<figure><img width="780" height="520" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b921a9c7e80680e06f12cjpeg.jpg" alt=""/><figcaption>HAPSA Nepal and White Grain Foundation team assemble home isolation kits for distribution in rural nepal. Photos: HAPSA NEPAL</figcaption></figure>Even as the Nepal’s Covid-19 second wave appears to be cresting, and many hospitals do not have to turn away patients anymore, there are still at least 80,000 active cases across the country, most them isolating at home often without proper medical consultation.The pandemic is also <a href="https://www.nepalitimes.com/latest/in-nepal-virus-climbs-from-plains-to-mountains/" target="_blank" rel="noopener noreferrer">spreading rapidly in villages</a> across Nepal’s remote districts, where there is not much testing being done and no medical care for the severe cases. There is an urgent need to ensure essential healthcare and hygiene products to local communities and infected people.This is where the non-profit Health Advancement Programs to Serve All (HAPSA) Nepal and the White Grain Foundation have stepped. They are distributing home isolation kits in more than 20 municipalities in the remotest parts of Nepal in Jajarkot, Khotang, Baglung, Gulmi and Sindhupalchok districts.The money was mainly raised via a crowdfunding campaign on the <a href="https://www.gofundme.com/f/help-nepal-fight-covid19-support-hapsa-nepal" target="_blank" rel="noopener noreferrer">GoFundMe platform</a>. The project is a brainchild of Ramu Kharel, and HAPSA Nepal and has received $50,000 so far through hundreds of donors. The German non-profit Impact Week, Nepal Rising in the US, and Pasa Puchah Guthi UK are also supporting the cause. Students from the local Nawa Asha Griha school sewed the first 100 kits.   <figure><img width="780" height="585" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b921d9c7e80680e06f12djpeg.jpg" alt=""><figcaption>Local in Galkot Rural Municipality, Baglung receiving the home isolation kits items and receiving training on how to use them. </figcaption></figure>“Currently we are on a mission to deliver 20,000 home isolation kits across the country. They are distributed by the concerned municipality to affected households,” says Kharel, whose team works directly with mayors and local representatives to distribute the kit. He adds: “We value partnering with the local government and building the government’s capacity to serve its people. That is why our work is done in partnership with the municipal administration.” Kharel works as an emergency medicine physician in the United States and has been in Nepal for the past three months. In collaboration with <a href="https://www.nepalitimes.com/latest/vaccines-are-the-only-solution/" target="_blank" rel="noopener noreferrer">the Covid Alliance for Nepal</a>, his team has also been actively involved in providing training to isolation centres, medical professionals, frontline doctors, and clinical care providers. Kharel’s team had also been conducting meetings with mayors across the country to find out the kind of technical or material need the group could help with to counter the surge of <a href="https://www.nepalitimes.com/latest/rural-nepal-fights-back-covid-19/" target="_blank" rel="noopener noreferrer">Covid-19 cases in the villages</a>.In the course of our conversation with the mayor of Dhangadi, Nripa Odd, it became clear that one immediate point of intervention was encoring the large population of folks coming in from the district and from India to isolate at home for as long as possible," says Kabita Parajuli of the Covid Alliance for Nepal. "With that in mind, some quick brainstorming yielded the isolation kit idea. The municipality's enthusiasm and use of local resources was also instrumental in getting this off the ground."  The kit includes a pulse oximeter, thermometer, at least 25 surgical masks, medications that are important during home isolation, sanitiser and soap, as well as a brochure on what to do and not to do while isolating at home. The brochure includes a video with detailed instructions on how to use the kit. <figure><img width="780" height="547" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b92209c7e80680e06f12ejpeg.jpg" alt=""><figcaption>Contents of the home isolation kits, including pulse oximeter and thermometer. </figcaption></figure>Presently there are 77,858 active cases in Nepal. 5,860 of them are undergoing treatment in various hospitals across the country with 1,261 in ICU and 382 requiring ventilator support.On Thursday, Nepal recorded 3,749 new confirmed cases, with 5,293 having recovered. There were 59 fatalities in the last 24 hours. Kathmandu registered record low new infections at 540. Lalitpur and Bhaktapur have 125 and 99 new cases.“Eighty per cent of those infected with the coronavirus are managed at home or at an institutional isolation centre. We have started providing home isolation kits to facilitate the process and reduce the burden in hospitals,” says Aman Bhattarai from HAPSA’s strategic partner <a href="https://www.impactweek.net" target="_blank" rel="noopener noreferrer">Impact Week</a>.The team recently delivered its first batch of home isolation kits to Shankharapur Municipality, Sindhupalchok, where HAPSA has been working on health advancement for more than 10 years.“We very much appreciate this support from HAPSA, the kits will be crucial in our battle against coronavirus in the region,” says the Mayor of Shankharapur Municipality Subarna Shrestha. <figure><img width="780" height="520" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109121140/636b92239c7e80680e06f12fjpeg.jpg" alt=""><figcaption>Ramu Kharel of HAPSA Nepal training locals on how to use pulse oximeter at Shankarapur Municipality in Sindhupalchok.</figcaption></figure>, Once a household has recovered, local recipients are expected to return the pulse oximeters to the municipality which are them re-distributed to other isolation centres or local health facilities, according to HAPSA Nepal president Pankaj Bhattarai. Says Kharel: “Each kit costs nearly $20, and for the goal of 20,000 Home Isolation Kits, we need to raise nearly $400,000. Funding for this important work is our biggest bottleneck right now.” Interested individuals can <a href="https://www.gofundme.com/f/help-nepal-fight-covid19-support-hapsa-nepal?utm_campaign=p_cp_url&amp;utm_medium=os&amp;utm_source=customer" target="_blank" rel="noopener noreferrer">GoFundMe</a> or by visiting the HAPSA Nepal <a href="http://www.hapsaglobe.org" target="_blank" rel="noopener noreferrer">website</a>.

