The present infection rate is around 40 per cent against the overall infection rate of around 16 per cent on the basis of the number of tests. As per the WHO guidelines, an infection rate of more than 5 per cent is serious. Hence, contact tracing and testing must be expanded to detect additional cases on a community level
The Institute of Health Metrics and Evaluation (IHME), an international health research centre at Washington University, USA, has come up with a dreadful forecast for Nepal.
As per the forecast, the death toll from the COV- ID-19 pandemic in the country will have reached 41,609 by September 1. The forecast is based on the enforcement of lockdowns or prohibitory orders, the death toll, the infection tally, the rate of hospitalisations, the number of people wearing face masks and so on. If people wear face masks, the death toll is forecast to decrease to 38,288, i.e., by about 3,000.
Further, if the vaccination campaign progresses smoothly, a further 900 deaths can be avoided.
In recent times, the number of both infections and deaths has been rising in Nepal as the second wave of the COVID-19 pandemic has erupted in the country.
On May 3, the number of infections was 7,388 with 37 deaths, followed by 7,587 infections with 55 deaths on May 4 and 8,605 infections with 58 deaths on May 5. Till May 5, the death toll stood at 3,475.
The IHME drew on the data from these three days to make the forecast. As per the forecast, the rate of daily deaths will be 320 on an average from May 6 till September 1. The highest intraday death toll was recorded at 225 on May 11. The research centre has forecast the highest death toll at 848 on May 29.
The forecast is formidable, but if effective steps are not taken in time, the situation may be more dangerous.
Nepal is now in the grip of the second wave of COVID-19, which started in April. As per the Ministry of Health and Population, there were around 278,000 infections with around 3,000 deaths during the first wave. Since the second wave hit the country, around 200,000 infections with over 2,000 deaths have been reported, which is alarming.
The UK variant, detected in January, has a transmissibility that is as high as1.7 times the original virus.
The most worrying aspect is that it severely attacks the human respiratory system.
That is why, patients of the coronavirus due to the UK variant need more oxygen than those infected with the original coronavirus.
Now hospitals, both government and private, are facing difficulty in treating COVID-19 patients for lack of beds, medicines and, especially, oxygen. Some government hospitals like Tribhuvan University Teaching Hospital, Bir Hospital and Patan Hospital have been converted into COVID hospitals. But as there is an acute shortage of oxygen, the government has introduced the quota system to distribute oxygen to various hospitals.
In the beginning, the government was complacent that the oxygen produced by domestic companies would be enough to treat patients. Hospitals claim that the quota system has aggravated the situation as they find it heavy going to save patients for lack of adequate oxygen.
Oxygen is in so short supply that its production can meet only 50 per cent of the demand. Nepal does not produce liquid oxygen (lox); it has to be imported from abroad. The use of oxygen concentrators is also low in the country. Oxygen concentrators produce and store oxygen in concentrated form by separating nitrogen from the surrounding air. Taking into consideration the lingering shortage of oxygen, the government has instructed hospitals with 100 or more beds, or those that are capable, to install oxygen plants. The government is making allout efforts to manage oxygen from China and other countries.
Nepal did not have to face such a dire situation during the first wave of COVID-19. As the situation was coming back to normal with no lockdowns or prohibitory orders in force, neither the government nor people deemed it necessary to abide by health safety protocols. People engaged in parties, festivals and other gatherings, while the government engaged in political rallies, inaugural functions and other programmes.
When the UK variant was first detected in the country, the government did not pay any heed to the need for curbing the second wave of COVID-19. The situation at present is dreadful as infections are being detected in the thousands on a daily basis. The daily death toll has also unexpectedly spiked at more than 100.
The present infection rate is around 40 per cent against the overall infection rate of around 16 per cent on the basis of the number of tests. As per the WHO guidelines, an infection rate of more than 5 per cent is serious.
In such a situation, contact tracing and testing need to be expanded to detect additional cases on a community level, and treatment should be conducted accordingly.
The Kathmandu Valley has been under prohibitory orders since April 29. Many other districts are also under restrictions. Despite this, there has been no remarkable improvement in the situation. The government should have enforced prohibitory orders as soon as the UK variant was detected in the country. The political turmoil is also to blame to some extent for the predicament the country is in now.
However, with the reappointment of KP Sharma Oli as the Prime Minister of the country and the lingering political instability expected to come to an end, the government is expected to seriously take steps to curb the second wave of COVID-19.
It is unfortunate that health facilities have been overwhelmed.
Most of them have thrown up their hands at not being able to admit additional patients. It is the duty of the government to help its citizens in times of crisis like this. If the situation goes from bad to worse, the healthcare infrastructure may collapse, and more and more people may suffer.
So to cope with such a situation effectively, all three tiers of government – local, state and federal – need to work in tandem with the management of resources, both human and logistics, to the optimal extent so that the situation can be restored to normal in short order and at the same time the forecast made by the IHME can be falsified.
A version of this article appears in the print on May 20, 2021, of The Himalayan Times.
