Uttam Maharjan

The government has imposed prohibitory orders in the Kathmandu Valley for two weeks since April 29 in a bid to break the chain of transmission of COVID-19. Such orders have also been imposed in other hotspots. The second wave of the respiratory contagion has been affecting Nepal for some time. Now the daily infection tally has crossed 5,000, which is not a small deal. Likewise, the number of deaths has also surged.
When the first wave of COVID-19 was subsiding, both the government and people adopted a lackadaisical and nonchalant attitude towards the contagious disease. The government indulged in mass meetings, rallies and other crowded gatherings or events, while people flouted health safety protocol, moving around without face masks, not using hand sanitisers, not washing hands with soap and water or not maintaining social distancing as if the coronavirus were gone forever.

The UK variant
The variants of the coronavirus are responsible for the emergence of the second wave of COVID-19. The mutant coronavirus seen in Nepal is the UK variant, which has come from India. The UK variant is more dangerous than the original coronavirus. The RO of the variant is 2.3, meaning an infected person can transmit the disease to 2.3 people. The death rate from this variant is 1.6 times as high as that from the original virus. It is disheartening to note that more and more people are succumbing to COVID-19 in the country now.
COVID-19 has, in a sense, exploded in Nepal. Although more infected people are staying in home isolation, hospitals and health facilities across the country have turned out to be inadequate. There is a paucity of beds, oxygen and medicines. The government has already directed hospitals, both government and private, to earmark 50 per cent of beds for COVID-19 patients. The number of patients is going up at such a rate that all the hospitals and health facilities have been overwhelmed, with the possibility that the disease will go out of hand. The medical community has demanded to the government that schools, party palaces and stadiums be converted into COVID hospitals.
The government knew that the second wave of COVID-19 was coming to Nepal with the detection of the first person infected with the UK variant. But it did not pay adequate attention to curbing it. Neither did people deem it necessary to take precautionary measures to stay away from it. As a result, the situation has worsened to such an extent that the government was forced to enforce prohibitory orders. The enforcement of prohibitory orders should not be taken as a means for confining people to homes. The period of prohibitory orders should be utilised in designing health strategy so that COVID-19 can be contained soon.
The number of RT-PCR tests has been increased in recent times. Antigen tests are also being conducted at border areas. Still, the number of such tests seems to be inadequate. Only those with symptoms of COVID-19 and those needing tests for going abroad or for other purposes have come forward for tests. So the tests need to be expanded. Local governments should take the initiative in conducting contact tracing thick and fast.
The healthcare system in Nepal is showing symptoms of breakdown. All hospitals have been packed with COVID-19 patients. Many patients have to be turned away for lack of beds. Oxygen and medicines like remdesivir are in short supply. The government has ordered industries that use oxygen to shut down. The government has also exempted tax on the import of oxygen cylinders. This is a laudable step. However, taking into account the current situation, the government should take steps to expand isolation beds in hospitals across the country. New isolation centres should also be put up to cope with the increasing number of patients.
There is also a shortage of vaccines. With the imposition of prohibitory orders, the vaccination drive has been postponed. Nepal has used Covishield and Vero Cell vaccines. The Covishield vaccine is an Astra-Zeneca product of Serum Institute of India. Since India itself is facing a shortage of vaccines, an additional procurement of the vaccine from the country is out of the question at present. On the other hand, the Vero Cell vaccine is a product of China. Nepal got 800,000 doses of the vaccine in the first phase. Whether additional vaccines will arrive in the country is not certain. So the government's target of inoculating 72 per cent of the population within one year seems to be unattainable. That is why the government should take the initiative in procuring vaccines from India, China, Russia or other countries through political or diplomatic channels. In this regard, the private sector should also be encouraged to import vaccines.
Besides improving health infrastructure, it behoves the government to motivate doctors, nurses, paramedics and other health workers. These frontliners are always at high risk. They can be motivated by supplying them with necessary medical equipment like PPE or by providing them with special allowances.

Safety measures
This is not the first time that the government has imposed prohibitory orders on people. Back in Chait 2076, the nationwide lockdown was enforced. During the lockdown, no remarkable strategy for containing COVID-19 was drawn up. As a result, prohibitory orders had to be enforced in Bhadra 2077. After the lifting of the restrictions, people did not strictly adhere to health safety measures. When the first patient was detected with COVID-19 due to the UK variant, the government did not take it seriously. Consequently, now people have been forced to live under prohibitory orders.
The government should not allow the period of prohibitory orders to go down the plug hole. Appropriate strategy, such as construction of additional healthcare infrastructure, upgrading of existing healthcare facilities and ensuring that there will be no dearth of medical personnel, isolation beds, oxygen and medicine, needs to be devised without delay. COVID-19 seems to persist for longer periods than expected. So it is high time the government, the private sector and all other stakeholders struck at the root of the disease.

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