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2020’s tips for 2021

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181148/636be8269c7e80680e087841jpeg.jpg" alt="" width="747" height="600"/><figcaption></figcaption></figure>As <a href="https://www.nepalitimes.com/here-now/pandemic-stress-grips-nepals-journalists/" target="_blank" rel="noopener noreferrer">part of my job as a journalist</a>, I have interviewed many in the past months who were seriously sick with Covid-19. On all those occasions, at the back of my mind was always the fear that I myself might be infected one day.Our work takes us to the <a href="https://www.nepalitimes.com/latest/nepals-journalists-are-also-on-the-frontlines/" target="_blank" rel="noopener noreferrer">frontlines of this pandemic</a>. When the lockdown was imposed, I started working out of my home in Butwal. Regardless, I had to travel to nearby regions to report. And while I tried to follow all the necessary safety measures, I never really found out where I caught the coronavirus.The infection hits patients with varying degrees of intensity. Some show severe symptoms, while others have milder ones, followed by a quick recovery. Mine were mild, and did not last long. I have since recovered.I experienced those 15 <a href="https://www.nepalitimes.com/latest/kathmandu-homes-and-hotels-turn-into-hospitals/" target="_blank" rel="noopener noreferrer">days of isolation</a> were different for me. As a journalist, I was constantly exposed to how the news, social media interactions and conversations with friends can affect the morale of those infected. It was on the day of <a href="https://www.nepalitimes.com/latest/rani-pokhari-open-for-bhai-tika/" target="_blank" rel="noopener noreferrer">Bhai Tika</a> on (16 November, 2020) that I started feeling lethargic and weak. By evening, I was running a slight temperature. This was not unusual, I often had fevers and they passed.But these were extraordinary times, and I suspected it might be the dreaded coronavirus. So, I isolated myself at home.I took a paracetamol and managed to get some sleep, but at 3AM I was wide awake with 37.3° fever. This was not high, but I had a hard time going back to sleep.In the morning, I went to Lumbini Regional Hospital in Butwal for <a href="https://www.nepalitimes.com/latest/why-nepal-lags-in-covid-19-testing/" target="_blank" rel="noopener noreferrer">PCR test</a>. At around 4PM, I received my report. I was confirmed Covid-19 positive.I had been preparing myself for it mentally, so I took it well. I had no other symptoms besides fever. Once I took a paracetamol, my fever would go down, but it would return every six hours. This went on for three days.I found my CT (cycle threshold) value to be at 14, which is considerably low, so I visited the hospital to get further tests done. The reports came back normal. After the third day I no longer had fever, but a blocked nose.But it was after Day 6, that I started to experience a sore throat. Gargling with salt water and hot water steaming with a dash of sancho twice a day, helped gradually reduced the cold and the soreness by Day 8.I had heard about how a positive mental attitude builds up physical immunity. From the beginning of isolation, I was careful not to let external factors influence me. I removed Facebook and Twitter from my phone, stopped checking online portals to keep myself away from news about Covid-19 deaths.I had noticed that negative news made me anxious. It made me sweat profusely and I had difficulty breathing. Because my oxygen saturation level was normal at 97, I was clearly overthinking. It was my exposure to media that was affecting my physical recovery.So, I tried my best to forget about my circumstance by watching travel and environmental documentaries. I listened to folk music and positive discourses. I took in the sun.I asked my wife to forward to me any positive news she came across. Politician Chitra Bahadur KC’s recovery, and news about <a href="https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/" target="_blank" rel="noopener noreferrer">successful vaccine trials</a> gave me hope.Throughout my career, I have heard people complain that journalists only report negative news. As a Covid-19 patient in isolation, I realised how true this is.Positive news is like the oxygen for those who are trying to recover from the coronavirus. Positive thoughts can be half the cure.While recovering, there were many who tried to give me advice. Not all of it reassuring. “Can’t say anything with coronavirus, even the healthiest have died just like that,” said one friend. Another called to say: “You should have had severe symptoms, but you seem normal.”Take it from me: trust only the experts.Doctors confirm that the <a href="https://www.nepalitimes.com/latest/dont-take-covid-19-lightly/" target="_blank" rel="noopener noreferrer">impact of the virus is stronger in people with weaker immunity</a>. Many acquaintances have been severely affected. But because I was conscious about my diet and fitness, it seems I was able to fight back. More importantly, I was mentally prepared.It has been a week since I tested negative, but my health is still not back to what it used to be. I feel lethargic and listless, and cannot concentrate on work. But I am getting there because to be negative you have to be positive.Mukesh Pokhrel is the Himal Khabarpatrika and Nepali Times reporter based in Nawalparasi, covering the environment and development.

