<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.”

Sonia Awale

original

674x448

610x380

500x500

400x266

400x240

400x203

301x200

China’s surge: should Nepal be worried?

<figure><img width="1319" height="1975" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410110/637203ae9c7e80680e0b281ejpeg.jpg" alt=""/><figcaption>Photo: UNICEF NEPAL</figcaption></figure>For the first time in four months, Nepal recorded over 1,000 daily new Covid cases on Sunday. Of the 12,632 people tested nationwide, 9% were positive – proving that <a href="https://www.nepalitimes.com/latest/nepal-has-all-the-conditions-for-an-omicron-surge/" target="_blank" rel="noopener noreferrer">Omicron</a> has replaced Delta as the dominant strain.Reacting to the sharp rise in infections, Nepal’s Covid-19 Crisis Management Committee (CCMC) has imposed a ban on gatherings of more than 25 people in public spaces, and made it compulsory to show vaccine certificates before entering them. Schools that had just opened following winter vacation, will also be shut for another three weeks.“It will be foolhardy of us not to expect a surge now. But if the vaccination drive slows, we will pay for it dearly,” warns Buddha Basnyat, a physician at Patan Academy of Medical Sciences.But Nepal’s vaccination drive has hit a speed bump because of a shortage of syringes. Although <a href="https://www.nepalitimes.com/here-now/from-scarce-vaccines-to-storage-shortage-in-nepal/" target="_blank" rel="noopener noreferrer">there is a stockpile</a> of 12 million doses in refrigerated stores across the country, and 6 million more doses on the pipeline, there are a limited number of needles to administer them.Nepal was one of the first countries in the region to start Covid vaccinations in March 2021, and has managed to fully inoculate only 36.8% of its 30 million population. Only half the population has received the first dose. The needle shortage is holding back first jabs, second doses and booster shots for the vulnerable groups including health workers, the elderly and immuno-compromised individuals.“Two doses of vaccines against Omicron is not as effective but a booster is. So we have to provide the third dose not so much to prevent mortality, but to stop Omicron from spreading rapidly and overwhelming our healthcare system,” says epidemiologist Lhamo Yangchen Sherpa.She adds: “Yes, there is a moral dilemma to boosters. Given that a majority of Nepalis haven’t yet been fully vaccinated we have to consider the latest development as the doses are approaching their expiry date.” Nepal is planning to provide boosters only when 40% of the population has been fully inoculated. But studies have shown that the immunity afforded by vaccines wanes over time with a significant decline in the level of antibodies. And while most of the vaccines are not as effective against Omicron, they still <a href="https://www.nepalitimes.com/latest/all-vaccines-prevent-severe-covid/" target="_blank" rel="noopener noreferrer">largely prevent severity</a>.Says Minister of Health and Population Birodh Khatiwada: “We are trying to sort out some final details and will make an announcement on boosters soon.”Studies have now confirmed that Omicron produces less damaging infections with impacts largely limited to the upper respiratory tract and does not multiply readily in lung tissue, leading many to believe that <a href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care/" target="_blank" rel="noopener noreferrer">the new variant is much milder</a> and hence likely to replace Delta.“We must provide boosters for the most vulnerable groups, I have seen many patients at my hospital who are fully inoculated but struggling with complications,” says virologist Sher Bahadur Pun at Kathmandu’s Teku Hospital. “Just because they have already received two doses we can’t leave them to die.” He adds: "In the meantime, we also have to identify groups who can’t access shots and those who are still hesitant to inoculate, and work out strategies that address them best to speed up the vaccination drive.”Most infected people are also experiencing much milder symptoms of Omicron, either because they have been vaccinated or have natural immunity due to previous infections that they were not aware of. Even so, the sheer transmissibility of the new strain will likely <a href="https://www.nepalitimes.com/here-now/living-with-covid-in-2022/" target="_blank" rel="noopener noreferrer">overwhelm Nepal’s understaffed and underfinanced healthcare</a> mechanism. <figure><img width="640" height="296" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410110/637203b19c7e80680e0b281fjpeg.jpg" alt=""><figcaption>Daily case load in India and Nepal (below). Source: WORLDOMETERS</figcaption></figure><figure><img width="640" height="327" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111410110/637203b49c7e80680e0b2820jpeg.jpg" alt=""><figcaption></figcaption></figure>In neighbouring India, the daily caseload is now nearing 150,000 a day, and it is doubling every 1.5 days in Bihar state across the border. During the Delta surge, Nepal’s cases peaked two weeks after it did in India, but with Omicron it may not even take that long. “We are prepared for hospitalisations if cases are milder and not as serious but we don’t know how the virus will behave. We are also better prepared than the last surge with oxygen, ICUs and other facilities,” says Sangita Kaushal Mishra at the Ministry of Health Health Coordination Division.That may be the case, but across Nepal many rural hospitals are still understaffed and <a href="https://www.nepalitimes.com/latest/donated-ventilators-gather-dust-in-nepal/" target="_blank" rel="noopener noreferrer">do not have trained personnel</a> to operate ventilators and run ICU wards. Similarly, not all newly installed oxygen plants are functional yet.Then there is virtually no contact tracing, leading experts to believe that figures for Omicron are underreported, and only individuals with symptoms are being tested. “Given how contagious Omicron is, increased testing can go a long way in controlling the surge, so can institutional isolation of active cases,” says Bikash Gauchan of the Gandaki Province Infectious and Communicable Disease Hospital in Pokhara.Children all over the country are still largely unvaccinated, and should be prioritised during the time that schools are closed. There has been a worrying rise in paediatric hospitalisation in the US and Europe among unvaccinated children. And while people below 18 years have been largely spared so far, they are nonetheless an active medium for the virus to spread rapidly to more at-risk groups.The community spread of Omicron in Nepal is blamed on large gatherings of major political parties during their conventions in the past month. Such irresponsibility from top leaders has also led general populations to flout safety measures. Maoist Centre Chair Pushpa Kamal Dahal, his family and many of his close aides have tested positive, and leaders of other political parties, including ministers are in isolation.The once-in-12-year <a href="https://www.nepalitimes.com/banner/creation-to-destruction-then-revival/" target="_blank" rel="noopener noreferrer">Makar Mela</a> is expected to draw 6 million visitors in a month to Panauti starting next week, and can be a hyper-spreader event. So can the lead-up to the local elections slated for April. “The fact that Omicron is much milder can make people more careless, so we must once again reinforce the importance of masks, ventilation and distancing,” says Pun.Besides this, the second line of defence is to vaccinate as many people as soon as possible, and start giving boosters to the rest. Adds Buddha Basnyat: “We were lucky with Omicron that it is mild but we should use it as an opportunity to vaccinate both the unvaccinated and boost the vulnerable groups simultaneously on war footing to prevent stronger variants from arising.”

