Nepal | December 02, 2020

Government should reconsider decision: Free PCR tests are a must

UTTAM MAHARJAN
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With the government washing its hands of its responsibility for controlling the coronavirus pandemic through free tests and treatment, people may hesitate to get themselves traced, tested and treated at their own expense. They will, in all probability, hide their infection, if they catch it

The government has recently come up with new rules and guidelines regarding COVID-19. As per the rules, all expenses on the test for and treatment of the coronavirus will have to be borne by the patients themselves. Till recently, the government had been bearing such expenses.

However, free tests and treatment will be done by the government for selected groups of people – those who are economically backward, disabled people, helpless people, single women, senior citizens and frontline workers like healthcare workers, security personnel and janitorial staff, if they are symptomatically infected with the virus.

Likewise, the government has issued new guidelines on the management of the dead bodies of the people who have died of the coronavirus. According to the guidelines, the responsibility for managing the dead body of their relative falls on the shoulders of the family members.

The transmission rate of the coronavirus has been increasing unabated for the last ten months. The virus has affected 215 countries and territories around the world. In recent times, the Kathmandu Valley has become a powder keg of the virus. Around half of the nationwide infections are in the Kathmandu Valley.

Lockdowns or prohibitory orders enforced in various districts of the country from time to time have not remarkably helped in containing the spread of the virus.

In such a situation, ‘trace, test and treat’ should be the leitmotif to bring the virus under control.

The effects of the coronavirus on the lives of the people are colossal. Daily-wage earners, temporary workers and those working in the informal sector have been hit the hardest. They have lost jobs and income.

They are finding it heavy going to eke out a living. In such a situation, it will be very difficult for them to get treatment in case they are down with the virus.

The government says economically backward people, inter alia, will get free treatment. But the question is, how will the government identify that somebody is economically backward? There are no criteria developed in this regard.

In developed countries, there is provision for social security numbers, and on the basis of such numbers it is easy to identify the poor. In the country, poverty identity cards have been distributed but on a limited scale. The distribution of national identity cards, which would include vital data of the card holders, has started in some districts, but it will take several years to complete the task.

Had the task been completed earlier, it would have been easier to identify the poor.

One option is that recommendation letters from local bodies may be used as criterial for proving the economic backwardness or poverty of those claiming to be poor. Here again, it will be difficult for the local bodies to do so. On what basis can they recommend that the infected applicants seeking free tests and treatment are actually poor when no survey has been done in this regard? First, the local bodies need to make a comprehensive survey in their jurisdictions to identify those who are indigent. But due to constraint of time, manpower and resources, it is not possible right now.

On the other hand, with the government washing its hands of its responsibility for controlling the coronavirus pandemic through free tests and treatment, people may hesitate to get themselves traced, tested and treated at their own expense.

They will, in all probability, hide their infection, if they catch it. Till now, when a person tested positive for the virus, others who had come into his or her contact would be tested for the virus free of cost under a procedure called contact tracing. Now, many will not participate in the contact tracing procedure at their own expense.

As a result, the RT-PCR (reverse transcription polymerase chain reaction) tests will decline, leading to an undercounting of infections, while the transmission of the disease will escalate beyond the third stage with more infections and deaths. This will invite a more horrible situation.

Further, the decision of the government that from now onwards family members should themselves manage the dead bodies of their dead relatives is regrettable and condemnable.

The coronavirus is a contagion, and it can spread from person to person.

Even the dead body of a person who has succumbed to the virus can transmit the disease. The government says in a somewhat consolatory tone that it is not very risky to dispose of the dead body of a coronavirus patient, urging the people disposing of the dead body to take precautionary measures like wearing face masks, gloves and full-sleeve dresses and avoiding fluids like saliva, nasal mucus and blood oozing out of the dead body. Many people cannot follow the procedure properly. On the other hand, it will be difficult for poor people to procure safety gear.

The decision of the government not to bear the expenses for the tests for and treatment of the coronavirus is both irresponsible and unfortunate for a poor country like Nepal. The decision is also in contravention of the country’s constitution and the Public Health Act 2075. As per the Public Health Act 2075, infectious diseases fall under the basic health services, and so people should have access to free tests and treatment. The worldwide incidence of the coronavirus has engendered an emergency situation.

At a time when it should respond to the coronavirus by mobilising all the manpower and resources, the government has backed down from its responsibility, making the people fend for themselves. The decision of the government will, for sure, exacerbate the situation, allowing it to go out of control. So it would be prudent of the government to reconsider its decision and fight the virus tooth and nail.


A version of this article appears in print on October 22, 2020 of The Himalayan Times.


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