Staying positive to become negative

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109191116/636bef1f4b0ad905ca02ef8ajpeg.jpg" alt="" width="747" height="600"/><figcaption></figcaption></figure>As <a href="https://www.nepalitimes.com/here-now/pandemic-stress-grips-nepals-journalists/" target="_blank" rel="noopener noreferrer">part of my job as a journalist</a>, I have interviewed many in the past months who were seriously sick with Covid-19. On all those occasions, at the back of my mind was always the fear that I myself might be infected one day.Our work takes us to the <a href="https://www.nepalitimes.com/latest/nepals-journalists-are-also-on-the-frontlines/" target="_blank" rel="noopener noreferrer">frontlines of this pandemic</a>. When the lockdown was imposed, I started working out of my home in Butwal. Regardless, I had to travel to nearby regions to report. And while I tried to follow all the necessary safety measures, I never really found out where I caught the coronavirus.The infection hits patients with varying degrees of intensity. Some show severe symptoms, while others have milder ones, followed by a quick recovery. Mine were mild, and did not last long. I have since recovered.I experienced those 15 <a href="https://www.nepalitimes.com/latest/kathmandu-homes-and-hotels-turn-into-hospitals/" target="_blank" rel="noopener noreferrer">days of isolation</a> were different for me. As a journalist, I was constantly exposed to how the news, social media interactions and conversations with friends can affect the morale of those infected. It was on the day of <a href="https://www.nepalitimes.com/latest/rani-pokhari-open-for-bhai-tika/" target="_blank" rel="noopener noreferrer">Bhai Tika</a> on (16 November, 2020) that I started feeling lethargic and weak. By evening, I was running a slight temperature. This was not unusual, I often had fevers and they passed.But these were extraordinary times, and I suspected it might be the dreaded coronavirus. So, I isolated myself at home.I took a paracetamol and managed to get some sleep, but at 3AM I was wide awake with 37.3° fever. This was not high, but I had a hard time going back to sleep.In the morning, I went to Lumbini Regional Hospital in Butwal for <a href="https://www.nepalitimes.com/latest/why-nepal-lags-in-covid-19-testing/" target="_blank" rel="noopener noreferrer">PCR test</a>. At around 4PM, I received my report. I was confirmed Covid-19 positive.I had been preparing myself for it mentally, so I took it well. I had no other symptoms besides fever. Once I took a paracetamol, my fever would go down, but it would return every six hours. This went on for three days.I found my CT (cycle threshold) value to be at 14, which is considerably low, so I visited the hospital to get further tests done. The reports came back normal. After the third day I no longer had fever, but a blocked nose.But it was after Day 6, that I started to experience a sore throat. Gargling with salt water and hot water steaming with a dash of sancho twice a day, helped gradually reduced the cold and the soreness by Day 8.I had heard about how a positive mental attitude builds up physical immunity. From the beginning of isolation, I was careful not to let external factors influence me. I removed Facebook and Twitter from my phone, stopped checking online portals to keep myself away from news about Covid-19 deaths.I had noticed that negative news made me anxious. It made me sweat profusely and I had difficulty breathing. Because my oxygen saturation level was normal at 97, I was clearly overthinking. It was my exposure to media that was affecting my physical recovery.So, I tried my best to forget about my circumstance by watching travel and environmental documentaries. I listened to folk music and positive discourses. I took in the sun.I asked my wife to forward to me any positive news she came across. Politician Chitra Bahadur KC’s recovery, and news about <a href="https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/" target="_blank" rel="noopener noreferrer">successful vaccine trials</a> gave me hope.Throughout my career, I have heard people complain that journalists only report negative news. As a Covid-19 patient in isolation, I realised how true this is.Positive news is like the oxygen for those who are trying to recover from the coronavirus. Positive thoughts can be half the cure.While recovering, there were many who tried to give me advice. Not all of it reassuring. “Can’t say anything with coronavirus, even the healthiest have died just like that,” said one friend. Another called to say: “You should have had severe symptoms, but you seem normal.”Take it from me: trust only the experts.Doctors confirm that the <a href="https://www.nepalitimes.com/latest/dont-take-covid-19-lightly/" target="_blank" rel="noopener noreferrer">impact of the virus is stronger in people with weaker immunity</a>. Many acquaintances have been severely affected. But because I was conscious about my diet and fitness, it seems I was able to fight back. More importantly, I was mentally prepared.It has been a week since I tested negative, but my health is still not back to what it used to be. I feel lethargic and listless, and cannot concentrate on work. But I am getting there because to be negative you have to be positive.Mukesh Pokhrel is the Himal Khabarpatrika and Nepali Times reporter based in Nawalparasi, covering the environment and development.