1250x600

1084x550

Boosting booster jabs against Omicron

<figure><img width="1902" height="1266" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161152/636d1ed59c7e80680e0af431jpeg.jpg" alt=""/><figcaption>Photo: AMIT MACHAMASI</figcaption></figure>Following initial lab reports that AstraZeneca and VeroCell boosters afford lower or no protection against <a href="https://www.nepalitimes.com/latest/nepal-on-high-alert-for-omicron/" target="_blank" rel="noopener noreferrer">the new Omicron strain</a>, Nepal Times reached out to <a href="https://www.nepalitimes.com/opinion/im-sad-vaccines-are-delayed-in-nepal/" target="_blank" rel="noopener noreferrer">Andrew Pollard</a>, who helped develop the Oxford AstraZeneca vaccines. Majority of the vaccinated Nepalis have been administered either with the Chinese VeroCell or the AstraZeneca Covishield manufactured in India. At least 12.2 million Nepalis (42% of the population) have got at least one dose of vaccine, and 9.7 million have got both jabs (33% of population).Of these 28.5% got the Covishield and 62.1% got the VeroCell which are vector vaccines made from disabled viruses, as per the government figures last updated 18 November. Another 9.2% got J&amp;J. Less than 4,000 have received Pfizer or Moderna which are genetically engineered mRNA vaccines. Nepal currently has nearly 14 million <a href="https://www.nepalitimes.com/here-now/from-scarce-vaccines-to-storage-shortage-in-nepal/" target="_blank" rel="noopener noreferrer">vaccines in stock</a> and wants to fully vaccinate 40% of the population before offering booster shots by the end of the month.Excerpts of the conversation with Andrew Pollard:Read also: <a href="https://www.nepalitimes.com/latest/nepal-has-all-the-conditions-for-an-omicron-surge/">“Nepal has all the conditions for an Omicron surge”</a>, Nepali TimesNepali Times: Is it true that AstraZeneca boosters are not as effective against Omicron?Andrew Pollard: The new coronavirus is here to stay and it will remain with us for decades to come. To do this is will find ways to continue to infect people in communities even if they are vaccinated. The important role of the vaccines is to prevent severe disease and the evidence so far, even with Omicron, does appear to indicate that vaccines are still holding up in preventing most of the severe outcomes.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/omicron-may-not-be-as-risky-but-take-care/" target="_blank" rel="noopener noreferrer">New variants</a> are able to cause asymptomatic or mild disease in vaccinated people with any of the vaccines that are being used around the world, and Omicron is the champion so far in doing this. But vaccines remain highly effective in preventing severe disease from all variants and make us a lot safer than if we are unvaccinated.Is the negative publicity likely to increase <a href="https://www.nepalitimes.com/banner/why-is-there-vaccine-hesitancy-in-nepal/" target="_blank" rel="noopener noreferrer">vaccine hesitancy</a> in Nepal, and fuel the pandemic even more?I think the interpretation of the data is wrong. The evidence is clear, vaccines have already saved millions of lives. A recent analysis showed that AstraZeneca jabs have saved more lives than any other vaccines worldwide.Viral evolution means that Omicron and its children will evade immune responses and allow infections with any of the vaccines. At this moment, Omicron can cause infection whether you have had AstraZeneca or Pfizer with very low protection from both of them. However, the vaccines still prevent severe disease. <img width="400" height="400" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161152/636d1ed99c7e80680e0af432jpeg.jpg" alt="">Read also: <a href="https://www.nepalitimes.com/here-now/living-with-covid-in-2022/">Living with Covid in 2022</a>, Sonia Awale What options Nepal and India can pursue to stop the spread of Omicron? The impact of first/second doses is huge and these should be prioritised over boosters where there is a short supply of doses. Omicron spreads very easily and so it is more likely that the virus will find the unvaccinated and put them at risk, so we do need to get <a href="https://www.nepalitimes.com/banner/vaccines-or-no-vaccines-mask-and-distance/" target="_blank" rel="noopener noreferrer">vaccine coverage</a> high everywhere but especially in older adults and those with health conditions who have not yet been vaccinated as they are at greatest risk. Is it time to administer booster doses, and if so, who should get it first? <a href="https://www.nepalitimes.com/here-now/do-nepalis-need-covid-booster-shots/" target="_blank" style="font-size: 15px; letter-spacing: 0.01em;" rel="noopener noreferrer">Boosters</a> do seem to increase antibodies and some early evidence from the UK shows that boosters increase protection against these mild infections. Boosters may be important for some of the frailest in our communities to keep them safe if their protection has waned. Some countries have started booster programs focusing on these risk groups first. Read also: <a href="https://www.nepalitimes.com/latest/nepal-needs-to-prepare-for-new-covid-wave/">Nepal needs to prepare for new Covid wave</a>, Cilo Bazakas

