rectangular and had rounded corners. There are a few witnesses still alive who have a clear recollection of the object that fell from the sky that night.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014.jpg" data-media-id="editor_0" data-image-id="2024120707128_75cc85aac56b9cc4a77366471f058d7b3eb6868776811b0923845c2d0a61f014" data-rendition-name="original" width="1170" height="601" loading="lazy" alt="UFO over Pokhara"> <figcaption>The field in Batulechaur belonging to Kul Timilsina where fragments of a flying object fell from the sky in 1968.</figcaption> </figure>  One of them is Timilsina’s wife Gyanu, who was 22 at the time. She had been at home, and remembers hearing the big bang and the sky becoming very bright. “We saw the thing in the field in the morning,” she told us. “It looked like a lid, a covering of some sort. The way it was stuck in the ground, it must have fallen from the sky. We thought we could use it to dry clothes on, and took it home.”&nbsp; Another witness is Kul Narayan Paudel. “I was only eight then. We ran to the field to see what had fallen. It was a four-sided metal sheet. The elders took it away, and I don't know what happened to it.” &nbsp; Ram Bahadur Baniya, a teacher at the local school, says he had heard the sheet had been brought to the school, and later handed over to the Zonal Commissioner at the time, Nanda Prasad Malla. “But that is all hearsay,” he says.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54.jpg" data-media-id="editor_1" data-image-id="2024120707128_0bf207a12063fb8155b3c8d9a00a94887b126380c9e0627527c84cf5e1101f54" data-rendition-name="original" width="1170" height="610" loading="lazy" alt="UFO over Pokhara"> <figcaption>Gyanu Timilsina, wife of Kul Timilsina.</figcaption> </figure>  There are two versions of what happened to Kul Timilsina’s metal sheet. One is that an American Peace Corp Volunteer teaching at the nearby Bindyabasini School took it, and another is that it was handed over to the government. Recently declassified Central Intelligence Agency (CIA) and US State Department documents from the time say that the US Embassy in Kathmandu tracked down the object two years later and had it shipped back to the US. A telegram from the Department of State and Department of Defense tagged as ‘MOON DUST / Space Fragments’ dated 1 March 1972 stated: ‘1. Restored space fragment will be on board Embassy support flight 115 arriving Kathmandu on or about March 10. Fragment is packed in shipping crate (cargo no. 72-33365) marked in care of DAO.&nbsp; 2. State and Defense representatives examined fragments prior to shipment finding restoration acceptable.’  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df.png" data-media-id="editor_2" data-image-id="20241207071212_929d903ee06d41baa4f6040e981cd7c7d7bd75cc9c37c9b617d307fc8538d2df" data-rendition-name="original" width="856" height="568" loading="lazy" alt="UFO over Pokhara"> <figcaption>Declassified CIA documents about the investigation into the object sighted in Pokhara. </figcaption> </figure>  The documents show that the US government, military and intelligence agencies investigated this incident thoroughly when it occurred, and have continued to revisit it ever since, as recently as five years ago. What is even more intriguing is that the object that fell in Pokhara was not the only unidentified space object that fell to earth that year. There were similar sightings of objects falling from the sky in Ladakh, Sikkim and Bhutan between 19 February and 25 March 1968.&nbsp; These mysteries were the subject of a CIA investigation in 1968 titled ‘<a href="https://www.cia.gov/readingroom/docs/CIA-RDP81R00560R000100070007-8.pdf">Sighting of Unidentified Flying Objects in Ladakh, Nepal, Sikkim and Bhutan</a>’, and the report is part of the recent online declassification of 800,000 top-secret documents from the period.&nbsp; &nbsp;Although unidentified flying objects (UFOs) have a connotation now of being alien craft, it could be pieces of satellite, missile, rocket or even aircraft. The CIA report documents six sightings in 1968 and quotes local sources as describing all of them having similar characteristics: bright blue or red streaks in the sky accompanied by loud sounds like lightning and thunder and objects falling to the ground. Aside from the metallic object that was found in Batlechaur, there were other items also found nearby in Tallakot, Tureypasal, Armalakot and Maidan. Whatever the object was, it seems to have disintegrated even before it hit the ground.&nbsp; The CIA report records the first sighting on 19 February 1968 in various parts of Sikkim and Olangchung Gola and Ghunsa in eastern Nepal. The light was said to be ‘long and thin’ and giving out ‘green and red light’. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb.png" data-media-id="editor_4" data-image-id="20241207071212_c3c825027d966a2aedc846970390eebe063957503c7eacc8e01e0517843f9bbb" data-rendition-name="original" width="892" height="596" loading="lazy" alt="UFO over Pokhara "> </figure>  Two days later on 21 February, a soundless blue object was seen traveling fast across the sky above Thimphu in Bhutan. Then on 4 March there were multiple daytime sightings or white streaks in the sky at Chang La Pass, Fukche and Koyul in Ladakh. There were more sightings in Ladakh on the very day fragments fell near Pokhara on 25 March 1968.