<figure><img width="2048" height="1364" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181140/636be6219c7e80680e08778bjpeg.jpg" alt=""/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>Going by the Ministry of Health figures, Nepal’s Covid-19 pandemic has peaked, and the number of daily cases, the positivity rate and the number of active cases are all going down. The recovery rate now exceeds 90%. Is Nepal turning the corner on the pandemic? Experts say no. The number of fatalities is at an all-time high. There were 29 deaths reported each on Monday and Tuesday, taking the total to 1,538. And the reason the daily case rate is lower is because the government is conducting fewer tests, there is virtually no official contact tracing, and active cases are at home and going to hospital only when they are really serious. These are ideal conditions for community spread. “The fact that the fatalities are increasing, especially in Kathmandu, won’t allow us to say that fewer people are getting infected. This coronavirus isn’t going anywhere just yet,” explains Sher Bahadur Pun of the Ministry of Health. “Yes, the positivity rate has gone down, but the government has also more or less stopped contact tracing.” Since the government started charging for RT PCR tests and hospital admissions, patients and their families are reluctant to have tests despite symptoms, and do not want to go to hospital. The rates have remained high because <a href="https://www.nepalitimes.com/banner/heat-map-of-nepals-covid-19-hotspots/" target="_blank" rel="noopener noreferrer">those infected during Dasain-Tihar</a> are developing symptoms. The current marriage season is another super-spreader event.   There are 77 hospitals and labs across the country conducting an average of  9,000 PCR tests a day, which went down from a daily total of 15,000 after the government directive to charge Rs2,000 for PCR tests in public facilities. The positivity rate went down, which is a good thing – but it happened for the wrong reason. In October a quarter of people tested came out positive, it is now down to 15% despite the onset of the winter season.   “The risk cannot be underestimated based on numbers of infected people by reducing tests itself at a time when increasingly more people are getting sick or dying of coronavirus,” says infectious diseases specialist Pravat Adhikari. “This argument would be valid only if the infection rate goes down despite an increase in total tests. However, very few tests are being conducted at the moment.” In fact, such hidden positives lead to more unidentified Covid-19 deaths, adding to the risk. It is reckless of the government to still not launch low-cost PCR tests with quick results, adds Adhikari. <figure><img width="2340" height="1216" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109181140/636be6249c7e80680e08778cjpeg.jpg" alt=""><figcaption>Total Covid-19 cases from January 23 until 1 December in Province 2 and in Bagmati province. Source: MINISTRY OF HEALTH</figcaption></figure>The problem is further exacerbated by unmanaged home isolation, and quarantine cases. According to the Ministry of Health, 10,741 people across seven provinces are self-isolating at home, often without much resources or knowledge on how to manage their condition.Ideally, asymptomatic or mildly symptomatic <a href="https://www.nepalitimes.com/latest/kathmandu-homes-and-hotels-turn-into-hospitals/" target="_blank" rel="noopener noreferrer">people self-isolating at homes</a> should have a separate room and a bathroom. Patients should confine themselves in their rooms, wash their own utensils, wear masks while going to the toilet and sanitise it after use and wipe touch points with disinfectant.  Individuals need to keep track of their temperature and symptoms, measure oxygen saturation level if possible, take paracetamol for body ache and fever and make sure to eat nutritious food. One must be aware of danger signs: oxygen level below 93, chest pain, difficulty in breathing and blue tint to lips and limbs.But most families who have members in home isolation do not have this information, or live in such crowded quarters that it is impossible to fulfil all precautions. Conflicting directives from the government haven’t helped.At one point, overwhelmed with the surge of Covid-19 cases in Kathmandu, the Ministry of Health spokesperson Jageswar Gautam advised people live on television to go to hospital only if they feel faint. By then it is too late because it means the patient’s oxygen saturation is already dangerously low.The government has left the people to their own devices, and ignored expert advice on <a href="https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/" target="_blank" rel="noopener noreferrer">increasing the number of beds in wards with basic oxygen supply</a> instead of spending money on ICUs and ventilators."When I tested positive for coronavirus and had slight difficulty breathing, I called a government health expert for advice, and he himself dissuaded me from going to a public hospital," says Rajendra Dahal, Editor of the magazine Shiskyak. “This is why the death rate is going up, while the positive totals are going down. People are at home, and their oxygen levels are falling, and they have no idea. The main point is that the people have lost their trust in the government health system.”The chief consultant at the Infectious Diseases Hospital in Teku Anup Bastola agrees that the risk has been heightened because health experts are unaware about the actual condition of people isolating at homes. “Nepalis have a tendency to not visit hospitals until it’s too late. We have found that this is even more true for coronavirus,” he says. With much of the 2020 overshadowed by the pandemic and its impact on all the sectors, young people wanting to get back to their lives are now ignoring the signs and symptoms, preferring not to voluntarily test in case they might have to isolate for two weeks.Even according to government figures, the number of people testing positive in Kathmandu Valley is not going down. With the marriage season, and people intermingling indoor in banquet halls, the surge is not expected to subside. At Pashupati Aryaghat, there are five times more <a href="https://www.nepalitimes.com/latest/with-3rd-covid-19-fatality-nepal-issues-funeral-guideline/" target="_blank" rel="noopener noreferrer">cremations</a> happening compared to the same period last year, according to reports. It is not clear how many of these extra deaths are due to Covid-19.The movement of the younger people has had a <a href="https://www.nepalitimes.com/here-now/spared-at-first-elderly-hit-hard-by-covid-19/" target="_blank" rel="noopener noreferrer">direct impact on the elderly</a>, as they take home the virus and make parents and grandparents seriously sick. People in their sixties and above now make up over 60% of Covid-19 fatalities in Nepal.Even without the added risk of coronavirus, senior citizens are prone to <a href="https://www.nepalitimes.com/latest/covid-19-will-get-worse-before-it-gets-better/" target="_blank" rel="noopener noreferrer">pneumonia and other chronic respiratory illness in winter</a>. Public health experts advise being alert in regards to their condition even before they complain of symptoms and keeping communication channels open.Says Sher Bahadur Pun: “These are extraordinary times and we need to take extraordinary measures to protect the more vulnerable among us. <a href="https://www.nepalitimes.com/latest/vax-populi/" target="_blank" rel="noopener noreferrer">Until we get a vaccine</a>, we must realise our responsibility in containing the virus and not become a medium for more deaths.”