“All vaccines prevent severe Covid”

<img width="1594" height="986" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161152/636d1ed09c7e80680e0af42fjpeg.jpg" alt=""/>The rapid spread of the<a href="https://www.nepalitimes.com/latest/nepal-on-high-alert-for-omicron/" target="_blank" rel="noopener noreferrer"> new coronavirus variant Omicron</a> across the globe has cast serious doubts about the efficacy of different Covid-19 vaccines in use worldwide. In particular, non-mRNA vaccines have been put on the spotlight, with initial lab reports suggesting their decreased protection against the new strain. Nepali Times spoke with regional <a href="https://www.nepalitimes.com/here-now/nepal-needs-urgent-american-vaccine-support/" target="_blank" rel="noopener noreferrer">health expert Sushil Koirala</a> based in Bangkok this week about Omicron setting off a <a href="https://www.nepalitimes.com/latest/nepal-needs-to-prepare-for-new-covid-wave/" target="_blank" rel="noopener noreferrer">new surge</a> in the Subcontinent, the danger of falling vaccine efficacy, and the best strategy for Nepal moving into 2022. Nepali Times: Initial lab reports suggest that non m-RNA vaccines are largely ineffective against Omicron. Would this be accurate? Sushil Koirala: I am not aware of any specific evidence that says viral vector vaccines are ineffective against the Omicron variant. I have also not seen any evidence of it being effective. The problem is the lack of transparency from manufacturers. That unknown, compared to some evidence we have with the mRNA vaccines, is the problem. Since little is known on the effectiveness of viral vector vaccines particularly VeroCell, the natural tendency is to think that the mRNA vaccines are a better choice as a booster against delta reinfection and Omicron variant. Read also: <a href="https://www.nepalitimes.com/latest/all-vaccines-prevent-severe-covid/">“All vaccines prevent severe Covid”</a>, Nepali TimesIn that case, how should our vaccination drive move ahead now?Nepal should swiftly provide booster doses to the vulnerable population, many of whom were vaccinated almost a year ago. Early evidence based on lab studies shows that a recent (booster) jab provides ‘increased’ protection against Omicron. Most importantly, The Imperial College London Covid-19 response team has recently estimated that the risk of reinfection with the Omicron variant is 5.4 times greater than that of the Delta variant. This implies that the protection against reinfection by Omicron afforded by past infection may be as low as 19%.  <figure><img width="126" height="150" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221110161152/636d1ed49c7e80680e0af430jpeg.jpg" alt=""><figcaption>Sushil Koirala</figcaption></figure>In short, there is some evidence that natural immunity from past infection and or vaccine-induced immunity from prior vaccination may not be sufficient to prevent Omicron infection. However, it’s good to point out that it is too early in the day, and there is insufficient knowledge on how those infections will translate to increased severity and or death at a population level. Good thing is, Nepal has now received sufficient Moderna vaccines to provide booster doses to elderly and vulnerable groups and will have additional 2 million doses to continue vaccinating those of 12-18 years of age.  Read also: <a href="https://www.nepalitimes.com/here-now/living-with-covid-in-2022/">Living with Covid in 2022</a>, Sonia Awale Is there now a clearer picture of Omicron? What can we say about a possible new surge, increased transmissibility and severe diseases? Though it is still quite early to conclude anything, there is a broader general consensus on the following evidence:  1) Due to mutations in the spike protein, Omicron is highly transmissible. Early studies suggest that it is four-fold more infectious than the original coronavirus and two-fold more infectious than <a href="https://www.nepalitimes.com/banner/we-knew-the-tsunami-was-approaching/" target="_blank" rel="noopener noreferrer">Delta</a>.  