Uttam Maharjan

COVID-19 has been around us for over one and a half years. We are in the second wave of the pandemic. The second wave began in the last week of April when the first wave had not ended and the caseload had not significantly come down. It may be recalled that the second wave emerged in the country after a surge in cases in India. The number of infections and deaths in the second wave has far exceeded those in the first wave.
The government imposed restrictions or prohibitory orders in the Kathmandu Valley and other places from the end of April. These restrictions were lifted from mid-June when the number of infections came down. With the restrictions relaxed, most people began disobeying health safety protocols. They quit wearing masks, using sanitizer and maintaining social distancing. As a result, the number of infections and deaths has worryingly risen although restrictions in certain areas like party palaces, cinemas, sports venues, gyms and educational institutions are still in force. The chain of transmission that was broken by effectively enforcing restrictions has been active again.

Case positivity rate
Now, hospitals and other health facilities are packed with COVID-19 patients. With the rise in the number of infections, the number of active cases has also grown. There are over twenty districts, including the Valley districts, that have more than 500 active cases. And many other districts have more than 200 active cases. The case positivity rate hovers at around 20 per cent. As per the WHO guidelines, the case positivity rate should be below five per cent. In such a case, it will be easier to stem the spread of the disease. Viewed thus, the situation in the country is still alarming.
Analysing the COVID-19 situation, public health experts, epidemiologists, virologists and officials from the Ministry of Health and Population (MoHP) have already warned of an outbreak of the third wave of the pandemic. An MoHP official the other day told the Education and Health Committee of Parliament that the third wave of the pandemic would strike the country in seven weeks. As things stand, the third wave could hit the country much earlier.

The MoHP has asked provincial logistical management centres to keep at least 1,000 oxygen cylinders on standby; repair dysfunctional oxygen plants and oxygen concentrators; and keep oxygen tanks in working order. The ministry has appealed to the general public to be alert to the possibility of the third wave of the pandemic emerging any time. The possibility of the pandemic entering the third wave depends on public behaviour as well as the status of vaccinations. People should strictly obey health safety protocols to break the chain of transmission. If they assume a nonchalant attitude towards the safety measures, the pandemic may infect more and more people, that too in various mutant forms.

Delta and Delta Plus variants have emerged in Nepal. These variants are spreading across Europe and North America. Scientists are of the opinion that such variants affect those countries and regions that have low vaccination rates. Vaccinations are a remedy against the transmission of COVID-19. The more vaccines are administered to people, the less the impact of the third wave will be.
The vaccination drive in Nepal, which remained stalled for some time owing to the unavailability of vaccines from India, has got into overdrive with the procurement of Vero Cell, Johnson and Johnson and AstraZeneca vaccines. The number of people having received the first dose of COVID-19 vaccines has reached around 4.9 million, while around 3.9 million people have been fully vaccinated.

Although the MoHP has sounded a cautionary note on the third wave of the pandemic emerging any time, it has not yet assessed the timeline of the third wave and its impacts on public health and health institutions. Doctors say that we are already in the initial stage of the third wave of the pandemic. Should the third wave emerge, it may be difficult to control it. Health institutions may be overstretched. Some months ago, health institutions had to experience a shortage of oxygen and beds leading to more deaths. Such a grim situation may come up again, if the third wave hits the country.

Cross-border movement
Prime Minister Sher Bahadur Thapa has also warned people of the third wave of the pandemic and asked them not to come out of their homes unless necessary. It is a matter of satisfaction that the executive head of the country has expressed his concern about the possible emergence of the third wave of the pandemic. It is the unvarnished truth that the surge in COVID-19 infections is due mainly to the cross-border movement between Nepal and India. Nepal and India have a long porous border. Unless border activities are controlled, it will be hard to control the pandemic. Completely controlling cross-border mobility is well-nigh impossible but effective measures like testing, tracing and quarantining can be taken so that the pandemic does not run riot through people entering Nepal from across the border.

We should learn lessons from the past. The government should monitor the situation and take measures accordingly. At the same time, people should also strictly follow health safety protocols. And hospitals and other health facilities should be kept well-equipped with necessary equipment, medicines, isolation beds, oxygen cylinders and oxygen concentrators. The efforts of the government alone are not adequate to control the raging pandemic. The role of the general public is perhaps even more important in this direction. So the government, the general public, healthcare workers and other stakeholders should act synergistically in the fight against the pandemic.

(Former banker, Maharjan has been regularly writing on contemporary issues for this daily since 2000. uttam.maharjan1964@gmail.com)