Why Nepal’s Covid-19 figures are deceptive

<figure><img width="2048" height="1364" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110919118/636bed424b0ad905ca02eed4jpeg.jpg" alt=""/><figcaption>Photo: MONIKA DEUPALA</figcaption></figure>Going by the Ministry of Health figures, Nepal’s Covid-19 pandemic has peaked, and the number of daily cases, the positivity rate and the number of active cases are all going down. The recovery rate now exceeds 90%. Is Nepal turning the corner on the pandemic? Experts say no. The number of fatalities is at an all-time high. There were 29 deaths reported each on Monday and Tuesday, taking the total to 1,538. And the reason the daily case rate is lower is because the government is conducting fewer tests, there is virtually no official contact tracing, and active cases are at home and going to hospital only when they are really serious. These are ideal conditions for community spread. “The fact that the fatalities are increasing, especially in Kathmandu, won’t allow us to say that fewer people are getting infected. This coronavirus isn’t going anywhere just yet,” explains Sher Bahadur Pun of the Ministry of Health. “Yes, the positivity rate has gone down, but the government has also more or less stopped contact tracing.” Since the government started charging for RT PCR tests and hospital admissions, patients and their families are reluctant to have tests despite symptoms, and do not want to go to hospital. The rates have remained high because <a href="https://www.nepalitimes.com/banner/heat-map-of-nepals-covid-19-hotspots/" target="_blank" rel="noopener noreferrer">those infected during Dasain-Tihar</a> are developing symptoms. The current marriage season is another super-spreader event.   There are 77 hospitals and labs across the country conducting an average of  9,000 PCR tests a day, which went down from a daily total of 15,000 after the government directive to charge Rs2,000 for PCR tests in public facilities. The positivity rate went down, which is a good thing – but it happened for the wrong reason. In October a quarter of people tested came out positive, it is now down to 15% despite the onset of the winter season.   “The risk cannot be underestimated based on numbers of infected people by reducing tests itself at a time when increasingly more people are getting sick or dying of coronavirus,” says infectious diseases specialist Pravat Adhikari. “This argument would be valid only if the infection rate goes down despite an increase in total tests. However, very few tests are being conducted at the moment.” In fact, such hidden positives lead to more unidentified Covid-19 deaths, adding to the risk. It is reckless of the government to still not launch low-cost PCR tests with quick results, adds Adhikari. <figure><img width="2340" height="1216" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022110919118/636bed454b0ad905ca02eed5jpeg.jpg" alt=""><figcaption> </figcaption></figure>The problem is further exacerbated by unmanaged home isolation, and quarantine cases. According to the Ministry of Health, 10,741 people across seven provinces are self-isolating at home, often without much resources or knowledge on how to manage their condition.Ideally, asymptomatic or mildly symptomatic <a href="https://www.nepalitimes.com/latest/kathmandu-homes-and-hotels-turn-into-hospitals/" target="_blank" rel="noopener noreferrer">people self-isolating at homes</a> should have a separate room and a bathroom. Patients should confine themselves in their rooms, wash their own utensils, wear masks while going to the toilet and sanitise it after use and wipe touch points with disinfectant.  Individuals need to keep track of their temperature and symptoms, measure oxygen saturation level if possible, take paracetamol for body ache and fever and make sure to eat nutritious food. One must be aware of danger signs: oxygen level below 93, chest pain, difficulty in breathing and blue tint to lips and limbs.But most families who have members in home isolation do not have this information, or live in such crowded quarters that it is impossible to fulfil all precautions. Conflicting directives from the government haven’t helped.At one point, overwhelmed with the surge of Covid-19 cases in Kathmandu, the Ministry of Health spokesperson Jageswar Gautam advised people live on television to go to hospital only if they feel faint. By then it is too late because it means the patient’s oxygen saturation is already dangerously low.The government has left the people to their own devices, and ignored expert advice on <a href="https://www.nepalitimes.com/here-now/when-will-nepals-covid-vaccine-turn-come/" target="_blank" rel="noopener noreferrer">increasing the number of beds in wards with basic oxygen supply</a> instead of spending money on ICUs and ventilators."When I tested positive for coronavirus and had slight difficulty breathing, I called a government health expert for advice, and he himself dissuaded me from going to a public hospital," says Rajendra Dahal, Editor of the magazine Shiskyak. “This is why the death rate is going up, while the positive totals are going down. People are at home, and their oxygen levels are falling, and they have no idea. The main point is that the people have lost their trust in the government health system.”The chief consultant at the Infectious Diseases Hospital in Teku Anup Bastola agrees that the risk has been heightened because health experts are unaware about the actual condition of people isolating at homes. “Nepalis have a tendency to not visit hospitals until it’s too late. We have found that this is even more true for coronavirus,” he says. With much of the 2020 overshadowed by the pandemic and its impact on all the sectors, young people wanting to get back to their lives are now ignoring the signs and symptoms, preferring not to voluntarily test in case they might have to isolate for two weeks.Even according to government figures, the number of people testing positive in Kathmandu Valley is not going down. With the marriage season, and people intermingling indoor in banquet halls, the surge is not expected to subside. At Pashupati Aryaghat, there are five times more <a href="https://www.nepalitimes.com/latest/with-3rd-covid-19-fatality-nepal-issues-funeral-guideline/" target="_blank" rel="noopener noreferrer">cremations</a> happening compared to the same period last year, according to reports. It is not clear how many of these extra deaths are due to Covid-19.The movement of the younger people has had a <a href="https://www.nepalitimes.com/here-now/spared-at-first-elderly-hit-hard-by-covid-19/" target="_blank" rel="noopener noreferrer">direct impact on the elderly</a>, as they take home the virus and make parents and grandparents seriously sick. People in their sixties and above now make up over 60% of Covid-19 fatalities in Nepal.Even without the added risk of coronavirus, senior citizens are prone to <a href="https://www.nepalitimes.com/latest/covid-19-will-get-worse-before-it-gets-better/" target="_blank" rel="noopener noreferrer">pneumonia and other chronic respiratory illness in winter</a>. Public health experts advise being alert in regards to their condition even before they complain of symptoms and keeping communication channels open.Says Sher Bahadur Pun: “These are extraordinary times and we need to take extraordinary measures to protect the more vulnerable among us. <a href="https://www.nepalitimes.com/latest/vax-populi/" target="_blank" rel="noopener noreferrer">Until we get a vaccine</a>, we must realise our responsibility in containing the virus and not become a medium for more deaths.”