Lab studies suggest that Omicron was able to replicate 70 times faster in human respiratory tissue than Delta, which may help the variant spread more rapidly between people. There were also higher levels of the Omicron variant in respiratory tissue 48 hours after infection than the Delta variant.  2) There is some evidence that natural immunity from past infection and or vaccine-induced immunity from prior vaccination may not be sufficient to prevent Omicron infection as discussed earlier. 3) There is mixed evidence based on small lab-based studies that suggest that vaccine still provides some level of protection against Omicron and while other studies suggest that there are vaccine escapes. The magnitude of either one is unknown.  4) Early data suggests that Omicron may be milder than previous variants, but most of this anecdotal data comes from young and fully vaccinated patients. It is also important to note that many of these initially confirmed Omicron cases were already fully vaccinated or previously infected, revealing the occurrence of breakthrough reinfection and the immune escape of the Omicron variant. 5) There are not many studies/data that look at the severity of Omicron infections among unvaccinated and elderly/vulnerable people. Some experts believe that Omicron's increased transmissibility could still result in high rates of severe disease and death particularly among vulnerable and unvaccinated people.  Read also: <a href="https://www.nepalitimes.com/opinion/masks-and-vaccines-to-stop-nepals-2nd-wave/">Masks and vaccines to stop Nepal’s 2nd wave</a>, Sushil Koirala At this point in the pandemic, what should be Nepal's best strategy moving forward? We have three confirmed imported cases of Omicron. Since the first case arrived in Nepal in mid-November, it is safe to assume that there must be small cluster transmission happening in Nepal, particularly in Kathmandu. Recent<a href="https://www.nepalitimes.com/latest/unconventional-party-conventions/" target="_blank" rel="noopener noreferrer"> superspreader political events</a> have exacerbated the risks of the transmissions to other parts of Nepal. All three confirmed cases were detected when they were clinically sick and among vaccinated people. It shows that our active surveillance is not working well.  Despite having multiple cases from fly-in travelers, our real risk of a large-scale outbreak is likely to come from across the southern border. So, yet again, what will happen in Nepal will largely depend on how the Omicron outbreak unfolds in India. Nepal should keep its focus on surveilling border cases and up its vaccination drive, which has flattened in recent months.   As natural immunity seems to be unable to prevent Omicrom infections, it is of outmost importance that<a href="https://www.nepalitimes.com/banner/how-nepal-must-prepare-for-3rd-covid-wave/" target="_blank" rel="noopener noreferrer"> Nepal prepare critical care </a>for a large-scale Omicron outbreak.  We have a relatively lower vaccinated coverage, we have not provided <a href="https://www.nepalitimes.com/opinion/to-boost-or-not-to-boost/" target="_blank" rel="noopener noreferrer">booster doses</a>,  the efficacy of the Chinese vaccine against the new variant is unknown, and public health measures at population levels are sketchy and insufficient.  This presents all necessary conditions for a highly contagious variant to spread in Nepal. It is still too early to tell how this increased transmissibility translates to the severity and deaths. We will eventually know that, but we cannot afford to wait. Read also: <a href="https://www.nepalitimes.com/here-now/delta-variants-wake-up-call-for-nepal/">Delta variant’s wake-up call for Nepal</a>, Sushil Koirala and Ben Ayers

“Nepal has all the conditions for an Omicron surge”

