High-profile figures test positive as Kathmandu sees uptick in Covid cases

Deputy Prime Minister and Defense Minister Ishwar Pokhrel and Home Minister Ram Bahadur Thapa are in self-isolation now. They decided to isolate themselves after a government employee working for the Covid-19 Crisis Management Committee tested positive for the coronavirus. Both DPM Pokhrel and Home Minister Thapa had attended a meeting together with the employee on Monday. 

“Health workers have collected the DPM’s swab for RT-PCR testing and I can confirm he is now in self-isolation,” said an aide to DPM Pokhrel. 

Minister Pokharel heads the CCMC, while Minister Thapa is in charge of the country’s administration and policing. 

With these two key leaders going into self-isolation, the ruling party’s Secretariat meeting scheduled for Saturday has been deferred. 

On Friday, Nepal’s only Forbes-listed billionaire, Binod Chaudhary, also tested positive for the coronavirus. Chaudhary--who is also a lawmaker representing the main opposition party, the Nepali Congress--recently announced on Twitter that he had isolated himself from other family members, as per his doctor’s advice. He has asked everyone who came in contact with him to get tested and to take possible precautions.

The list of public figures who have tested positive keeps getting longer. On July 30, Birgunj Metropolitan City’s mayor, Bijay Sarawagi, tested positive. He was the first high-profile personality to be deemed infected. Then a number of elected representatives, heads of constitutional bodies, and Supreme Court justices were found to be infected--which prompted urgency at the centre. Federal parliamentarians Pradip Yadav, Surya Narayan Yadav, and Yagya Bahadur Bogati; Deputy Speaker of Bagmati Province Radhika Tamang; the chief of the Commission of Investigation on Abuse of Authority, Nabin Kumar Ghimire, all have tested positive. SC Justices Ishwar Khatiwada, Hari Phuyal, and Mira Khadka are now in self-isolation. 

It has been nine months since the pandemic broke out, but it took the recent spike in case numbers and the positive results of public figures for the government to finally start rethinking its handling of the crisis.  

And yet, as of today, Nepal’s capital neither has a quarantine centre nor an isolation centre. On Thursday, DPM Pokhrel, who also coordinates the government’s measures against Covid-19, instructed Kathmandu Valley’s local governments to set up isolation beds in all available public premises in the Valley. Such measures are needed because until now, the only intervention the government has focused on is conducting RT-PCR tests. It has not traced the contacts of infected persons. And quarantining and isolating them remain out of the question.

On Friday, the Ministry of Health and Population (MoHP) announced that it had managed to arrange a total of 1,000 beds at the federal level and 1,957 beds at the provincial. The government has arranged for at least five beds in each of the 649 rural municipalities. Thus, a total of 3,254 hospital beds have been managed at the municipal level, said Dr Jageshwor Gautam, the ministry’s spokesperson. 

The government has also enlisted an additional three hospitals--Birgunj National Medical College, Kantipur Hospital, and Janamaitri Hospital—as Covid-19 hospitals. Once hospitals around the country started filling up with patients, the government had asked private hospitals to allocate 20 percent of their beds for Covid patients, a request private hospitals turned down.

Those beds would be of help now because the number of Covid cases is constantly rising.  A total of 927 new Covid cases were detected on Friday, taking the national tally to 36,456. Of that total, 20,242 infected people have overcome the disease and returned home. 

On Friday, the country’s Capital recorded the highest number of daily Covid cases so far. Of the 415 Covid cases reported on the day (up from the 377 cases reported the day before), 350 cases were detected in Kathmandu District alone. 

Researchers have warned the crisis could get worse in the days ahead. An Oxford Policy Management, Oxford University’s report entitled ‘Modelling of COVID-19 Strategies’ has estimated the country’s possible Covid scenarios by extrapolating from the impacts of the existing interventions being deployed. The model offers predictions for three possible containment strategies the government could adopt. The first one, called the “low disruption strategy”, assumes the continuation of existing measures--which includes self-isolation, social distancing, handwashing, and school closures for 8-10 weeks. If this strategy continues to get employed, the model estimates that 81 percent of the country’s population will be infected by the end of the year and that the peak will occur between June and September. Additionally, the model estimates that Covid-19 could result in at least 49,200 deaths by the end of the year. 

The second strategy is the “medium disruption strategy”, which would mandate handwashing, school closures, and so on for an additional 26 weeks beyond the period that existing measures are in place. The study claims that using this strategy will reduce the burden of the disease by approximately 5,000 cumulative deaths, meaning the ceiling would be around 44,200 deaths. 

The third one, the “high disruption strategy”, involves mandating self-isolation for symptomatic patients and asking them to voluntarily quarantine for an additional 16 weeks. It also mandates that protocols such as hand washing continue for an additional 26 weeks beyond the current phase. This strategy is expected to reduce the cumulative mortality by approximately 15,800 deaths, meaning it predicts that the death count will plateau at 32,900.

But some of Nepal’s epidemiologists argue that those figures, although mathematically derived, have been overstated and are unrealistic. According to the report, the peak is to be expected between June to September. But although there has been a significant rise in the number of cases, these public health specialists argue that the peak may occur only after September. 

As of August 28, the overall death toll is 195--far fewer than the numbers the model predicts. Further, the model’s most implausible number is its estimation of the number of daily new cases. It estimates that new cases could reach 846,000 per day under the low disruption strategy, i.e. with Nepal's current package of measures. Nepal has significantly increased the number of RT-PCR tests it is conducting, to around 13,000 per day. And the highest number of new cases recorded in a single day so far has been 1,100. 

The report also estimates that under the medium disruption strategy, 548,000 new cases will be detected per day, and that under the high disruption strategy, the country will see 531,000 new daily cases. 

The report was prepared a few months back, but was made public only recently. Experts say that the publicising of the report is one of the main reasons that the government has been rolling out new containment measures of late. That, and some experts say, the recent spike in high-profile cases testing positive.

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