Sonia Awale

Nepali Congress (NC) President Gagan Thapa's candidacy in Sarlahi-4 has thrust this Madhes constituency into rare national focus. If Thapa wins and the NC emerges as the largest party, Sarlahi-4 will send Nepal's next prime minister to Parliament. But if he does not, Nepal’s grand old party will face the next years in the opposition to fight another day. There is a troubling paradox in Sarlahi-4 where the district bordering the Indian state of Bihar has been a battleground for national politicians with fierce electoral competition, all while remaining one of the region's most underserved and underdeveloped constituencies.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260305140344_069cbbc11e971a851b444866dee57f760c0cc611ed40bdf96c627e343e3c0485.png" data-media-id="editor_0" data-image-id="20260305140344_069cbbc11e971a851b444866dee57f760c0cc611ed40bdf96c627e343e3c0485" data-rendition-name="original" width="1802" height="1276" loading="lazy" alt="Sarlahi-4 voting"> <figcaption>Photo: MADHES PAHARA MEDIA</figcaption> </figure>  Ever since Mahant Thakur split from NC in 2008 to form the Tarai Madhes Loktantrik Party, the district has seen rotating political alliances and fragmented votes. Yet, despite 18 years of candidates promising change irrigation schemes remain incomplete, market access for farmers has not improved, unemployment is high.&nbsp; On election day, voters here marked their ballots with fingers stained by dye from the Holi festival the day before. The road leading to Barathawa Bazar was deserted for the most part, except for some youth riding in motorcycles. This is where the high-profile contest between Gagan Thapa and RSP nominee Amresh Singh is being staged. Among the other aspirants is 27-year-old UML candidate Amnish Yadav, the son of former MP Shiv Pujan Yadav. The Yadavs are a political family with considerable caste influence in the constituency. In 2022 Yadav’s daughter Madhumala Yadav received over 14,000 votes here, ranking third overall. Yadav was voted MP from the Maoist party, but defected to the UML this time. His other son is the chair of Sarlahi’s Ramnagar Rural Municipality. Sarhali-4 has 121,012 voters, and the Yadav is banking on the 27,000-strong Yadav vote bank. Sarlahi-4 voter Avishek Sah told us he wanted his vote to go to a young nominee and not someone who has been MP thrice already, like Amresh Singh. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260305140344_527c5c2f9aa6a6c7e3bbdfbfe79fdafb0a0b56a62427e9ced86b924c6c563b10.jpg" data-media-id="editor_1" data-image-id="20260305140344_527c5c2f9aa6a6c7e3bbdfbfe79fdafb0a0b56a62427e9ced86b924c6c563b10" data-rendition-name="original" width="1200" height="1600" loading="lazy" alt="Sarlahi-4 voting"> <figcaption>Photo: AYUSHA CHALISE</figcaption> </figure>  To make local loyalties even more complicated, Amnish Yadav’s uncle, Harinder Yadav is an active NC member and walked side by side with Gagan Thapa during his door-to-door campaigns.&nbsp; The NC is betting on Thapa getting over 60% of the total votes. Amresh Singh’s tally could be limited to 10,000 votes — that too because of the nationwide RSP wave, and the popularity of its prime ministerial hopeful Balendra (Balen) Shah. “Amresh Singh lost his appeal when he played victim after he was denied a ticket by the NC in 2022,” Harinder Yadav says. Voters we spoke to here agreed with this assessment that Singh did not do much for the district once he got elected in the past, and being a part of the RSP seems to be his biggest asset. “The only reason I voted for Amresh Singh is because Balen is in RSP,” local voter Mahendra Gupta from Barathawa. &nbsp;“This is his last chance to return the people’s trust.”&nbsp; Gupta is aware of the institutional presence of the NC here. The party received the most votes in 2022 local elections, adding that the candidacy of someone as high-profile as Thapa is a positive sign for Sarlahi-4.&nbsp; Other voters like Ruby Gupta are rooting for both the NC and the RSP. “I will vote for Gagan and for Balen,” she says, adding that her FPTP vote will go to Thapa while her PR ballot would be for the RSP. RSP supporters are confident that their candidate will win big because even though many voters may not have openly voiced their support they still voted for the party and candidate. The Balen Wave was not limited to RSP voters, but also to UML candidate Yadav, who said in a gathering that he will be “the voters Balen” if they elect him. He touted his party’s track record in government, and largely campaigned on administrative efficiency, infrastructural expansion, and local service delivery. Amresh Singh ran on the RSP’s anti-establishment brand, promising to fight corruption, challenge traditional party politics, improve basic services such as education, health, jobs, and infrastructure, while pushing for stronger representation and development for Madhes.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20260305140344_982df01801fa7d3532ca0555ecb8a0756e3223be3d93650e08ca82a312dc2ebd.jpg" data-media-id="editor_2" data-image-id="20260305140344_982df01801fa7d3532ca0555ecb8a0756e3223be3d93650e08ca82a312dc2ebd" data-rendition-name="original" width="1600" height="1200" loading="lazy" alt="Sarlahi-4 voting"> <figcaption>Photo:AYUSHA CHALISE</figcaption> </figure>  Singh’s rivalry with his NC competitor goes beyond the ballot— he allegedly blames Thapa for being denied the NC ticket in 2022, which led him to win the election from Sarlahi-4 as an independent. &nbsp; For his part, Gagan Thapa focused on a more pragmatic development agenda that includes upgrading roads and irrigation, improving schools and hospitals, supporting farmers, and creating employment opportunities with improved governance at the centre. He also promised to build an engineering college in the constituency.&nbsp; Thapa also promoted his own anti-establishment image within the NC, repeatedly reminding voters on the campaign trail that he represents the aspirations of the youth.&nbsp; On Thursday, as voting progressed, there were violent disruptions in two centres where voting was briefly halted. But Sarlahi district police spokesperson Saroj Rai told Nepali Times that there were no major problems. Police in collaboration with the Nepal Army sent the ballot papers to the district’s counting stations, where the votes are expected to be tallied through the night and the winner announced Friday morning.