<figure><img width="720" height="480" src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/2022111016118/636d14819c7e80680e0a997ejpeg.jpg" alt=""/><figcaption>A student being administered the Pfizer BioNtech vaccine last week in Kathmandu. There are questions about the efficacy of current vaccines against the Omicron variant. Photo: AMIT MACHAMASI</figcaption></figure>The new Omicron coronavirus strain that is spreading concern about a new surge of the pandemic has not been detected yet in samples tested this week in Nepal, but virologists urge <a href="https://www.nepalitimes.com/banner/behind-the-masks/" target="_blank" rel="noopener noreferrer">caution and stricter enforcement of precautions</a>.  The variant B.1.1.529, also known by the Greek alphabet Omicron, is said to have evolved in southern Africa, and has already been detected in Hong Kong, Belgium, the UK, Czech Republic, Italy, Germany and the Netherlands.Israel, in fact, now requires all foreign travelers to quarantine for two weeks. Nepal on Saturday announced restrictions on travelers from six southern African countries as a precaution.  A private lab which had been conducting genetic sequencing tests on about 50 samples every week from Kosi, Bheri and Teku hospitals, so far has found only the <a href="https://www.nepalitimes.com/here-now/delta-variants-wake-up-call-for-nepal/" target="_blank" rel="noopener noreferrer">Delta variant</a> and not the Omicron strain. Nepali health experts say it is too early to speculate about the <a href="https://www.nepalitimes.com/banner/vaccines-variants-and-a-third-wave/" target="_blank" rel="noopener noreferrer">new variant</a>, and making a judgment on response. But they advise even stricter adherence to precautions.“Let’s not panic but prepare, Omicron has spread faster in South Africa but it is also the relatively less vaccinated region,” says virologist Sher Bahadur Pun at Teku Hospital. Only 24% of South Africans have fully inoculated against Covid-19, 28.7% are partially vaccinated. Nepal's figures are only slightly better at 27.4% and 31.6% respectively. It is only because of advances in genetic sequencing technology that a new coronavirus strain is identified in South Africa on 24 November and within four days was designated as a variant of concern by the WHO. Already, Omicron has become a household word, synonymous with a new, possibly deadly, <a href="https://www.nepalitimes.com/banner/how-nepal-must-prepare-for-3rd-covid-wave/" target="_blank" rel="noopener noreferrer">phase in the Covid-19 pandemic</a>.South Africa, where daily cases spiked from 200 to three times that number, have called the travel bans unnecessary and hasty, and that the new variant was not making people seriously sick. But preliminary evidence suggests an increased risk of re-infection, immune escape, and lower vaccine efficacy because of multiple mutations in its spike protein.
“The new strain seems to be spreading fast but what we need to look at is what is happening in countries where Delta has established itself as the dominant strain and that data will determine if it is stronger or more lethal in Nepal,” says Sameer Dixit of <a href="https://www.cmdn.org.np/" target="_blank" rel="noopener noreferrer">Centre for Molecular Dynamics Nepal</a>. “We need to wait a couple of weeks to see if Omicron will replace Delta, overspread, co-exist, or do nothing.”
Dixit’s Centre has partnered with the <a href="https://bnmtnepal.org.np/" target="_blank" rel="noopener noreferrer">Birat Nepal Medical Trust</a> in the EPIINTEL Initiative under the supervision of Nepal Health Research Council to monitor the genetic composition of new variants in the country.
The fact that the new variant has over 30 mutations in its spike protein is a cause for concern. Most current Covid vaccines might be rendered ineffective, except for the Chinese VeroCell and <a href="https://www.nepalitimes.com/latest/jabs-and-jab-nots/">Indian Covaxin</a> which are made from the inactivated virus, and do not only target spike proteins. Experts recommend keeping a close eye on countries that primarily administered VeroCell to monitor their response to Omicron.
Similarly, it is yet to be seen how the new variant will affect people with <a href="https://www.nepalitimes.com/editorial/two-schools-of-thought/" target="_blank" rel="noopener noreferrer">natural immunity</a>. While initial reports point to an increased risk of re-infection, those who have previously recovered from Covid-19 will have antibodies against all proteins, not just spike protein, unlike vaccinated individuals.
Given that most vaccines against Covid-19 including Pfizer, Moderna, J&amp;J and AstraZeneca primarily target the spike protein, chances are that these jabs will be significantly less effective against variant B.1.1.529. 
Even if the re-infection rate is high, it doesn’t mean severe symptoms. The WHO previously designated Gamma and Beta strains as the variants of concern, but these did not spread much and caused only mild symptoms – before the arrival of the deadlier Delta strain.
Nepal has 30 million new doses of different vaccines in the pipeline, and the government is inoculating everyone from 12 years and above with the <a href="https://www.nepalitimes.com/latest/pfizer-vaccines-arrive-in-nepal/" target="_blank" rel="noopener noreferrer">Pfizer jabs</a>. The new challenge is to increase intake among those who have so far refused to be inoculated such as pregnant women, new mothers and those with co-morbidities – and after that to <a href="https://www.nepalitimes.com/here-now/do-nepalis-need-covid-booster-shots/" target="_blank" rel="noopener noreferrer">start administering booster shots nationwide</a>. 
Pun adds: “Now that the Omicron strain is here, our priority should be to <a href="https://www.nepalitimes.com/latest/vaccines-are-the-only-solution/" target="_blank" rel="noopener noreferrer">vaccinate as many remaining people as possible</a>, especially because people have started becoming complacent due to the declining number of Covid cases. We must be on high alert and follow safety precautions and genetic sequencing of the variants.”
Adds Sameer Dixit: “We are at a very early stage, but a travel ban is not the way to prepare for what might be ahead. The restrictions can only do so much, at best it prevents early transmission but once the virus is in, it won’t take long to overwhelm the health system as we saw during the second wave. So we must up our vaccinations, keep distance and mask up. That is the only way.”

Nepal on high alert for Omicron

Fenerbahçe Beko won the Turkish Airlines EuroLeague finals in Abu Dhabi, held 23-25 May, defeating Monaco 81-70 in the final. Olympiacos, who defeated Panathinaikos 97-93, finished the series in third place. The Most Valuable Player (MVP) of the final match, Nigel Hayes-Davis from Fenerbahçe Beko, received a prize of 1,000,000 Miles&amp;Smiles from Turkish Airlines’ Chief Commercial Officer Ahmet Olmuştur. The carrier has been the title sponsor of the Turkish Airlines EuroLeague, a top tier tournament, since 2010.