&nbsp; After the sightings in Pokhara, rumours started flying in Kathmandu that these were aliens trying to land on Earth, it could be Russian or Chinese spy planes or satellites, and some even say it as a sign from heaven that the end of the world was near. This was at the height of the Cold War. The Russians and Americans were testing their thermonuclear devices as well as intercontinental ballistic missile delivery systems. The Washington-Beijing rapprochement had not yet happened, and China was making quick progress testing atomic bombs. Within two years after its first atomic test, in 1966 China exploded its first hydrogen bomb at the Lop Nur site in Xinjiang, 3,000km to the north from Nepal. After neary six decades, what is still intriguing is that all the sightings within a few months of each other in 1968 were along the Himalayan arc bordering Tibet: from Bhutan, Sikkim Nepal, to Ladakh. The US military intelligence seems to have concluded that this was not a coincidence and there were frequent research trips to the site in Pokhara by American officials in the months after the incident. With the help of the Royal Nepal Army, the region north of Pokhara was thoroughly searched.&nbsp; A confidential memo dated 25 June 1968 by Jerry C Trippy to a ‘Mr Farley’ mentions that the US Air Force’s Foreign Technology Division had decided that the debris could be important because it may be related to a Chinese missile test or a Soviet ‘Vehicle Venik’ rocket.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe.jpg" data-media-id="editor_5" data-image-id="20241207071216_feb5425692dc36b20187de4e4fcc2ce9fd12b6d9e1b8724398e50bcdbf9032fe" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="UFO over Pokhara"> </figure>  On 28 August 1968 the US Embassy in Kathmandu sent a letter to Washington DC saying that the object could be of Soviet origin, possibly from when the rocket carrying the ‘Kosmos 208’ satellite re-entered the atmosphere. But why were the fragments falling to earth several weeks apart, and in the same region? No one knows where the metal sheet that Kul Timilsina recovered is now. It was definitely packed in a crate and taken to the US, and although it is rumoured that it was returned that is not very likely. Archivist Sunil Ulak heard from the Timilsina family that CIA officials had returned to the site five years ago. &nbsp; Interest in UFOs peaked in the US in the 1950s, with the Cold War space race and tests of atomic weapons and delivery rockets. CIA and scientists were being sent to investigate sightings, both publicly and privately. Could the Pokhara fragments as well as the sightings in Ladakh and Bhutan actually be alien craft falling to earth? The renewal in interest in space travel in large part due to Elon Musk’s SpaceX, UFOs and sightings are again subjects of public interest.&nbsp; Even 57 years later, even if there was definitive proof about whether the Batlechaur fragment was from a Chinese missile or a soviet rocket, it has not been made public in documents declassified so far. We may never know.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598.jpg" data-media-id="editor_6" data-image-id="20241207071216_b6938795f40731e7657fd6dcbb3cf460a326186a15eb11d4f832f602201ff598" data-rendition-name="original" width="642" height="320" loading="lazy" alt="UFO over Pokhara"> </figure>  Sunil Ulak speculates if the debris actually came from an American aircraft, perhaps on an intel mission upon China. “Which could explain why they were so thorough in collecting the fragments in Pokhara,” he says. But that still does not explain the multiple sightings weeks apart in 1968.&nbsp; Indeed, US military aircraft were at that time flying frequent night-time missions from air force bases in India to supply weapons to Khampa guerrilla camps in Nepal located north of Pokhara in Mustang. It could very well be that the Chinese shot down one such aircraft. The other sightings could have been contrails of US spy planes, or Chinese anti-aircraft missiles.&nbsp; There were quite a few developments regarding UFOs in 2024. In a US congressional hearing in July, former intelligence officer David Grusch claimed that the government had long been involved in a program to investigate and retrieve non-human craft crashes, and then try to reverse engineer them. However Grusch did not show any evidence.&nbsp; The UAP Disclosure Act of 2024 was signed into law by Joe Biden in December 2023. It plans to oversee the public disclosure of UFO information. However, there is a clause in it that prevents disclosure if it would cause threats to military defense, intelligence operations or foreign relations.&nbsp; It is unlikely that the declassified documents about sightings in the Himalayan will cause any real surprise about definite evidence of alien life even if it was found. It seems humanity will continue, at least for now, to wonder about curious lights in the sky and whether there is anybody out there.&nbsp;

UFO over Pokhara

When Rastriya Swatantra Party (RSP) president Rabi Lamichhane was arrested in October on charges of defrauding depositors of cooperatives, the party’s vice president Swarnim Wagle gifted him Fareed Zakaria’s book, Age of Revolutions.