Sarlahi-4 nervously watches ballot count

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Nepal election live results

As this report is uploaded, the latest results in Nepal’s election show that the Rastriya Swatantra Party (RSP) is headed for an even bigger sweep than most had predicted.
The RSP was leading by large margins in 49 of 165 constituencies, &nbsp;with the UML, NC and NCP trailing far behind. Prominent political figures from the old parties like K P Oli, Minwndra Prasad Rijal, Ishwar Pokhrel, Bishnu Prasad Poudel, Bimalendra Nidhi all seem headed for defeat.
It does look like the RSP’s bell election symbol is ringing right across Nepal — from cities to the remotest districts in the mountains and plains. The party’s blue colour is sweeping the land.
The Nepali people seem to have sent a clear message that they were throughly dissatisfied with the chronic failure of the three main parties to work in the national interest to create jobs and deliver development. It was also an expression of lingering outrage over the the 8 September massacre outside Parliament. &nbsp;
It now looks almost certain that Balendra Shah will get to be Nepal’s next, and youngest, prime minister. Hopefully he will be leading a cabinet of competent and honest technocrats. It remains to seen how the power equation between Shah and the RSP’s leader, Rabi Lamichhane will play out.
Lamichhane is out of jail on bail for fraud cases which he has called political vendetta by the previous regime. Both he and Shah are charismatic and ambitious. Their working relationship will determine Nepal's political stability and whether it can avoid the political cronyism of the past.
This election was not just about casting votes. It was about standing up to principles and a value system, and respecting the hopes and aspirations of Nepal’s youth. It to push for transparent government and against impunity — including for the gunning down of young Nepalis in cold blood.
<div class="embed-block"><iframe src="https://election-geo-dashboard.pages.dev/" width="100%" height="600" frameborder="0"> </iframe>Live election results as winners of candidates are announced.</div>
CAN DO MAN
Shah got mixed reviews as mayor. He was impulsive and ad hoc, but most people inKathmandu and beyond liked his can-do attitude and unconventional style which stood in sharp contract to the legacy leaders. Over his three year mayorship he showed more maturity and planning capacity.&nbsp;
But he always ran headlong into opposition from the federal government over his urban planning and other initiatives to make Kathmandu more liveable. Coming from a civil and structural engineering background, he was involved in building low-cost housing after the 2015 earthquake.
But his public persona is more tied to his irreverent rap lyrics that stood up for the marginalised underprivileged in society, while exposing the high-handedness and apathy of the state. But this also exposed contradictions because he also used his own municipal guards to beat and chase away street vendors and squatters.
But there is no doubt that a combination of the sharp messaging in his rap videos amplified by the algorithms of social media ignited Nepal’s youth to rise up. It was more about optics and emotion than policy and strategy.
He studied Kathmandu district for five years, visiting experts in every field before announcing his independent candidacy for mayor in 2022. Many like me in his own constitunecy did not know who he was and where he came from.
He is a year younger than my architect son, and I saw in him a reflection of my own son’s commitment to serving the nation. I voted for him to be mayor despite his sometimes erratic behaviour, which could be attributed to his youth.
The best sign of his strategic planning, which unsettled septuagenarian and octogenarian politicians, is the he did not grab the first easy option of becoming prime minister in September when GenZ activists offered him the post.&nbsp;
Joining RSP was a masterstroke, as was his challenge to Oli in Jhapa to project national branding. He needed a party platform and Lamichhane needed a popular prime ministerial persona since he himself could not hold the post.
Shah has shown the capacity to take risks when he believes the value justifies the action for the country. Now, he will have to show more strategic thinking on a national scale, as well as understand the delicate geopolitics of Nepal.&nbsp;
He must rise above the kind of crude social media posts that earned him followers on X, but did nothing to erase his erratic and impulsive image.&nbsp;
Some assume that behind his trademark RayBan shades is a closet dictator, and his past remarks about Hitler are still up on social media. He has in the past shown impatience with criticism, unleashing supporters on social media to troll detractors.&nbsp;
Even so, the public seems willing to place their hope on an educated young man with integrity and a proven record for planning at the helm. By tomorrow it will be clear whether the hope Nepalis have held has been fulfilled, and the coming years will show if the RSP will lead Nepalis to a better future.
The voters seem to have shown the door even to the NC despite the fact that under Gagan Thapa, the party had turned a new leaf. A strong government under Prime Minister Balendra Shah heading a carefully selected cabinet and a strong opposition of the NC, UML and other parties for check and balance may be just what we need for a stable Nepal.&nbsp;
Nepalis have collectively always shown maturity in elections. This time they have given a resounding endorsement for integrity and for good governance.