Turkish Basketball

While Nepal was hosting the Sagarmatha Sambaad international climate conference in Kathmandu this month, on Mt Everest it was pretty much business as usual.&nbsp; The signs of climate breakdown are all there: a river now runs through Base Camp in summer, the Khumbu Icefall is more unstable, and there are more &nbsp;frequent avalanches. When expeditions arrived in March, the mountains were bare: it had not snowed since September, but then blizzards dumped unseasonal snow in May. And despite climate worries, such is the pull of Himalayan mountaineering that the Everest Industry showed no signs of slowdown. More than 600 international climbers and their Nepali guides had made it to the summit of the world’s highest mountain. At one point there were an estimated 2,000 people in the tent city on the Khumbu Glacier. All the ropes and ladders on the Icefall came down on Thursday, marking the official end of the spring climbing season, and just in time to avoid a monsoon cyclone approaching from the Bay of Bengal. It has been an action-packed season. One factor could be that Everest fees will go up from September: each foreign climber needs to pay a $15,000 royalty, up from the present $11,000. The cost for a Nepali climber on the South Col route will also go up: from Rs75,000 to Rs150,000.&nbsp; The fee to climb Everest in autumn is $7,500 (up from $5,500), but most climbers still prefer spring. Winter permit fee (December-February) is only $3,750 per person and the mountain is now also open for monsoon (June-August) climbs, when the fee is ever lower at $2,750. The revised rule also makes it mandatory for every two climbers on an 8,000m peak to hire one Nepali mountain guide.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046.jpg" data-media-id="editor_0" data-image-id="2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046" data-rendition-name="original" width="931" height="732" loading="lazy" alt="The Everest Industry graph 1"> </figure>  In addition, climbers also have to pay for porters and guides, equipment, Base Camp costs, Ice Fall and fixed rope team fees, so climbing Everest does not come cheap. But such is the draw of climbing the world’s highest peak that some say the increased fees will not diminish the crowds next year. The government has tried to spread expeditions out to other seasons and other 8,000ers, but with not much success. Earlier this year, Nepal unilaterally increased the number of 8,000m peaks to 14 by adding six more sub-summits to broaden the choice for climbers. Added were: Yalung Kang (8,505m), Yalung Kang West (8,077m) &nbsp;Kangchenjunga Central (8,473m), Kangchenjunga South (8,476m), Lhotse Middle (8,410m) and Lhotse Shar (8,400m).&nbsp; The announcement could go against the accepted topographic criteria that a stand alone peak has to be at least 300m higher than an adjoining prominence, and at more than 3km isolation from it. The UIAA (Union Internationale des Associations d'Alpinisme) still recognises only 14 mountains as eight-thousanders, and only eight of those are in Nepal, or on the border with China. Nepal’s revised mountaineering regulations also increased the insurance coverage of high-altitude workers to protect porters and high altitude guides who usually take more risks on the mountains. Rescue teams and clean-up campaigners to collect trash and remove bodies of dead climbers up to Camp IV of Mt Everest do not need permits.&nbsp; The Sagarmatha Pollution Control Committee is now using drones to fly down trash in 20kg sacks. Each climber is also required to bring down at least 6kg of waste and not just their own, but this rule is erratically enforced. With five fatalities on Everest and Lhotse, Spring 2025 had a historically low death toll. Another five climbers died on Annapurna, Kangchenjunga and Makalu.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a.jpg" data-media-id="editor_1" data-image-id="2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a" data-rendition-name="original" width="665" height="740" loading="lazy" alt="The Everest industry graph 2"> </figure>  Journalist Ben Ayers who ran the Everest Live social media channel from Everest Base Camp with daily updates credited the low death rate to dramatic rescues of climbers from the ‘Death Zone’ by their Nepali guides and longline helievacs — the visuals all uploaded on YouTube.&nbsp; “Ironically, this perception of safety is bringing more and more inexperienced climbers to the mountain, and they need more rescues,” Ayers said in one of his dispatches.