Nepal’s Response to COVID-19 Pandemic

Dr. Manish Thapa
April 14, 2020

 

Officially, there have been only nine corona virus cases in Nepal to date (as of April 4, 2020). Compared to other South Asian countries, the spread of the Covid-19, in Nepal has been relatively modest and under control. 

The first instance of the virus was reported in the country on January 24, 2020 (very early), but it took almost two months for the second case to be detected on March 23, 2020. Soon after the second case was reported, the Nepalese government enacted a week-long lockdown across the country with a realistic assumption that if the Covid-19 virus spreads, Nepal’s healthcare infrastructure and facilities cannot handle the tsunami. The first lockdown expired on March 30 and has been extended for another week which is assumed to be extended for an additional week to match the lockdown period imposed in India. Flights and long-distance buses have been suspended, and the country’s borders are sealed—even for its own citizens.

Till now, most of the cases have been detected are ‘imported’ cases (except one, which is transmitted from the infected patient) as the first case detected was in a student who came from Wuhan, China. The second case, was also detected in a Nepali student arriving home from France via Qatar Airways and on the same flight the case of fifth and sixth was also detected mainly among those who returned from Europe. The third, fourth, seventh and eighth case were detected among migrant workers returned from UAE and India. Only 1 case reported so far has been a ‘case of local transmission’ of the disease to the relative of a person who had earlier tested positive for the disease.

As the number of corona virus cases gradually increasing, it is clear that the government has committed some mistakes. When the virus was spreading rapidly in other countries, Nepal did not act to impose travel restrictions. Meanwhile, all visitors to Nepal did not strictly follow government requests that they self-quarantine for 14 days, and the government did little to follow up with travelers to ensure compliance. A ban on international flights was only imposed in the third week of March, and subsequently, the border with India was closed.  

Initially, when the Covid-19 outbreak in China and around the world, Nepal and even government officials treated the outbreak as a distant threat. There were local jokes going around highlighting the immunity of Nepalis to the virus even caught on with government officials, including Minister of Tourism, who declared the country a “corona virus-free zone” to boost the Visit Nepal 2020 tourism campaign. 

Nepalese government officials and citizens only started to get serious after the World Health Organization (WHO) labeled it as a pandemic. Then only Nepal decided to suspend on-arrival tourist visa for all countries, with an exception to diplomatic and official visas, to last from 14 March till 30 April. The government closed land border entry points for third-country nationals and canceled all mountain climbing expeditions, including on Mount Everest, to be enforced from March 14 to April 30, 2020. It also declared a two-week mandatory self and home-quarantines for everyone visiting Nepal. 

On March 17, 2020, the government instituted a High-level coordination committee for prevention and control of Covid-19, which decided to add 115 ICU and 1,000 isolation beds in the Kathmandu Valley. It also instructed all provincial governments to set up a total of 120 ICU beds. 

Subsequently, on March 18, the government declared suspension of all classes (schools and colleges) and postponement of all academic examinations, including the Secondary Education Examination (SEE), until 12 April. It also decided to shut down all cinema halls, gymnasiums, museums, and cultural centers, and ban gathering of more than 25 people in any public spaces, including at places of worship. Soon after this announcement, Nepal began to see a significant influx of people from India to Nepal as India saw an increase in new cases throughout the country. 

On March 20, Prime Minister Oli addressed the nation for the first time since the start of the pandemic and announced a list of preventative measures. The Health Ministry also decided to halt all non-urgent health check-ups and surgeries until 12 April in hospitals in the Kathmandu Valley with 50 or more beds so that healthcare professionals can be reserved to focus only on treating Covid-19 patients. 

It seems that Nepal is on the right track as among detected cases, one person is already treated, and five reported patients so far do not need any emergency medical attention. However, World Health Organization (WHO) and medical professionals are skeptics of Nepalese performance as they point out that due to lack of massive testing facilities, the cases are under-reported, and Nepal might have a significant number of ‘asymptotic’ cases which are not detected due to lack of testing facilities.

If the number of cases rises, then it would be very challenging for Nepal to fight the corona virus tsunami due to its inadequate resources and fragile healthcare infrastructure. Nepal’s healthcare system is not accustomed to deal with a large-scale pandemic that is straining healthcare systems, even in developed countries. The local governments in Nepal, which have been designated to deal with the crisis and performing contact tracing and treatment, are also facing a severe resource crunch and have been slow to act.