Bells ring all over Nepal

After Thursday’s election, Nepalis are in a wait-and-watch mode. The Election Commission says counting ballot papers will be expedited this time, and the results for the First-Past-The-Post (FPTP) will start being declared within days. In 2022, it took three weeks for the final results to be tallied.&nbsp;
But winning an election is only half the challenge for the parties, forming a government under parliamentary politics is like a complicated mathematical equation.&nbsp;
In 2022, the Nepali Congress (NC) emerged as the biggest party, winning 89 seats. But the UML with 78 seats and the Maoists with 32 formed a minority government. In fact, Sher Bahadur Deuba did not become PM then despite leading the biggest party in Parliament.
This time, there is an unmistakeable Rastriya Swatantra Party (RSP) wave led by its prime ministerial candidate, Balendra Shah. Besides his own popularity, Shah represents change which most Nepalis are clamouring for after decades of corrupt and feckless coalitions that did not deliver.&nbsp;
The past months of campaigning has seen massive youth engagement on social media through memes, AI clips, and viral images. Digital content that appeals to emotion rather than policy debate between candidates shape electoral outcomes in Nepal and elsewhere. &nbsp;
Shah represents GenZ aspirations, and was their candidate for prime minister. It was only when he declined that Sushila Karki was nominated. None of the political parties in the recent past -- new, old, or revolutionary — have won enough seats to go it alone.&nbsp;
The most recent majority government was formed by the short-lived Communist Party of Nepal after the UML-Maoist merger in 2022. But that rare two-thirds majority collapsed after a power struggle between K P Oli and Pushpa Kamal Dahal. The only party to have won a majority was the NC in the 1991 and 1999 elections. But it is near impossible for it to repeat this success now, even with Gagan Thapa's rebranding of the party.&nbsp;
We have compiled these possible scenarios for election outcome in order of likelihood:
RSP gets a majority
RSP hits the magic 138 to form a government entirely on its own. Balendra Shah wins Jhapa-5, and becomes the new prime minister at 35, the youngest ever to hold the office in Nepal. But danger lurks: there could be a personality clash between Shah and Lamichhane who are both equally ambitious. History could repeat itself.&nbsp;
RSP wins but does not get a majority
RSP is likely to sweep the most votes, but what if it does not secure enough seats for a majority? It would need a coalition partner and Nepali Communist Party (NCP) under Pushpa Kamal Dahal could fit the bill, but only if it has the numbers. The RSP is not likely to team up with the UML or NC.
The NCP is relatively untainted by the 8 September events, and also has former UML defectors like Madhav Kumar Nepal and Bhim Rawal who could bag their rural vote banks. After all, there are no permanent foes in politics. If the royalist RPP and Tarai-based Janata Samajwadi have enough seats, those could be options for the RSP. &nbsp;
NC is second
The NC under the new leadership of Gagan Thapa could become the second biggest force and form a government with RSP in a power-sharing deal with Shah. This would be the most stable scenario since the RSP and NC have competent and idealistic young technocrats. Thapa himself embodies a strong combination of both old and new politics to navigate the system for more efficient government. But then Thapa and the RSP's Rabi Lamichhane do not get along.
NC and NCP form a majority
If the NC becomes the largest party but not by a big margin, it could join up with the NCP and Ujyalo. Teaming up with the UML would likely face backlash with the party and outside. If Gagan Thapa becomes prime minister he will face internal pressure from both Deuba loyalists. Same old story.
Minority coalition of NC, UML and NCP
RSP becomes the first party but does not get a majority, paving the way for the three legacy parties to cobble together a minority government. While this is possible in Nepal’s parliamentary system, such a scenario is likely to lead to more instability and dissatisfaction among young Nepalis demanding change, and even trigger street unrest. &nbsp;

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