&nbsp; American expedition chronicler and summiteer Alan Arnette suspects there is a lot of under-reporting given that the jet stream and storms were lashing Everest even till late in the season. He told us: “I heard a lot about frostbite and rescues that were not made public. It’s become practically impossible to cover the details on Everest. All the teams report nice news, and they don’t talk about bad stuff to avoid hurting businesses.” Although trash on Nepal’s mountains makes headlines, what does not receive as much attention is the climate impact of so many expeditions. The Sagarmatha Sambaad conference sidestepped this issue, which is ironic given that the impact of climate breakdown is most evident on Himalayan peaks and their glaciers.&nbsp; <h2>Need for Speed</h2> The big stories this year have been about speed-running from their home cities to the top of Everest. Ukrainian entrepreneur Andrew Ushakov flew out of JFK on 15 May at 10:15AM Nepal time, and was on the summit 3 days, 23 hours, and 7 minutes later on 19 May at 9:22AM.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885.jpg" data-media-id="editor_2" data-image-id="20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885" data-rendition-name="original" width="1440" height="1800" loading="lazy" alt="The Everest Industry"> <figcaption>Andrew Ushakov at the summt. Photo: ELITE EXPED</figcaption> </figure>  “I could never find the time for the traditional 40-50 days of acclimatisation,” Ushakov explained matter-of-factly. His ‘Everest Sea-to-Summit’ climb was possible because he spent 400 hours in hypoxic sleep tents over the past four years in New York. However, Ushakov did use ropes already fixed, hired four Nepali guides, helicoptered to Base Camp, and used much more oxygen than an average climber. And after the climb, Ushakov was arrested at Kathmandu airport for being in possession of $20,000 of undeclared cash and spent a night in jail and fined $60,000.&nbsp; The other speedsters were Garth Miller, Alastair Cairns, Anthony Stazicker, and Kev Godlington, all former British Army commandos. They left London and summited five days later on 21 May, and flew right back. They also used hypoxic tents to simulate the thin air high on Everest.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8.jpg" data-media-id="editor_3" data-image-id="20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8" data-rendition-name="original" width="810" height="668" loading="lazy" alt="The Everest Industry "> <figcaption>All four members of the Furtenbach team at the summit. Photo: Sandro Gromen-Hayes</figcaption> </figure>  But more controversial was their use of xenon gas therapy in a German hospital to ramp up the production of oxygen-carrying haemoglobins in their blood. Xenon is banned by the World Anti-Doping Agency for being performance enhancing in sports. Expedition leader Lukas Furtenbach said this rule does not apply to mountaineering, as it is not a regulated sport like swimming. Nepal has no rules about xenon, but the Department of Tourism said it was launching an ‘investigation’ to decide on future policy since it is difficult to ban xenon, but allow oxygen. The controversy has also divided the mountaineering community, with some climbers saying they just want to maximise their chances of survival. Spending less time on the mountain could make climbing safer by reducing avalanche risk. It would also mean less trash on the mountains, but it would reduce the income of Nepal’s expedition industry. It is also unclear how much of the success was due to xenon therapy and whether the ex-special forces were already in good physical shape.&nbsp; The need for speed hides the fact that climbing in the Himalaya is dangerous business, and climbers cannot sprint to the top just by huffing xenon. But ultra-fast climbs could be charged more, and the revenue generated can be used to establish state-of-the-art rescue operations, and increase pay and insurance for guides. Two other speed chasers this season were Swiss-Ecuadorian Karl Egloff and American Tyler Andrews, both on Everest without oxygen. Andrews choppered to Base Camp to catch a weather window, but turned back from 8,500m due to high winds. Heavy snow and wind also forced Egloff to descend from 7,000m. Slow and steady climbers like Anja Blacha from Germany did make it to the summit without oxygen, while Kami Rita Sherpa broke his own record with his 31st Everest summit as he led a 26-strong Indian Army group. There were 468 permits issued for foreign climbers from 48 expeditions to Everest this spring. Nepal’s other eight-thousanders together had only 17 expeditions. Nepal has more than 1,000 peaks above 6,000m, and has opened only 476 of them for climbing.&nbsp;