Since then, Lamichhane has been shunted around from Kathmandu to Pokhara to Chitwan and back to Pokhara to attend police investigations and court proceedings. He was being flown to Birganj via Kathmandu on Buddha Air on Monday. There is another pending case in Janakpur.
Human rights groups and civil society have criticised the government for hounding Lamichhane with inhumane treatment that borders on physical torture. The two parties in the coalition, Nepali Congress (NC) and the UML, see Lamichhane’s RSP as a potentially formidable challenge to their power.
Even if the fraud charges against Lamichhane are true, the Nepali public is increasingly looking at the government’s actions through the police and courts as political vendetta.
Despite all the travelling, sometimes by plane and often by road at night, Lamichhane appears to be in high spirits, waving to supporters who often gather if they know he is going to be driven around. A social media video shows him giving high fives to fellow passengers on a recent flight to Pokhara.&nbsp;
In the past weeks, streets in Pokhara have erupted with parallel protests by Lamichhane’s supporters as well as depositors of cooperatives who lost their savings to the scam.&nbsp;
Although family visits are allowed, prison officials in Pokhara told Nepali Times that not many people visit Lamichhane these days. He added, “When he does get visitors, he asks them to bring him books.”
Lamichhane is currently Nepal’s most high-profile public figure in custody, and highlights the stark difference between how influential prisoners are treated compared to ordinary inmates.
There are six prison cells at Kaski District Police Office’s two-story detention centre, three on each floor. And while authorities pack prisoners into already overcrowded cells, Lamichhane has an entire room on the second floor to himself.&nbsp;
He has also been allowed to call his family every few days. Other prisoners are not permitted phone calls except for emergencies.
Meanwhile, Lamichhane’s former business partner Chhabilal Joshi, an ex-Deputy Inspector General of Police with whom he established his Gorkha Media Network, is in custody under the same charges in the prison cell next to him.
Lamichhane is accused of siphoning off depositors' money to the tv network in which he was part-owner and anchor. &nbsp;
Both Lamichhane and Joshi are able to buy food from the police canteen instead of being served the regular meal like other prisoners. Joshi has also given his statement to authorities in Rupandehi and Kathmandu for his alleged role in the scam. Lamichhane is yet to be presented in Kathmandu for questioning.
While he was in custody at the Kathmandu District Police Complex, Joshi expressed his desire to sleep in a police officer’s office, reportedly assuring authorities that he would not run away and he was entitled to certain facilities as a former officer of the law.
“He seemed to be under the impression that he is still a police officer,” says a source at the Kathmandu District Police. “We made it clear to him that as someone accused of a crime, he was not entitled to special treatment.”
Former ministers Balkrishna Khand and Top Bahadur Rayamajhi, and ex-home secretary Tek Narayan Pandey, who were arrested in connection with the fake refugee scam last year, were similarly housed in the offices of law enforcement officials instead of prison cells. Khand has since been released after six months in jail.
While there is no legal provision to keep high-ranking officials in separate detention centres when they are arrested, authorities granting them special facilities is not uncommon. Law enforcement officials say VIP detainees expect preferential treatment while in police custody.
Among those is former Kosi Province minister Lila Ballav Adhikari, who was arrested from Biratnagar on 10 November over his alleged involvement in human trafficking and brought to Kathmandu. Adhikari had flown to Japan without government approval with three individuals on 29 October to attend a cultural conference, but had been sent back to Nepal from Narita.&nbsp;
His three companions were arrested at Kathmandu airport upon their arrival, but Adhikari was able to exit unscathed from the VIP lounge. Adhikari had resigned as the Kosi Province Minister for Internal Affairs and Law when it became public that his companions had been taken into custody, and was himself arrested shortly after. He has since been cleared by the courts.
Throughout his detention, Adhikari was kept separately from other inmates. Senior Superintendent of Police (SSP) Basant Rajouri, head of the Bhadrakali complex, says that while there is no separate detention area for VIPs, some detainees are kept separately depending on the nature of their crime.
