Two more coronavirus cases suspected but government agencies are woefully prepared to combat its spread
A man and a woman, who returned from Shanghai and Nanjing recently, are under observation at Teku hospital, officials say. Visitors wearing masks walk past Shanghai Disney Resort, China, on Friday. The resort was closed during the Chinese Lunar New Year holiday on Saturday following the outbreak of a new coronavirus. Reuters
A day after first coronavirus case was confirmed in Nepal, the first country to report the deadly disease in South Asia, officials on Saturday said two more Nepalis—one man and the other woman—have been suspected to have been infected with the virus.
“Both of them have been kept in isolation at Teku hospital,” said Mahendra Prasad Shrestha, spokesperson for the Ministry of Health and Population. “Both had returned from China.”
The man, said to be in his late 20s, had returned from Shanghai on January 19. He had gone to Pokhara the following day but returned to visit the Dhapasi-based Grande International Hospital on January 21 for respiratory problems.
Doctors at the hospital then referred him to Sukraraj Tropical and Infectious Disease Hospital in Teku two days ago, according to an official, who spoke on condition of anonymity, at the Teku hospital. The official said the woman, who had visited a private hospital in Kathmandu, also has been brought to the Teku hospital.
"Health condition of both the patients is stable," Shrestha told the Post. "They are under observation in isolation. Doctors are trying to ascertain if they have indeed been infected with the deadly virus.”
Preparations are underway to send specimens—throat swabs and blood samples—collected from both patients to the World Health Organization’s collaborating centre in Hong Kong to confirm if they have been infected with the new strain of coronavirus, dubbed “novel coronavirus”.
Earlier, throat swab and blood samples of a 31-year-old Nepali student, who had returned from Wuhan, the capital of Hubei province, the epicentre of the new strain of coronavirus, were also sent to the WHO laboratory in Hong Kong, which on Friday confirmed that he was infected with the virus.
Even though the UN health agency has yet to declare the outbreak a public health emergency of international concern, the virus, which causes symptoms that are akin to pneumonia and Severe Acute Respiratory Syndrome, has been spreading fast since it was first detected in December last year.
According to the BBC, the death toll from the virus in China has risen to 41, with another 15 deaths in Hubei province, where the outbreak began, on Saturday alone. The number of confirmed cases in China stands at 1,287.
The virus, which has already been detected in Thailand, Vietnam, Singapore, Japan, South Korea, Taiwan, Macao, and the United States, has also made its way to Europe, with three confirmed cases in France. Australia also reported four cases on Saturday, while the United Kingdom is said, according to the BBC, to be investigating a number of suspected cases. Officials there are trying to trace around 2,000 people who have recently flown to the UK from Hubei province, said the BBC.
The new strain of coronavirus has created alarm across the world because scientists still do not know much about it. Neither have scientists been able to ascertain how dangerous it is and how easily it can spread between people.
While the countries across the world are scrambling to keep the virus at bay or curb its entry and spread, Nepali authorities appeared largely unprepared.
A health desk set up at Tribhuvan International Airport, the country’s only international airport, is ill-equipped—in terms of human resource and technology.
Officials were clueless about the status of the man whose samples tested positive for the virus.
According to an official at the Sukraraj hospital, the man who returned from Wuhan was called again for a check-up a few days ago, but he was allowed to return home.
Dr Basudev Pandey, director at the Teku hospital, said that none of the health workers including doctors at his hospital who had attended to the 31-year-old man or came in his contact has taken ill or applied for leave.
“It’s already three weeks since the man returned and no other person who came to his contact has been infected,” said Pandey. “We can say that he might not have passed the virus to others.”
According to Pandey, officials at the Epidemiology and Disease Control Division have started contact tracing (tracing of people who come to close contact with patients).
Since the hospital does not have a dedicated isolation ward, it has allocated six cabins for the treatment of patients suspected to have contracted the virus. Pandey said the hospital management is mulling over vacating the entire ward so that it could treat people with influenza-like illnesses in some isolation.
There has been no progress in improving the isolation facility at the hospital, four days after the World Health Organization’s Nepal office furnished a draft report on the status of the facility built 10 years ago.
“Nothing has been done so far,” said Pandey. “We have first come up with an estimate. Only after it’s approved can we call a tender. It’s a lengthy process, but time is running out.”
Officials at the Epidemiology and Disease Control Division on Saturday, however, chose not to speak, saying the Health Ministry has barred them from talking to the media.
An official with whom the Post had scheduled an interview agreed to meet but refused to share details on measures being taken to tackle the virus, the person who has tested positive for the virus and how his office is planning to put him under observation.