Nepal is currently facing resources crunch on both manpower and testing kits for the extensive testing and treatment of people that may be needed. There is only one testing facility, the National Public Health Laboratory based in Kathmandu, with a capacity to conduct 4,000 tests in a week, but a lack of swab kits and extensive guidelines for swab testing has limited the daily test to 50 only. To date, only about a thousand people have been tested. 

Recently the government has started to set up testing labs in other regions (1 in each Provincial level) of the country, but there is a serious lack of sufficient manpower and logistics for testing. There is an evident lack of a specialized agency to deal with such a pandemic situation (such as the Centers for Disease Control that exist in some countries), neither has Nepal done any long-term planning to deal with a pandemic.

 Some countries have stepped front to support Nepal on the fight against Covid-19 crisis — such as the United States and Germany — have announced monetary assistance to Nepal to fight the corona virus. Nepal also received support from China’s Sichuan province, Chinese Embassy in Kathmandu and Jack Ma Foundation provided necessary medical equipment’s including masks, thermometers, chloroquine phosphate tablets, protective clothing, and portable ventilators weighing 1.1 tons. However, Nepal desperately needs further support for basic needs such as testing kits, personal protective equipment (PPE), and other medicines. The Nepalese government rolled out the necessary budget for the purchase of necessary medical equipment from China and in the process of acquiring more in the coming week.

India, to date, has not announced any assistance to Nepal, but Indian media reports that Delhi is ready to send a rapid response team to Nepal. According to The Hindu, “Army medical teams and two Indian Navy ships were on standby to provide the required assistance to friendly countries in the neighborhood.” In this crisis, India is not in a position to send largescale medical logistics and equipment because of its own domestic needs.

Due to an open border, there is a need for strong collaboration between Nepal and India to fight the corona virus. Approximately 1 million Nepali migrant workers are in India. Due to the 21-day lockdown enacted by the Indian government, Nepali migrant workers are returning to Nepal, and hundreds are stranded along the border area. Due to the open border, it is challenging to restrict the movement of people. 

Regional organizations such as the South Asian Association for Regional Coordination (SAARC) and the Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) must have briefed its activity to coordinate and provide support to member countries. 

On March 15, Indian Prime Minister Narendra Modi held a video conference with SAARC members proposing a common strategy to fight the corona virus, where PM Modi extended $10 million as India’s contribution to a Covid-19 emergency fund. Other nations Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Sri Lanka – except Pakistan, responded to PM Modi’s call and have contributed towards the Covid-19 Emergency Fund. Pakistan has demanded that the fund should be placed under the General Secretary of the South Asian grouping. So far, BIMSTEC has not taken any measures to fight the corona virus collectively. 

Obviously, developing countries like Nepal, which is hamstrung by resource constraints and fragile healthcare systems, it cannot fight the corona virus alone. The best it can do is to ask its citizens to get locked down and the increasing number of testing so that it can trace and isolate the ones with the virus. With luck, it seems that Nepal might escape the worst of the corona virus itself—but it cannot shake off the economic damage done by a crashing world.

*** The author is a Visiting Professor at the University of Warsaw in Poland and teaches to Doctoral Students at the Department of Conflict, Peace, and Development Studies at Tribhuvan University, Nepal ***

References:

Baral, B. (2020, April 2). Nepal’s halfhearted corona response. The Annapurna Express. https://theannapurnaexpress.com/news/nepals-halfhearted-corona-response-2371

Peri, D. (2020, March 28). India ready to assist Nepal in Dealing with Covid-19. The Hindu. https://www.thehindu.com/news/national/india-ready-to-assist-nepal-in-dealing-with-covid-19/article31188101.ece

Poudel, A (2020, April 4). Nepal confirms three more Covid-19 cases, including first case of local transmission. The Kathmandu Post. https://tkpo.st/2R8pGM8

Poudel, A (2020, March 4). Hospitals urge ministry to arrange for face masks, gloves and other protective gear. The Kathmandu Post. https://tkpo.st/2IfUMwu

The Kathmandu Post (2020, March 21). The Covid-19 outbreak so far and how Nepal can prepare for the worst. The Kathmandu Post. https://tkpo.st/2QCgTSG

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