However, sources say that arrangements were made for retired judges and others to visit Adhikari frequently worked at the office of a Deputy Superintendent of Police (DSP) during his time in custody.&nbsp;
“He used to constantly pester the authorities to let him sit outside in the sun, and to be able to use the police officer’s shower area,” added an officer.
Adhikari was released on 25 November after the government prosecutor’s office decided not to charge him in a move that was seen to expose the government’s double standards.
Over at Kathmandu’s Dilli Bazar Prison, former Kist Bank CEO Kamal Gyawali emerges from his prison cell into the courtyard of the prison’s ‘Ka (क)’ block every morning with a thick book in his hands, ready to give his daily sermon.
With his long beard, Gyawali, who is serving a prison sentence for banking fraud, looks the part of a religious guru as he implores his rapt listeners to “walk the right path, abandon bad thoughts and turn to scripture and spirituality”.&nbsp;
Afterward, the attendees gather to discuss politics and current affairs. Inmates at his daily sermons at the prison include other high-profile detainees, including former MP Ichchha Raj Tamang, who is in jail for money laundering and cooperatives fraud, former joint secretary Chudamani Sharma, who was convicted of corruption, as well as NC leader Chandra Bahadur Lama and Krishna Bahadur Upreti of the UML both of whom are on trial for embezzling billions of rupees.
Victims of the cooperatives scam that former lawmaker Tamang was involved in have made trips to the prison and requested visits, but he has refused to meet with any of them.
“Tamang often complains that the state has prevented him from returning the money to the victims by locking him up,” says a police officer at the Dili Bazar jail.
“All you hear every day from the VIP prisoners is that they have been framed,” adds the officer. “No one admits that they were involved in misdeeds.”
But while most high-profile prisoners complain about prison conditions, one exception is former provincial lawmaker Deepak Manange, who is serving a sentence at Dilli Bazar Jail for attempted murder.
“He is the happiest prisoner here,” says a warden. “Unlike the others, he doesn’t claim to have been framed, in fact he doesn’t seem to care that he is in prison.”
Manange is detained in the ‘Kha (ख)’ block of the prison complex, which he renovated at his own expense. The block previously housed female prisoners, but Manange used his influence to transfer them elsewhere. He faces no shortage of visitors, who range from political leaders to people from the underworld.
Along with Manange, other well-known prisoners in this block include Nepal Telecom Managing Director Sunil Poudel, and former executive director of the Surakshan Printing Centre Bikal Poudel, who are serving time for corruption.
Former prisoners at Dilli Bazar prison include ex-ministers Khum Bahadur Khadka and Shyam Sundar Gupta, NC leader Ganesh Lama, Maoist MP Balkrishna Dhungel, Nagarik Unmukti Party leader Resham Chaudhary, as well as former IGs Ramesh Chand Thakuri, Om Bikram Rana, and Hem Bahadur Gurung.
Section 54 of Nepal’s Prison Act assigns each prison’s internal administration the
responsibility of governing its prisoners, which means the more favourable the jail management is, the more comfortable it is for prisoners.
Dilli Bazar prison has been the prison of choice for many high-ranking prisoners, especially those convicted of white collar crimes, due to its more accommodating administrators. The prison, which has the capacity to house 700 inmates, is also less crowded than other jails.
Anuj Bhattarai, spokesperson of the Department of Prison Management, says that there is no legal classification in Nepal for felons to be assigned prisons based on the nature of their crimes.
“That Dilli Bazar Jail has a higher number of prisoners convicted of crimes like corruption is most likely a coincidence,” says Bhattarai. “There is no provision for influential people to be able to choose where they will be incarcerated.”&nbsp;
Translated by Shristi Karki from the Nepali original published in himalkhabar.com

What Nepal’s VIP prisoners do in jail

If you were raised in Nepal, you must have picked up its unique set of vocabulary: आन्दोलन, चक्का जाम, बन्द, राँके जुलुस, आफ्नो मान्छे, हाम्रो दल, कर्फु and many more words connoting political protest.
We became familiar with the acrid smell of burning tyres, and eyes smarting from tear gas. And yet, everyone speaks of another revolution in the making. Not by desire, but by suffocation.
We heard speeches about नयाँ नेपाल, but the New Nepal never arrived. The governance system changed, but it did not reflect on people’s lives — except for those close to centres of power. The state is still unreachable and is not bothered about <a href="https://nepalitimes.com/here-now/matter-of-life-and-debt">victims of loan sharks</a>, cooperative scams and other injustices.