Another official said the division on Saturday held a meeting with all private hospitals in Kathmandu Valley and directed them to “strictly follow the guidelines while treating suspected cases of the new strain of coronavirus”.
“The division has made its own treatment protocol based on the protocol developed by the UN health agency,” said the official.
On Saturday, almost all doctors and officials, both at the Teku hospital and the Epidemiology and Disease Control Division, refused to speak—a majority of them had their mobile phones switched off.
With information hard to come by and officials shying away from sharing details, there was confusion among the general public. Apart from issuing a public notice on the do’s and don’ts and on ways to avoid contracting the virus, the government has failed to apprise the public of the measures it is taking to protect the members of the general public.
Dr Baburam Marasini, a public health expert, said the authorities showed utter negligence while handling the first suspected case, which was confirmed later.
“They are still taking a lackadaisical approach and groping in the dark,” Marasini told the Post. “The hospital should not discharge anyone suspected of any deadly disease without confirmation.”
According to Marasini, all those people who came in his contact need to be kept under observation, as the virus can spread between humans.
Experts said with the authorities not making airport screenings mandatory, they are just turning a blind eye to imminent danger.
A thermal scanner has been installed, but the health desk is not air-conditioned. According to experts, a thermal scanner can show accurate body temperature only when it is used in an air-conditioned room.
Dr Anup Subedee, a consultant infectious disease physician at Hams Hospital, said the authorities’ delayed approach could have severe consequences.
“It’s high time the government agencies acted in a proactive manner. It will be very tough to contain the disease if the virus spreads to the masses,” Subedee told the Post. “All possible precautionary measures should have been in place to stop the virus from spreading.”
Frequently asked questions about the coronavirus outbreak
UPDATED as of September 22, 2020
What is Covid-19? Covid-19, short for coronavirus disease, is an illness caused by the coronavirus SARS-CoV-2, short for severe acute respiratory syndrome coronavirus 2. Common symptoms of the disease include fever, dry cough, fatigue, shortness of breath and breathing difficulties. In severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.
How contagious is Covid-19? Covid-19 can spread easily from person to person, especially in enclosed spaces. The virus can travel through the air in respiratory droplets produced when a sick person breathes, talks, coughs or sneezes. As the virus can also survive on plastic and steel surfaces for up to 72 hours and on cardboard for up to 24 hours, any contact with such surfaces can also spread the virus. Symptoms take between two to 14 days to appear, during which time the carrier is believed to be contagious.
Where did the virus come from? The virus was first identified in Wuhan, China in late December. The coronavirus is a large family of viruses that is responsible for everything from the common cold to Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). After an initial outbreak in Wuhan that spread across Hubei province, eventually infecting over 80,000 and killing more than 3,000, new infection rates in mainland China have dropped. However, the disease has since spread across the world at an alarming rate.
What is the current status of Covid-19?
The World Health Organisation has called the ongoing outbreak a “pandemic” and urged countries across the world to take precautionary measures. Covid-19 has spread to 213 countries and territoriesaround the world and infected more than 31,405,983 people with 967,505 deaths and 22,990,260 recoveries. In South Asia, India has reported the highest number of infections at 5,557,573 with 88,943 deaths. While Pakistan has reported 306,304 confirmed cases with 6,420 deaths. Nepal has so far reported 65,276 cases with 427 deaths.
How dangerous is the disease?
The mortality rate for Covid-19 is estimated to be 3.6 percent, but new studies have put the rate slightly higher at 5.7 percent. Although Covid-19 is not too dangerous to young healthy people, older individuals and those with immune-compromised systems are at greater risk of death. People with chronic medical conditions like heart disease, diabetes and lung disease, or those who’ve recently undergone serious medical procedures, are also at risk.
How do I keep myself safe? The WHO advises that the most important thing you can do is wash your hands frequently with soap and water for at least 20 seconds or use hand sanitizers with at least 60 percent alcohol content. Avoid touching your eyes, nose and mouth with unclean hands. Clean and disinfect frequently used surfaces like your computers and phones. Avoid large crowds of people. Seek medical attention if symptoms persist for longer than a few days.
Is it time to panic?
No. The government has imposed a lockdown to limit the spread of the virus. There is no need to begin stockpiling food, cooking gas or hand sanitizers. However, it is always prudent to take sensible precautions like the ones identified above.
Arjun Poudel is a health reporter for The Kathmandu Post. Before joining the Post, he worked for Sagarmatha Television, Naya Patrika, Republica and The Himalayan Times.
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