By Ajita Rijal/Sampada A. Khatiwada

Kathmandu, May 15:

Following a sudden spike in the number of new infections and fatalities, the nation is currently grappling with the second wave of the COVID-19 pandemic, creating a grim and panicky situation in hospitals and elsewhere.

More than 150,000 people were infected with the novel coronavirus in the past one month in Nepal. Exactly a month ago, in mid-April, the nation's total COVID-19 caseload was 307,925, which has now surged to 447,704 (as of 15 May). During the past one month, 166,117 new infections were recorded. A total of 2,236,526 RT-PCR tests were conducted until a month ago. Now, the total RT-PCR test count is 2,751,481 of which 514,955 RT-PCR tests were conducted in the last month. The number of active cases also spiked to a whopping 109,740 from 4,046 in a month's period.  

1,795 fatalities in one month

Health experts have been voicing that the new virus strains rampantly spreading all across the nation appeared to be significantly more contagious and fatal than the first wave, which occurred last year.

As many as 1,608 fatalities have been reported over the past month. In mid-April this year, a total of 3,061 fatalities were recorded. By mid-May, the number increased to 4,856 (as of 15 May), thus accounting for 1,795 deaths just in one month since the second wave began.

The daily death counts used to be nil a month ago. But now, the Ministry of Health and Population (MoHP) has been reporting around 200 COVID-19 related fatalities every day.

According to the Health Ministry, of the 4,856 total fatalities recorded until now, over 2,400 are senior citizens above 60 years of age and the remaining are aged below 60 years.

 In the first wave of the pandemic the elderly people were considered to be at a high risk as the fatality rate was higher among people above 60 years. But now, as the nature of the infection has changed along with the mutated strain of the virus, the fatality rate has increased among youths.

Immediate help

The MoHP on Monday submitted a request to international development partners for oxygen generation plants, ventilators, makeshift hospitals, and screening tents, along with other critical equipment, seeking help as soon as possible.

Similarly, the World Health Organisation (WHO) has said that Nepal is in need of emergency aid to address the COVID-19 crisis. Speaking at a media briefing on Friday, WHO Director-General Tedros Adhanom Ghebreyesus expressed serious concern over the rapidly spreading coronavirus cases. "Along with India, Nepal, Sri Lanka, Vietnam, Cambodia, Thailand, and Egypt has been grappling with a serious crisis as the cases and hospitalisations have been spiking," he said.

Meanwhile, the WHO chief also expressed his commitment to continue providing aid to Nepal to fight the crisis in every way possible.

Moreover, many nations and organisations, including the USA, China, and European Union have already announced that they would provide grant assistance to Nepal to manage uninterrupted oxygen supply and other measures required to fight the pandemic.

New, deadlier virus strains

Dr. Krishna Prasad Poudel, director at the Epidemiology and Disease Control Division under the MoHP, said, "As the new variant of COVID-19 is highly contagious, all family members and office staffers are being infected together. The UK Variant (B. 1.1.7) is highly responsible for a massive resurge in coronavirus cases."

According to the doctors, of the total active COVID-19 patients at present, 20 per cent need hospital care, and of them 15 per cent need oxygen support and around five per cent need intensive care and ventilator support. This proves that the virus has become more fatal this year.

Dr. Poudel added that India's double mutant variant (B. 1.617) had already been detected in Nepal in huge numbers.  

"The symptoms like dry cough, fever, headache, skin allergies, fatigue, loss of smell and taste, diarrhea, vomiting, and so forth could last a little longer if a person is infected with the new strain of the coronavirus," he said.  

According to him, the first week after infection is the riskiest phase of COVID-19. "Thus, anyone having even a mild symptom should immediately get their RT-PCR tests done," he said.

Dr. Poudel added that as the new virus strains are more fatal, regular monitoring of the oxygen level in COVID-19 patients must be done. "Late diagnosis of COVID-19 has led to deaths in many cases. Therefore, taking the COVID-19 test is important as soon as any symptom starts developing in the body.”

People’s negligence

The compliance and adoption of health safety protocols has somewhat lapsed, say the doctors.

Dr. Rabindra Pandey, a public health specialist, opined that one of the major reasons behind such a massive surge in infection rate was people's negligent behaviour. "Last year, the virus was not as contagious and as fatal as this year. However, people feared contracting the virus and adopted  all health and safety standards," said Dr. Pandey, adding, "This year, while the virus has become three times more contagious than before, the threat in people has decreased."

Dr. Pandey said that the chain of the spread of COVID-19 would break if people duly followed public health standards and stayed in self-isolation for a few weeks from now.

Similarly, Dr. Anup Bastola, spokesperson at Sukraraj Tropical and Infectious Disease Hospital, said, "People took the virus lightly, flouting the public health protocols because of which we are now facing a grave situation.”

In mid-April, as cases in India were spiking, many people participated in marriage ceremonies, political rallies, gatherings, religious activities, and fests due to which many caught COVID-19. Still, people continued defying rules as there were no monitoring authorities, said Dr. Bastola.

Stating that a massive surge in the number of COVID-19 cases had automatically increased the number of critically ill patients, Dr. Bastola said that it was very challenging to deal with such a critical situation as the hospitals have been overwhelmed with virus-infected patients requiring oxygen and ventilator support.

“All the beds are occupied, the emergency rooms are full and we are adjusting patients at the corridors and available spaces at the hospital,” said Dr. Bastola, adding, that the mortality rate was likely to increase due to the shortage of ICU beds and ventilators.

Follow health protocols

The MoHP has been requesting the public every day to follow all the health safety protocols to stay safe from COVID-19 and to prevent its spread.

The condition is becoming perilous day by day, said Dr. Jageshwor Gautam, spokesperson at the Health Ministry, adding that it may go out of control soon if we do not abide by all the safety precautions.

Dr. Gautam said, “If you have any symptoms or you were in contact with the COVID infected people, get tested and if you test positive, visit hospitals only in an emergency situation.” He also requested for adopting safety protocols during home isolation and recommended taking medications only on doctor’s advice.

According to the MoHP, all the government laboratories are providing a free test for those who have symptoms of COVID-19 and those who have been in direct contact with the infected people. 

Dr. Archana Shrestha, a virologist, said that the infected people could do contact tracing on their own. "If contact tracing is done effectively, we can break the chain of infection by 85 per cent at the community level," she said.

The infection rate is very high in Nepal, this shows that the number of infected people is much higher at the community level, said Dr. Shrestha

The local levels have an important role in containing the spread of the virus. They can coordinate contact tracing, testing, and treatment of COVID patients. The local representatives can monitor the health status of infected people and can reduce hospitalisation and fatalities, she added.