The Everest Industry

While Nepal marked <a href="https://nepalitimes.com/news/mt-everest-pvt-ltd">Mt Everest</a> Day on 29 May, on the other side of the planet in the US state of Colorado dozens of Nepalis who have climbed the world’s highest peak multiple times were busy working as chefs and Uber drivers. Among them is Nima Doma Sherpa, who climbed Mt Everest in 2019 after her husband Tshering Wangchu was among 16 crushed by an avalanche on <a href="https://nepalitimes.com/banner/on-thin-ice-in-the-khumbu">the Khumbu Icefall</a> five years earlier. A large serac broke off the West Shoulder of <a href="https://nepalitimes.com/news/the-everest-industry">Mt Everest </a>and fell directly on a group of <a href="https://nepalitimes.com/opinion/more-porters-sick-on-everest-trail">porters and guides</a> making their way up the Icefall at 5,800m. Their bodies were flown by helicopter to Khumjung where Tshering Wangchu was born. He was excited about climbing Mt Everest for the first time.&nbsp; In Khumjung, Nima Doma felt like her own life had also ended. This was the kind of news Sherpa wives, mothers and sisters dreaded every <a href="https://nepalitimes.com/here-now/peak-climbing-season-2025-s4abrxny">mountaineering season</a>. She stayed home for more than two years grieving, but ultimately gathered up all her emotional strength to take care of her 6-year-old son and 3-year-old daughter. Nima had grown up in Khumjung hearing <a href="https://nepalitimes.com/review/stories-of-nepal-s-summiteers">tales of adventure on the mountains </a>from their father, Ang Chubi Sherpa who had climbed Everest in 1993. He used to bring her and her sisters and brother European chocolates after every expedition, and used to tell them that the chocolate bars grew on the mountains. “It was only after we got older did we realise that he told us that chocolates grew in the mountains so we would not worry about him putting himself in harm's way,” Nima Doma recalled with a faraway look at her home in Boulder this week. Nima went to the school that <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/commemorating-edmund-hillary-in-nepal,4145">Edmund Hillary</a> opened in Khumjung till Grade 8, and then dropped out to help in the kitchen and <a href="https://nepalitimes.com/here-now/when-yaks-go-so-does-culture">tend yaks</a>. She was married off to Tshering Wangchu, who was also a high altitude guide. When Tshering went on expeditions, Nima also started working as a porter from Namche to Base Camp. It was perhaps her father’s tales of mountains of chocolates that had always attracted her to <a href="https://nepalitimes.com/here-now/knowing-our-mountains-43v4iyvo">the peaks</a>. After her husband was killed ten years ago this month, being a widow with children was not easy for Nima Doma. But she was not alone: there were at least 200 single mothers in <a href="https://nepalitimes.com/here-now/khumbu-since-1950-jaww4qn0">the Khumbu</a>, and 20 of them just in Khumjung whose husbands had been killed in <a href="https://archive.nepalitimes.com/article/nation/tragic-start-to-himalayan-spring-nepal,3695">mountaineering accidents</a>. Some were not even 20 years old, and had children growing up without fathers. But there were also women in the 50s whose husbands had been killed in the 1980s. Nima found sponsors for her children’s education, and moved to Kathmandu. In the capital, Sherpa widows used to meet to help each other. Some of them had joined the Nepal Mountaineering Association (NMA) training for rock and ice climbing. “I decided that it was no use sitting home and crying anymore, after meeting other single mothers I felt less alone,” remembers Nima, who joined the Juniper Foundation and enrolled in an NMA training camp in Manang. There she climbed Chulu East (6,584m) and met Furadiki Sherpa, whose rope-fixing husband had also been <a href="https://nepalitimes.com/news/on-mt-everest-s-70th-records-and-fatalities">killed on Everest</a> in 2013. They set themselves the goal of climbing Everest one day, and started a fund-raising drive.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250530090544_621be0724b9182c8e3594b2c562a71ec32ac01d985a71d0cf31646de9d51e15a.png" data-media-id="editor_12" data-image-id="20250530090544_621be0724b9182c8e3594b2c562a71ec32ac01d985a71d0cf31646de9d51e15a" data-rendition-name="original" width="2678" height="1274" loading="lazy" alt="Everest summiteers find new life in the US"> </figure>  “We decided we had to overcome society’s stigma of <a href="https://archive.nepalitimes.com/article/nation/widows-personal-happiness-comes-last-in-face-of-social-financial-hardships,1855">widowhood</a> and prove that <a href="https://nepalitimes.com/here-now/remembering-junko-tabei">women could also climb mountains</a>,” Nima said, adding that she was inspired by Nepal’s first woman Everest summiteer Pasang Lhamu Sherpa, who died during her descent in 1993. Nima Doma and Furdiki climbed the technically-difficult Ama Dablam (6,812m) and then arrived at Everest Base Camp in April 2019 as part of their Two Widows Expedition with the motto, ‘So Can We’. While climbing up the Icefall Nima passed the spot where her husband had been killed. It was a jumble of constantly-shifting ice blocks bigger than houses. She closed her eyes and said a prayer. “I remember thinking, this is so difficult and dangerous. This is what my husband had to do to support our family,” Nima Doma said. “I was determined to fulfil my husband’s dream of climbing Chomolungma, and to prove to ourselves that we two women could do it.” It was 23 May 2019 when <a href="https://www.reuters.com/article/world/two-sherpa-widows-scale-everest-and-smash-stigma-idUSKCN1SU0MV/" target="_blank">Nima and Furdiki stepped on the summit</a> and looked over into Tibet, and down at Tengboche Monastery to the south.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250530090544_6b822582b5d88ba5e972db084f184690b40653c6efd9901b2dd082ffba2a263b.png" data-media-id="editor_16" data-image-id="20250530090544_6b822582b5d88ba5e972db084f184690b40653c6efd9901b2dd082ffba2a263b" data-rendition-name="original" width="2700" height="1522" loading="lazy" alt="Everest summiteers find new life in the US"> </figure>  Nima Doma hugged Furdiki, took off her mask and wept. But for the first time in five years, it was not from grief but relief — relief for being free of all the sadness and sacrifices and for fulfilling her husband’s dream. They had found <a href="https://nepalitimes.com/here-now/life-after-death">life after death</a>. “I felt this immense joy to be on top of the world, it was indescribable,” Nima Doma said, “I have wept only twice in my life. Once when my husband died, and once there on top of Everest.” The tears had frozen on Nima Doma’s cheeks, as she and Furdiki headed back down the mountain.

Everest summiteers find new life in the US

Chinese EV company Dongfeng Nammi has exported 12,000 units of the JF-S3 to over 40 countries, doing especially well in Norway, Latvia, the Czech Republic, and the Netherlands. It is also setting up production facilities in South America and Southeast Asia.&nbsp;

omicron-variant