As daily Covid-19 death count hits a record high, govt scrambles to respond

On Friday, Nepal recorded 11 Covid-related deaths, its highest single-day total, which took the cumulative death toll to 137. The country has seen a constant rise in the number of deaths after the government relaxed the lockdown on July 22. And the infection and death rates show no sign of decreasing, even with the government enforcing prohibitory orders in Kathmandu and other major cities this week.

The case numbers are also on the rise because the government has increased testing. The Ministry of Health and Population (MoHP) said that it recorded 838 new cases on Friday, taking the total number of infected cases to 30,483. 

The ministry claims to have conducted 579,889 lab tests (accounting for roughly 2 percent of the country’s population) since the virus emerged in the country in January. The daily news briefings don’t provide details beyond the numbers: the ministry’s spokesperson simply provides the figures for deaths, new cases, tests conducted, and a district-wise breakdown of caseloads. 

That said, on Friday, the ministry’s spokesperson, Dr Jageshwor Gautam, did add one more variable to his usual briefing list: expenditure. Dr Gautam said a total of Rs 318 million has been spent on conducting tests alone. He also claimed that testing a single person costs the government Rs 104,000 and that providing ICU services costs around Rs 450,000 per month. “So, it would be wise if we observed hygiene and maintained social distancing,” said Dr Gautam.  

For the government, the increase in tests has become a point of pride. That increase could probably be seen as a response to pressure, such as from Kathmandu’s youth activists who launched protests last month demanding more tests. 

But experts have already raised concerns over the government's sole fixation on conducting tests. While it has been conducting tests on any individual willing to do so, the government has been neglecting the equally important task of contact tracing. 

During his briefings, Dr Gautam never speaks about contact tracing. He confines himself to simply reading out from his notes the latest figures for deaths, infections, district caseloads and so on. Contract tracing, as experts suggest, is the key to controlling the spread of the virus. But going by how it has handled contact tracing, the Nepal government seems to have not learned anything at all in the past four months.

Experts have long argued that to contain virus spread, contract tracing is a far cheaper intervention and far more effective than increasing testing. All the government has to do is to trace the people an infected individual has interacted with prior to the test. 

And then try to provide whatever care it can to the infected. That’s something the government has not been able to do in emerging hotspots like Birgunj, where the number of new cases has exploded. The metropolitan city, which is a major Nepal-India transit point, made up 52 of the 137 deaths recorded on Friday. The situation was so dire hospitals ran out of beds, and some Covid-positive cases were denied hospital service. 

Across Nepal, as Covid cases spike, government hospitals have already reached capacity. The government has thus decided to admit only clearly symptomatic corona patients and has recommended that asymptomatic suspects confine themselves at home.

Fearing the spread of the virus, 43 districts have imposed prohibitory orders, banning the mobility of people. Implementing such measures has become the government’s go-to response whenever case numbers start spiking. But besides asking the public to remain housebound during lockdowns, the government has no plans to implement other interventions--such as contact tracing. 

Contact tracing, according to Dr Samir Kumar Ghimire, deputy spokesperson of the health ministry, while important, is not being properly done because the government cannot find  volunteers who will help with the tracing. And the government has no plans to focus on it in the near future. 

Besides bungling its containment strategy, the government has also ignored the plight of working class people during the lockdown period. Tens of thousands of people--mostly daily wage earners and others in the informal economy--are now without a job. But the government has so far not come up with any plans on their behalf. 

Further, the government does not seem to be readying itself for the grim days ahead. As the government has not put any effort in increasing contact tracing, the case numbers are sure to spike even more. Nepal, a country of 30 million people, today has over 12,000 active infected cases, and every day around 700 new cases get identified. Health experts have warned the country could witness its worst phase in the days to come because coronavirus cases are just starting to spike in densely populated cities like Kathmandu.

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