Politicians continue to speak in sound bites, but fail to deliver. They have mastered the game of pointing fingers towards an external enemy and convincing people that they are never at fault. The political narrative is so disconnected from the actual analysis of the problem that suffocation doesn’t go away after every revolution.
No genuine effort has been made to deliver at all, which is why there is a palpable sense of disillusionment in the air forcing us to seek another revolution, even if Nepal may not be able to afford it.
How has the current system successfully held power, even if the public is deeply frustrated? How is it that for three decades we continue to be led by the same faces, who have time and again, proved to us that they may be great politicians but not national leaders?
<a href="https://nepalitimes.com/opinion/improving-internet-governance-in-nepal">My experience at the epicentre of politics</a> has led me to identify three cultures that have enabled political parties to keep a tight hold on power: acceptance, silence and dependency.
We accept things the way they are. We use fatalistic phrases like “नेपालमा यस्तै हो” or “नेपालको कानुन दैब जानुन”. While this resilience enables us to rise back up from devastating calamities, it is also a reason for our compliance with the status quo.
Despite so many ‘revolutions’ that have led to significant reforms, these phrases keep getting reinforced, to the point that the upcoming generations have made it their lingo.&nbsp;
This acceptance is not a symbol of law-abiding citizens, but citizens living in fear of those in power, unable to ask the whys and why-nots.
Innovation suffocates in this culture of acceptance of the status quo. This is manifested in remarks like “but we don’t have any laws for this,” or “we don’t have the capacity to implement this”. An innovator or entrepreneur therefore has to spend that energy to become a political lobbyist, often educating and convincing the bureaucracy.&nbsp;
Remember when locally assembled <a href="https://nepalitimes.com/banner/designed-and-made-in-nepal">Yatri motorbikes</a>, despite having willing customers, had to suffer to secure license numbers because of a lack of regulations? Instead of creating new laws, the government kept chanting the “We will promote Nepal-made goods” mantra, leaving entrepreneurs in a labyrinth of bureaucracy. The weight of acceptance of the law lies heavily on innovators. Fatalism is a tactic used by those in power to generate mass fear in society.
When we accept, we become silent. This is a pervasive phenomenon. We are trained to keep quiet, lest we ruffle feathers, burn bridges, or not get the help we need in future. We know, yet we don’t speak.
Read also: <a href="https://nepalitimes.com/here-now/bureaucratic-hurdles-in-researching-nepals-bureaucracy">Bureaucratic hurdles in researching Nepal's bureaucracy</a>, Daniel W Edwards
Here is one example: the 2021 census shows that the number of baby boys born for every 100 baby girls is 112. This is a clear indication of female foeticide because of boy preference in society.
Despite such horrifying realities, there is finger-pointing within the government between the Ministry of Health and Population with the Ministry of Home Affairs. At the citizen level, we know those who are involved in killing girls. Yet, we don’t speak up. The Nepal Medical Council reports state that despite this gender imbalance at birth, there is no indication of any action.
But why would anyone speak against one's own fraternity, no matter how vile the act is?
When we accept and keep quiet, we become dependent on those who yield power. From getting our government procedure completed on time to getting transfers, to accessing any of our legally protected rights as well, we are forced to depend on our networks of चिनेको मान्छे people we know by blood, village, relations, political affiliation.
The culture of dependency has been the established way in Nepal. If you drive a two-wheeler or four-wheeler, and you get into a small accident, you will be asked to sort it yourself, dialing up the most powerful person you know. It becomes a competition of who knows who.
Recently I was told that there were calls from the Ministry of Health and Population and another from the Prime Minister's Office for just one medical position in a private hospital. Each was pushing its own candidate. Guess which candidate got the position.&nbsp;
The dependency of people is not on the laws or the state, it is with people in power, a reliance on the network of somebody who knows somebody, including those not officially in power.
These cultures are deeply ingrained in our heads, and in society. Collectively they form a vicious circle that helps those in power to retain power. This is not the society we want to live in.
Then, what do we do as a collective to break away from this? How do we break away from the cultures of acceptance and silence that have created this dependency? What can we do to ensure that our children do not have to learn the jargon of आन्दोलन before they learn about the state?
These are the cultures political parties need to shed rather than use them to perpetuate their power. This is what <a href="https://nepalitimes.com/opinion/comment/an-alternative-to-alternative-politics-in-nepal">alternative politics</a> needs to be about.
Sumana Shrestha is a member of Parliament’s Education, Health and Information Technology parliamentary committee and represents the Rastriya Swatantara Party.

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